A health management professional’s journey back to grassroots from the corridors of policy making

Rajesh Singh

First time when I heard of PMRDF scheme, I decided that I will join this programme, because in my previous job with the Ministry of Health and Family Welfare I felt that I had been so removed from the realities of the ground level. I was involved at a level where policies and guidelines were made; yet I was not very clear about the real needs of rural areas of our country. By availing this opportunity I believed I would get a chance to see the rural India and ground level work environment. Being a management professional I was also curious about how the government manages it myriads of scheme at the grassroots with staff at different level of hierarchy.

After joining PMRDF, I got a chance to see myself how this huge machinery of administration works in challenging areas and situations where quality human resource is lacking. The other major factor which interested me was that in this programme I got a chance to work in left wing extremism affected areas which I had only read about till then.

I opted for Shahdol, Madhya Pradesh and was placed with district administration with a very broad job chart. District Administration was very welcoming but they had absolutely no idea what to do with us. Over time I realized that the system is completely Collector centric and tried to have more interactions with the Collector.  But then also realized that it is better to be working with the Zilla Panchayat as they are the ones who are in touch with the ground and all the development work. Same story repeated again with me. Zilla Panchayat was not clear as to how I fit in to their system. So I took it on myself to find a place for me and went to each department giving my introduction.

Initial days went by without much work because of changes in bureaucratic levels and I comforted myself saying this is learning phase for me! I started digging up work for myself based on my conversation with officials, letters, circulars, job charts and feedback from local people and news paper. My interactions with the Zilla Panchayat increased and improved over the days. The suggestions and inputs I gave during the period increased their confidence in me after they found it relevant and useful in managing their daily work as well as implementation of the schemes. My past experience with the Ministry and in policy making also paid off while developing this relationship with the administration. Slowly the administration started involving me in the planning and evaluation of various schemes as well training of human recourses at various levels.

I slowly had this realization that I was missing the real connection with the villages while I was assisting the administration with planning and designing operational guidelines. Then I started orientating myself more towards aspects of participative and responsible governance, found myself more involved in awareness camps, social audit, and gram Sabha. Basically I was trying to find a balance in my work by being involved with the administration as well as the issues of the villages.

Almost one year has passed. There was time when I was really happy and also there was time when I felt extremely helpless. But in spite of all those moment of helplessness I still believe that development is possible though not really easy. Past one year taught me two important qualities which are needed for those working in this secto r- patience and hopefulness. It also was a learning phase which gave me ideas to plan my future course of action in the district. I plan to use my experience in health sector to develop and improve upon the health facilities which is a major area of concern here.


Rajesh Singh is a PMRD Fellow based at Shahdol. He is an MBA in Health and Hospital Management from IIHMR, Jaipur. Before joining PMRDF, Rajesh worked for 2 years with the Ministry of Health and Family Welfare (GoI) on AIDS Control and Health Project. There he prepared and implemented Health centre M&E guidelines, reporting formats and Strengthened MIS. Rajesh was also actively involved in the development & establishment of Smart Card Systems for HIV patients.


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