In March, 2002, RCH Society, Chhattisgarh and the Regional Office (Raipur) of ActionAid India Society (AAI) executed a Memorandum of Understanding. The MoU was signed in the context of European Commission and Sector Investment Programme (SIP). The State Health Resource Centre, Chhattisgarh was founded as additional technical capacity to the Department of Health & Family Welfare, Chhattisgarh and as a state-civil-society body whereas the ActionAid's role was to coordinate civil society organisations in setting up such a body. During the following two years the initial team was put together and the institution was made able to stand on its own. Since 2004 the SHRC has been functioning as a fully autonomous institution.
There are many more examples - big and small - of the diverse catalyst roles that are needed and today it is inconceivable to think of health sector reform without such drivers for change. Whether it is changing prescription practices of doctors or procurement practices of the administration, whether it is introducing new training programmes or ensuring that BCC programmes conform to a scientific implementation framework, change does not happen only on the basis of right thinking and capacity building. Change requires having to contend with existing knowledge and mindsets and institutional structures and that is where the SHRC contributes.
Vision: We as a State Civil Society Partnership Organization of Public health Professionals are an enabler in Chhattisgarh attaining for its every citizen highest attainable level of physical mental, social and spiritual health and quality health care that is equitable universally accessible, affordable and gender sensitive through empowerment of communities and development of an accountable and responsive health system.
Mission: To aspire for achievement of the highest level of efficiency & quality in delivery System both Government & Non government to provide the most professional technical support to Government, to act as a catalyst and innovator in public health, to inspire and sustain motivation of committed staff and civil society groups in community health.
As mentioned above, the SHRC was established through a ‘host’ organisation which then had experienced officers who had worked closely with the government. The partnership with the NGO – ActionAid in SHRC's case – was formalized through a MoU which mandated the NGO to set up and manage the SHRC for and on behalf of the State, till it could be a truly autonomous institution.
The decision to engage a ‘host’ organisation guaranteed the freedom of being able to find the right initial persons and build the team for the SHRC. There was also considerable flexibility to head-hunt for suitable persons to constitute the initial team.
To ensure that the SHRC had a character of an organization working for change, and for reaching health care to the poor, the governing body was evolved out of a number of individuals and organizations known to be committed to such values and who had a good track record of supporting institutional development. The NGOs who were interested and who participated in the formulation of a health sector reform strategy were constituted into a state advisory committee for health sector reform and with their support the governing body was constituted. The executive committee was made of those who were part of the full time team.
Knowing the lack of skilled persons who would be available to work in the EAG states at the pay scales that we could offer (comparable or marginally higher than government scales – but not certainly at international agency pay scales) - the SHRC followed a policy of recruiting persons with the right mix of background and motivation and building up their capacities in house. This required a certain type of leadership and great emphasis on mentoring arrangements.
Knowing that this work requires experience and expertise on a wide number of areas, and it would not be possible to hire persons with such experience, the SHRC followed a policy of ‘contracting-in’ experts to work with its team and recorded this experience of working together in its institutional memory so that the expertise available locally increased cumulatively.
“Managing change” requires patience and persistence, the ability to withstand criticism and sometimes hostility both from within (the government) as well as from outside (e.g. civil society organisations’ initial refrain that the Mitanin initiative represented government’s intention to ‘withdraw’ from its public health responsibility). The change agents, at the same time, need to understand and negotiate with different points of view, take various initiatives and risks when no one else is ready to do so and yet understand that “success” requires ownership of the idea and the work by others - sometimes to the exclusion of the main movers. The SHRC, therefore needed to build-in a strong element of networking with similar minded individuals and organizations both in the state and national level, so that there was mutual solidarity and a specially created peer support for supporting the change process.
The bottom-line of SHRC experience, in other words, is not just about ‘establishing’ yet another structure but finding a suitable NGO and formalizing a partnership with it which allows the NGO partner sufficient flexibility in finding the right individuals who would become a team in supporting the State Directorate / State Institute for Health and Family Welfare / State Society on an on-going basis.