Intersectoral coordination

1. INTERSECTO
RAL
COORDINATIO
N
Mrs. NAMITA BATRA GUIN
Associate Professor

2. INTRODUCTIO
N
• The Alma-Ata Declaration suggests a multi
sectoral approach as one of the basic principles
underlying primary health care.
• The approach is based on the assumption that
health is intrinsically linked with other
development issues in a synergic manner.
• Some of the departments for inter-sectoral
coordination are Women and Child
Development, Department of Education, Rural
Development, Rural Water Supply and
Sanitation, Panchayati Raj Institutes, NGOs, the
Department of Agriculture, the Department of
Social and Tribal Welfare, and the Department
of Forest.

3. INTRODUCTIO
N
• The changes in other sectors affect health
and similarly health affects the development
in other sectors also.
• Therefore, a better understanding of the
relationship between health and other
development sectors is needed for best
results.

4. GUIDING PRINCIPLES IN
INTERSECTORAL COORDINATION
1. Development is basic to health: Health is closely related to
development. Health influences development and also influenced
by development. According to social scientists, improving the
state of health contributes to economic development, labour
productivity and growth. There is strong relationship between
economic development and health, economic development
trends to improve health status, while better health contributes to
economic development.

5. GUIDING PRINCIPLES IN
INTERSECTORAL COORDINATION
2. Equity: The most common understanding of equity, in terms of
health, is that “every man, woman and child, no matter where he
or she lives, has the right to enjoy good health and deserves to
have access to health care services”. This definition, then,
implies the following. First, there must be enough health care
services - availability. Second, whatever is available must be
accessible to the poor, forgotten, and the marginalised.

6. GUIDING PRINCIPLES IN
INTERSECTORAL COORDINATION
3.Promoting Economic Capacity of the Poor People: The
economy“status plays an important role in determining the health
status of the people. It not only enables the people to undertake
preventive and curative health care measures, but also promotes
sustainability of their health status. Many countries have initiated
community specific strategies, and programmes to improve
economic capacity of the poor. Some of the key strategies are: (i)
asset creation and development, (ii) capital formation, (iii)
employment opportunities in the private or public sector, and (iv)
access to market avenues.

7. INTERSECTORAL COORDINATION

8. AREAS OF
COORDINATIO
N
1. Promotion of Nutrition: the Health
Department organises activities related to
educating pregnant and lactating mothers
regarding quantity and quality of food,
supplementary nutrition, nutritional care of
child, educating adolescent girls and boys
regarding health, food habits, food hygiene,
balanced diet, malnutrition among children,
food for geriatrics, adulteration of food and
subsequent diseases, role of kitchen garden,
mid-day meals in schools; organising nutrition
education and preventing problems of
malnutrition and anaemia in the community.
Other departments involved in coordination
are: Agriculture, Education, Social Welfare,
panchayat raj, animal husbandry, cooperative
banks etc.

9. AREAS OF
COORDINATIO
N
2. Supply of water: Health departments
need to coordinate with the public health
department for supply of safe drinking
water. The public health department is
involved in site selection and surveys for
water sources; water analysis; and
educating communities on how to get safe
water. Other departments involved are:
Agriculture, education, Panchayati Raj
and social welfare/ Women and child
welfare development.

10. AREAS OF
COORDINATIO
N
3. Excreta Disposal: Health and Public
Health Department conducts education at
the household level for use of sanitary
latrine and safe garbage disposal.
Other departments involved are: Agriculture,
Education, Panchayat Raj, Rural
development and social welfare.

11. AREAS OF
COORDINATIO
N
4. Waste Water Disposal: Health and
Public Health Department organises
health education camps on methods of
safe disposal of waste water and its
advantages to the community. Other
sectors involved are: Education,
Agriculture, Panchayat Raj, Rural
Development, Social Welfare

12. AREAS OF
COORDINATIO
N
5. Maternal and Child Health: Health
Department is responsible for health
education on ante-natal, natal, and post-
natal care; infant and child care; and other
related maternal and child health care
services. Other sectors are: Cooperative
societies, Education, Panchayat Raj,
Social welfare.

13. AREAS OF
COORDINATIO
N
6. Family Health Care Education: The
Health and Family Welfare Department
conducts health and family welfare
education through various communication
methods at the grassroots. Other
Departments: Education, Panchayat Raj,
Social Welfare and Social welfare.

14. AREAS OF
COORDINATIO
N
• 7. Immunization against major Infectious
diseases: Health Department organizes
and conducts educational programmes
and provide service facilities on
immunization through the health centre
personnel at various levels. Other
departments included: education,
Panchayat Raj, Social welfare, women
and child development.

15. AREAS OF
COORDINATIO
N
• 8. Prevention and Control of locally
endemic diseases: Health Department
organises education on diagnosis,
treatment, and follow-up of cases of TB,
leprosy, malaria, scabies, etc. Other
department are: Animal Husbandry,
Education, Panchayat, Social Welfare.

16. AREAS OF
COORDINATIO
N
• 9. Improvement of overall environment in
Primary Health Care premises: This
includes plantation, gardening, water
supply, sanitation. Department involved are:
Forest, Public Health, Panchayat Raj, NGOs
and Community organizations.

17. COORDINATION MECHANISM
• i) listing out the programmes which need joint efforts
• ii) identifying the areas where coordination is required
• iii) knowing the categories of health personnel whose activities
should be integrated
• iv) locating the levels of health systems where joint efforts are
needed
• v) forming coordination committee of members of district health
team which includes all the middle level supervisors and
specialised functionaries working at district level and

18. COORDINATION MECHANISM
• vi) forming operations teams at field level
• vii) list different sectors, such as social welfare, women and child
development, public health, rural development, municipalities, and
municipal corporations, and the heads of those sectoral units which
are directly or indirectly related with health and family welfare
programmes
• viii) identify the non-governmental and voluntary health
organisations, which are working in the area of health and family
welfare.
• Ix) constitute a coordination committee with the representatives from
district, block, and village levels
• x) formulate specific task-forces

19. COORDINATION MECHANISM
• xi) jointly decide the objectives and areas for coordination to
achieve desired goals
• xii) decide the role and responsibility of each department and
mechanism of reporting and feedback sharing
• xiii) develop a plan of action that focuses on independent tasks,
joint tasks, sharing of resources, and field work in teams.

20. BENEFITS OF INTER-SECTORAL
COORDINATION
• i) achievement of goals which cannot be achieved alone,
• ii) increases the chance that those policy alternatives are
chosen which are most likely to result in the highest overall
welfare gains
• iii) helps prevent overall welfare losses because of policies that
entail positive welfare effects for individual actors, but
disadvantageous from an overall point of view
• iv) provides legitimacy and acceptance to public policy.

21. Requisites for Effective intersectoral
coordination
• Establishing an overall inter-sectoral strategy
• Establishing commonly agreed or binding priorities
• Defining common limits by setting parameters for sectoral activities
• Arbitration of inter-sectoral differences
• Avoiding policy divergences among sectors and seeking consensus
• Consultation with others
• Information Exchange among the sectors

22. STEPS IN
ISC
• Proper orientation of policies and programme of
each developmental department at all level.
• Formation of joint coordination committee at
each level i.e., village/block/ district.
• Defining roles and responsibilities of
participatory agencies and classifying them to
each other.
• Participatory decision making.
• Developing a formal system of interaction,
discussion and debate.
• Sharing of the problems faced in
implementation of health programmes and
seeking cooperation from each partner.

23. STEPS IN
ISC
• Spelling out strategies and procedures.
• Joint monitoring and evaluation.
• Remedial measures in solving problems
related to coordination/resource
mobilization.