Unit 2 Part 3 of HSMN

1. Inter-sectoral Coordination
By:
Vijaya Laxmi Shrestha
Lecturer (MPH, M. Phil)

2. Concept of Coordination
• Coordination is defined as the planned
teamwork of two or more persons,
departments, programs or organizations
who are concerned with achieving a
common goal.
• Co-ordination is the process of
synchronization and unifying the actions
of a group of people.

3. Contd….
• Providing quality health services is
possible only with the joint efforts of the
various factors. Eg, quality drugs, quality
equipments, qualified practitioners etc.
• Health is not only the responsibility of the
health sector, but of all the sectors such as
agriculture, education, transportation,
communication etc.

4. Coordination:
• Aims to strengthen unity of action.
• Is an orderly arrangement of group efforts.
• Is the process of integration among
different organizational unity.
• Means distributing authority and
promoting channel of communication and
arranging the work so that the right things
are done in right place at right time in the
right way by the right people.

5. Coordination in different plans
National Health Policy, 1991:
Necessary coordination will be maintained at
each level with the health related sectors.
Alma Ata Conference, 1978:
Inter sectoral coordination was identified as
one of the four principles of Primary Health
Care
The NHSP-IP 2004 has identified
coordinated management in the health sector
both at the control and field level as a major
sector management output.

6. Contd…..
Second Long Term Health Plan:
There is a need to develop a mechanism to
ensure ministries and their donor partners
effectively coordinate with themselves and
with other sectors.
Three year Interim Plan:
Coordination committee consisting of
Ministry of Health, Finance, Local
Development, Women & Children will be
formed to make decentralization effective.

7. Contd……
Thus co-ordination comprises:
• Integration
• Interdependence
• Goal harmonization
• Increase in efficiency
• Essence of management
• Increase in productivity
• Reduction in duplication

8. Importance of Coordination
• Effective & efficient use of resources
• Improved services
• Building of trust & decreased conflict
• Reduced duplications
• Enlarged scope of activities
• Standardization in policies
• More participatory, implies commitment,
economizes effort, improves quality of
work, avoid duplication and wastage, and
optimizes output.

9. Types of Coordination
• Horizontal Coordination
• Vertical Coordination
• Intra sectoral Coordination: within the same
sector
• Inter sectoral Coordination: with different
sectors

10. Horizontal & vertical Coordination
Ministry of
Health
Ministry of
Education
Ministry of
Local
Development
Provincial
Development
Office
Provincial
Education
Office
Provincial
Health Office
VDC/
MunicipalitySchoolsPHC/HP
District Health
Office
District
Education
Office
Provincial
Development
Office

11. Inter sectoral coordination
• It refers to the promotion and co- ordination of
the activities of different sectors of health care
system to enhance and to provide a qualitative
services to community.
• The ultimate aim of inter sectoral coordination
is the convergence of health care services in the
community.

12. Ministry
of Health
Health
Planning &
Policy
Section
Family
Welfare
Division
Child
Health
Section
NHTC
Family
Planning
Section
Health
Office
Fig. Intra sectoral Coordination

13. Ministry
of Health
Ministry of
Local
Development
Ministry
of
Education
Ministry of
Women &
Social
Welfare
Ministry of
Agriculture
Ministry of
Housing
Plan
Ministry
of Finance
Fig. Inter sectoral Coordination at central level

14. Inter sectoral Coordination at Central
Level
• Health sector requires a multi sectoral
approach with effective coordination
among GOs, private sectors, NGOs,
INGOs, bilateral & mutilateral partners.
• Coordination within the higher
managerial level of different sectors
• Practiced among policy maker and
decision makers.

15. Contd…
• It helps organization making rules and
regulation, policies.
• It also helps to prevent overlapping,
lacking, inconsistence and duplication
of task.
• Prevents conflict situation among the
workers.
• The central level coordination can
prevent grievance and gossips in the
organizations.

16. MoHP should have coordination with:
• Ministry of Education
• Ministry of Agriculture
• Ministry of Women & Social Welfare
• Ministry of Science and Environment
• Ministry of Local development
• Ministry of Finance
• Ministry of Water resources
• Ministry of Home Affairs
• Ministry of Housing & Physical Plan

17. Inter sectoral Coordination at District
Level
• Delivery of health services in the district
involves multiple agencies including GOs,
I/NGOs and private agencies.
• In planning and managing health services,
the local government & community
representative bodies are also involved.
• Therefore, it is quite required for District
Health Managers to effectively coordinate the
implementation of services interventions.

18. Different sectors in Province/districts
• District Education Office
• District Agriculture Office
• District Veterinary Office
• District Development Office
• District Ayurved Office
• District Women Development Office
• District Forest Office
• District hospital
• Other Government Organizations at district
• NGOs/INGOs at district

19. Coordination at Local/peripheral level
• Each PHCC/HP should have coordination
with:
▫ Schools
▫ Agricultural offices
▫ Veterinary offices
▫ VDC
▫ Different organization, clubs
▫ Local leaders/Intellectual persons
▫ Mothers group/Youth club

20. Mechanism of Coordination
• Listing out the programs that needs joint
efforts
• Identify the area where coordination is
required
• Locate the level of health system where
coordination is needed.
• Formation of coordination committee at
different levels

21. Primary health care requires support
of other sectors
• Good nutritional status
• Development in agriculture and home economics
• Women education and empowerment
• Availability of potable water
• Safe disposal of waste and excreta
• Road connectivity of remote villages
• Mass media
• Policies & legislation
• Industries
• Housing standards