Directions for Reforms in the Health Sector: Reflections from a State in a Developing Country

Meeting the health care needs of population goes beyond mere budget allocations. The organisation of programmes and commitment of people working in the health sector has significant bearing on sector performance and its reform process. The reform process, among other things, intrinsically makes some fundamental assumptions: high organisational commitment of health care providers, high professional commitment of health care providers and adequate skills of health care providers. The current paper attempts to analyse the HR practices in Madhya Pradesh and its implications on commitment of the health officials. The findings of the study indicate that district health officials do not share strong emotional bond with the department which is likely to affect their willingness to take initiative. The findings suggest the need to consult senior doctors in staffing decisions in order to develop a sense of belongingness in the mind of the health officials. The study suggests investing in development of multiple strategies for the growth and career development of health professionals. The study also advocates the need for intense socialisation among health professionals to facilitate the effective implementation of reforms. Finally the study advocates the need to develop informal channels of communications and networking among various health providers.