Strengthening Collaborative Health Systems Research and Capacity Building in India
Krishna Reddy Nallamallai
Strengthening health systems is key to securing good health for all people. Health systems are complex, comprising diverse actors who work in silos yet are loosely interconnected. The rapidly evolving area of health systems research has shown the impact of evidence-backed policy actions on population health outcomes. Over the years, India has seen various collaborative learning platforms involving government, development partners, the private sector and civil society organisations. The need to develop health systems capacity, particularly at the state- and district level, became a critical plan after the National Rural Health Mission (NRHM) initiation in 2005. NRHM strategies focussed on developing Programme Implementation Plans (PIPs) at the district and state level, which required handholding and capacity building of the health system actors. Hence, the Ministry of Health and Family Welfare (MoHFW) set up the National Health Systems Resource Centre (NHSRC) under the framework of the NRHM with the objective of strategic planning and development of health sector reforms in the country. The NHSRC was instrumental in providing collaborative training for developing district and state health plans with the support of state health departments and NGOs. The Public Health Resource Network (PHRN), a civil society initiative, partnered with the NHSRC to mobilise resource persons all over India for regional and state workshops across many states. The training helped in developing the capacity of the public health cadre in all tiers of the public health system and improving the planning processes under the NRHM. Later, this mandate was expanded to establish state health systems resource centres (SHSRCs) in many states. Along with the rollout of the NRHM, the Government of India also implemented the Rashtriya Swasthya Bima Yojana (RSBY), a health insurance scheme, for informal sector workers. Many state governments also initiated state health insurance schemes such as Rajeev Arogyasri in Andhra Pradesh, Vajpayee Arogyasree in Karnataka and Chief Minister’s Comprehensive Health Insurance Scheme in Tamilnadu. But there was limited capacity and technical expertise at the state level, especially on monitoring health insurance schemes, benefits package design, costing of packages, fraud control and data analytics.