Panchayati Raj in Health

PRI Structure - Grassroots Governance

• Constitutional Mandate: Established by the 73rd Constitutional Amendment Act, 1992.
  • Enshrined in Part IX of the Constitution.
  • Aims for democratic decentralization and local self-government.
• Three-Tier System: Aims to build democracy from grassroots level.
  • Village Level: Gram Panchayat (Sarpanch as head).
    • Foundation: Gram Sabha (all registered voters in the Panchayat area).
  • Block/Intermediate Level: Panchayat Samiti / Mandal Parishad (Chairperson elected by its elected members).
  • District Level: Zila Parishad (Chairperson elected by its elected members).
• Key Provisions:
  • Direct elections for all seats at all levels.
  • Regular elections every 5 years (conducted by State Election Commission).
  • Reservation of seats for Scheduled Castes (SCs) and Scheduled Tribes (STs) in proportion to their population.
  • Reservation of not less than 1/3rd of total seats for women (including SC/ST women).
  • State Finance Commission constituted every 5 years to review financial position.

⭐ The 73rd Amendment Act, 1992, granted constitutional status to Panchayati Raj Institutions (PRIs), making them mandatory and uniform across states (with some exceptions).

PRI Health Roles - Village Vanguard

• Gram Panchayat (GP): Overall responsibility for health, sanitation, safe drinking water, and nutrition within the village.
• Village Health, Sanitation and Nutrition Committee (VHSNC):
  • Operational at village level, chaired by Sarpanch/Panch.
  • Members: ASHA, AWW, ANM, elected Panch, community representatives.
  • Functions:
    • Develops Village Health Plan (VHP).
    • Monitors health services, ASHA/AWW performance.
    • Promotes sanitation, hygiene, nutrition.
    • Manages untied funds for local health needs.

  ⭐ VHSNC receives an annual untied grant of ₹10,000 for local health action.

• ASHA (Accredited Social Health Activist):
  • Community health volunteer; key link between community & health system.
  • Roles: Maternal & child health (MCH), immunization, family planning, DOTS provision, health education.
  • Accountable to Gram Panchayat; supported by ANM & AWW.
• AWW (Anganwadi Worker):
  • Implements ICDS scheme at village level.
  • Provides supplementary nutrition, pre-school education, health & nutrition education.
  • Works in close coordination with ASHA, ANM, and VHSNC.

PRI Committees & Challenges - Committee Counsel

Key committees significantly shaped Panchayati Raj Institutions (PRIs) and their evolving role in health:

-   **3 Fs Deficit**: Insufficient Funds, Functions, and Functionaries. 📌 Mnemonic: **F**ailures **F**rustrate **F**unctioning.
-   Inadequate financial autonomy and resource mobilization.
-   Limited capacity building and technical expertise.
-   Political interference and lack of genuine devolution.
-   Low community awareness and participation.
-   Weak inter-sectoral coordination with health systems.

⭐ The 73rd Constitutional Amendment Act (1992) is a landmark, constitutionally empowering PRIs with responsibilities for 29 subjects, including critical areas like health, sanitation, primary health care, family welfare, and women & child development.

High‑Yield Points - ⚡ Biggest Takeaways

• Panchayati Raj Institutions (PRIs): established by 73rd Amendment Act, 1992.
• Three-tier system: Gram Panchayat (village), Panchayat Samiti (block), Zila Parishad (district).
• Health functions: sanitation, safe water, family welfare, implementing national health programs.
• Gram Sabha: foundation for community participation and planning.
• PRIs manage untied funds for local health needs.
• Crucial for National Health Mission (NHM) implementation.
• ASHA works closely with Gram Panchayat for community health.