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Programme Report State Level Training Workshop on “Health Budget Analysis at District Level Governance” 27-28 December 2009 Brainstain Conference Hall, Bhubaneswar Organised by Centre for Enquiry into Health and Allied Themes (CEHAT), Mumbai, Jan Swasthya Abhiyan, Orissa & Network for Social Accountability (NSA)
A training programme was organised on 27th and 28th December 2009 at Brainstain Conference Hall, Bhubaneswar to orient and train activists from civil society and members of the media community on “Health Budget Analysis at District Level Governance”. The training organised by Network for Social Accountability (NSA), Jan Swasthya Abhiyan (JSA)-Orissa and Centre for Enquiry into Health and Allied Themes (CEHAT) was attended by more than 40 activists from 14 districts across the State of Orissa. The training workshop was a part of an ongoing process of forming a vibrant civil society group called “Orissa Budget Solidarity” to hold the government accountable towards the developmental needs of the people of Orissa. In June 2009, NSA and JSA in partnership with CEHAT organised a path-breaking state convention for preparing a People's Charter of Demand on public health budget in Orissa which was followed up with a widespread campaign to demand Mobile Health Units for all 314 administrative blocks in the State. Subsequently, the Government of Orissa announced its intentions to increase the number of mobile health units in the state. Although, some achievements have been made towards registering people's aspirations in public policies through consistent efforts of NSA and its partners across the state, much remains to be done in terms of implementations of policies. Network for Social Accountability (NSA) and other progressive forces of civil society activism such as Jan Swasthya Abhiyan and national level resource centres like CEHAT have joined hands to wage a continuous battle for removing structural bottlenecks and ensuring people's participation in health sector policy making and implementation. No doubt, there have been some earlier efforts by several groups both from civil society and academia in building a solid ground on budget analysis at state level governance from the perspectives of the poor and the marginalised. But, district level budget tracking still remains an unexplored area. The recent training programme was a move forward in that direction that aims to bring together district level activists towards civil society budget work and facilitate a process of tracking budgets at the district and state level in a much democratic manner.
The 2-day training programme was split into several sessions focussing on basic concepts in budget work, economics and public finance of health sector in Orissa. The training started on 27th December 2009 with an inaugural address by Ms. Sashiprava Bindhani, Honorary Director of Network for Social Accountability (NSA). She mentioned the journey of NSA over years and the challenges faced in bringing together numerous grassroots level groups in Orissa and in orienting them towards budget-work in the state. She mentioned the significant role played by activist-economist Siba Sankar Mohanty in promoting civil society platform like the Network for Social Accountability in Orissa that presently enjoys active support from more than 1200 activist organisations and individuals at the grassroots level in Orissa. She appreciated the significant role of CEHAT, Mumbai and its Research Officer Prashant Raymus for their concern for the toiling masses in Orissa as far as the government neglect for the health provisioning is concerned. CEHAT has always played a supportive role in ensuring people's participation in health related policy making and building the capacities of the people to ensure such participation more effectively. She also highlighted the tremendous impact of Jan Swasthya Abhiyan (JSA-Orissa), its convener Mr. Gouranga Mohapatra and Bharat Gyan Vigyan Samiti (BGVS-Orissa) in ensuring people's monitoring of basic services. In her introductory deliberations, she also highlighted some of the ongoing activities and interests of NSA to ensure government accountability in implementation of Scheduled Caste Sub Plan, Tribal Sub plan and Women's Component Plan in Orissa. The inaugural session was followed by technical sessions facilitated by Mr. Siba Sankar Mohanty and Mr. Prashant Raymus.
First part of the training focused on thematic issues related to macroeconomics of the state and the civil society perspective to hold the government accountable towards budgetary promises. This part of the training primarily focused on the nuances of the budget, basic terms, federal structure and the fund flow mechanisms across different levels of government and programme implementing bodies. Mr. Siba sankar Mohanty from Wada Na Todo Abhiyan who facilitated the sessions also highlighted the basic terminologies related to budgets and economic policies. The second part of the training focused on the real budget work at the district level health sector governance. This part facilitated by Mr Prashant Raymus from CEHAT focused on numbers and data, sources of data for budgetwork at the district level and the basic methodology on data analysis at the district level. This session also included an interesting analysis of the treasury accounts of Angul district, Mayurbhanj district and Balasore district health sector. The participants split into three groups analysed treasury accounts in the above districts and presented the findings. Discussions over the findings helped the participants clarify many doubts that came through the process of the district level budget analysis.
The last part of the training focused on charting out a plan of action for strategic intervention in budget work in Orissa. This session focused on the need for a vibrant health advocacy by using budget analysis as a tool of governance accountability. This session facilitated by Mr. Gauranga Mohapatra of JSA resolved on the following activities in the coming days. (1) The participants in their respective districts shall undertake necessary data collection work related to district level public finance. Towards this, documents related to treasury accounts, district planning offices, DRDAs shall be collected before the first week of February-2010. (2) Network for Social Accountability (NSA) shall take responsibility of consolidating all the information and make them public through its website www.nsa.org.in (3) In the month of February 2010, NSA shall take responsibility of organising a state level convention on health budget in Orissa and submit a memorandum containing a health Charter of Demand to the government. CEHAT has agreed to provide technical support and help to the activists of Orissa to face the methodological challenges. (4) As a follow up of the current training programme, NSA and JSA shall take responsibility of organising a series of training programmes at district level in coming days. Efforts shall be made to mobilise resources for the same. (5) The documents that shall be collected are as follows Performance Budget (Public Health department and, Medical Education and Drugs department) - comprehensive operational document conceived and presented in terms of functions, programmes and activities with their financial and physical aspects interlinked. The important feature of the document is the Programme-Workload Summary and the explanation of financial requirements. Or March ending Progress Reports of functions/ activities on Expenditure on medical and public health and Family Welfare Programme (under the major heads of 2210, 4210 and 2211); expenses according to line items for PHCs/CHC/district Hospitals , health programs such as malaria/TB, etc at district Zilla Parishad (ZP) budget documents- 73rd & 74rd amendments of constitution decreed PRIs to be self government at village , block & district level, politically PRIs has many weakness, role & responsibilities not clear, accountability mechanism not strong, higher authority supersede PRIs decisions , some functions are transferred to local government , fund & planning are still with the higher authorities. Some documents with information on local bodies (PRIs) receiving grants from the State and Central government for implementation of the development schemes and programmes. The State Government releases grant to the ZP, from the ZP the funds are released to the Panchayat Samitis (GPs) and Gram Panchayat (GPs). In some states it is also called ZP annual account document, giving the detail of the program budget, re appropriation and the actual expenditure. Given the fact that NSA is undertaking this activity for the first time, we do not have any idea about the name and availability of this document. But as suggested by the friends and comrades who have been into district budget work in other states, such a document exists and should be collected for the relevant information it contains. March ending Progress Reports of the District Annual Plans (General/Tribal Sub Plan – Outside Tribal Sub Plan/Special Component Plan documents) of the districts - which shows the plan allocation for all development sectors for all departments for a district for example, Tribal Sub Plan -Which shows plan allocations for tribal development programmes giving the detail of the program budget , re appropriation and the actual expenditure (District Plan approved outlay, budgeted and Actual expenditure). This document may be available at District Planning Committee (DPC) The 74th amendment has a provision for a DPC, which has the mandate of integrating the plans of rural and urban bodies.
District Socio-Economic abstract – Socio-economic profile of the district along with some selected information on the budget can be availed from the Suchana Bhawan at Bhubaneswar. Treasury Health Data Keeping in mind the lacunae of maintenance of health expenditure data at district, gaps in district level information were supplemented by information from state level offices and also from Treasury Data obtain from the Indian Audit & Accounts Department Office Of The Accountant General , Orissa. Treasury Data can be obtain from the Indian Audit & Accounts Department Office Of The Accountant General (Ag), Orissa. Apart from this treasury data AG has also other data like Combined transfer ledger (CTL), forest division compiled account (FRD), Settlement account inter departmental adjustment (SAA) etc which are not disaggregated for district wise. The sum total of treasury data, CTL, FRD, SAA and other documents apparently add up to the total State government expenditure. To start, one can try to get treasury data (under the major heads of 2210, 4210 and 2211); expenses according to line items (6) Network for Social Accountability has taken up the responsibility to collect all the treasury information for all the districts through its members and partners. Once such data is collected, everything shall be compiled and a charter of demands shall be developed through a consultative proves of involvement by CSO bodies from across the state. The training programme ended with the vote of thanks by Mr. Ratneswar Sahu, Programme Associate, Network for Social Accountability (NSA) Documents used in this Training Programme (a) Treasury Accounts of Angul, Balasore and Mayurbhanj (b) Finance Accounts for the State (c) Detailed State wise Allocation of Grants during 2008-09 (d) Report of the Committee for Finalising Financial Guidelines and Frameworks for Delegation of Administrative and Financial Powers Under National Rural Health Mission (March 2007) (e) A Note on How to Track Budget for Health Sector: A Case of Orissa -By Nilachala Acharya
List of participants who attended the programme
What Participants Observed about the Training Programme The following are the remarks and resolutions made by some of the participants. Such comments and observations are not only encouraging in NSA efforts to democratise debate on development, but also suggest some necessary improvements in our functioning. Mr.Tapan Mohapatra, Child Rights, Bhadrak: This training programme was very informative and stimulating for budget tracking. I got a lot of concepts clarified on budget and associated terms. The continuous focus on budget as a tool for advocacy was the most interesting aspect of this training. The group exercise was a bit difficult as the consolidation of all the information was difficult. I am interested in taking part in future training activities by NSA and if I am able to build my capacities to a satisfactory level, I shall be interested in providing training also, especially on the issues related to basic terms in budget and concepts. I shall start budget analysis at the district level on agriculture department budget. I can be contacted at childright@live.com Ms. Rashmita Samal, Lepra Society, Khurda As advocacy and CBMs are major components of my activities, this training programme helped me to have a basic understanding on budget, its codes and analysis techniques. The facilitation process was really nice. The group exercise that included tasks such as identification of codes w.r.t expenditure was exciting. It complemented and added much value to my own understanding and professional life. I am certainly interested in participating in future training activities of NSA both as a trainer and also as a participant. As I am working in urban slums on health and related isues, I shall use budget analysis tools learnt here in community mobilisation and advocacy. I can be contacted at rashmitasamal09@gmail.com Ms. Banajyoti Basa, CYSD BBSR I am already in the area of budget analysis. This training programme was very much useful to me. All the sessions were very interesting and nothing was difficult. I am interested in participating in future training programmes by NSA both as a trainer and a participants. I can provide training on basic concepts and terms related to budget. I can be contacted at jyotiripu@gmail.com Ms. Sumitra, Business Standard This training programme gave a wide understanding about different tools of budget and its allocation for a specific area of development. The process of facilitation was quite good. I found the preparation of district wise funding analysis most stimulating activity in this programme. However, without having sufficient handouts and materials, it was difficult to participate in practical group tasks. I am interested in future training activities of NSA and if possible shall also volunteer as a trainer/facilitator. I can extend my support in arranging open discussion programmes for advocacy. I can be contacted as jovial_sumit@yahoo.in Ms. Manashi Sahoo, DRUP, Sundergarh It really was a great awareness programme from which a clear idea about budget and services provided to us was established. The facilitators created awareness about district budget and expenditure for public. All the sessions were very interesting and new for me. This training helped me a lot as I was completely new to budget analysis although after this training I have a feeling of clear understanding about budget analysis. I am very interested to participate in future training activities by NSA. However, I need more ground before volunteering as a trainer. I can be useful in training on statiostical tools but need more knowledge on budget and thematic concepts. I like to track budget at district level in different areas to know more details. I can be contacted at drupsng@yahoo.com Mr. Pradip Kumar Danjee, ADHAR, Bolangir The training programme is very necessary for my working mainly because we are already working with the issues related to health and child rights. The ideas received from this training will be helpful for us. This training helped me to know more about the structure of public finance, DPC, TSP, SCSP, DRDA, Treasury and other agencies. I found the ataks related to identification of executive summary, plan and non plan expenditure a bit difficult during group exercise. But I am hopeful that with practice, such difficulties will be overcome. This training programme will help me in my working areas as I got a clear idea about the health sector budgeting. I shall work hard to collect the requisite information for my own district and increase my knowledgebase. I am currently not feeling confident about taking sessions on budget analysis as I lack adequate knowledge for the purpose. I want to attend NSA training programmes again to know more about these issues. Health and education are my priority areas and I can be contacted at pradipdanjee@gmail.com Roy Bahadur Singh, Samarthan, Chhatishgarh The above training was very useful to me since I am working in NRHM project. Looking at district budgets is one of my activities. The facilitation process were very target focussed and dealt with both macro and micro issues simultaneously. All the 2 days training was interesting and stimulating for me. I joined this workshop with an empty pocket. I am going out with many bags filled with useful knowledge. I shall be interested in attending more training programmes by NSA. If I get an opportunity I shall also be available as a trainer. My focus areas are health and MREGS. After going back to Chhatishgarh, I shall share the learnings with my colleagues and field activists and shall try for replicating the efforts in my state. I shall be contacted at roy-pankaj49100@yahoo.com Dr. Jyotshnarani Patnaik, SODA, Mayurbhanj I shall use the learnings from this training in my advocacy and research work on health. The facilitation process was very interesting with good presentations and I found all the exercises interesting. The tasks related decoding was a bit difficult. The training helped me in my professional pursuits in budget analysis for development. I am interested in future NSA training programmes both as a trainer and participant. Such programmes should be undertaken periodically. I can be contacted at drjyotshnarani@gmail.com
For more details, contact Network for Social Accountability (NSA) C/o Bharat Gyan Vigyan Samiti (BGVS) C-2, HIG, Baramunda Housing Board Colony, Baramunda, Bhubaneswar, 751003 Phone: 0674-3267405 |
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