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The influence of organisational climate on utilisation of funding streams is represented schematically in Figure 1.
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One of the major reasons for the apparent ineffectiveness of global interventions is historical weaknesses in the health systems of underdeveloped countries, which contribute to bottlenecks in the distribution and utilisation of funds.
In their assessment of the attempt in the 1970s to increase utilisation of research funded by the UK's Department of Health, Kogan and Henkel found, 'the interconnections between epistemologies and institutional relationships were a recurring theme' [ 7].
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I call on the Commission to also give due consideration to urban mobility during the mid-term review of the framework for the utilisation of structural funds.
The overall effect of the NHIS is therefore likely to have exacerbated a previously weakly pro-rich utilisation of public funds.
In this aspect, leadership is needed to make health care financing more accountable to the public, particularly in regards to inefficiencies and better utilisation of public funds and resources.
In all the FGDs and IDIs, ASHAs explained that they undertook most activities as instructed by the doctor and ANM and that their activities were limited to mobilising mothers for immunisation during the village health and nutrition day and utilisation of VHNSC funds (Rs. 10 000, approx. £115), rather than critical discussion on the status of health in the village and strategies to improve this.
Ultimately, good governance and leadership are needed to ensure adequate public spending on health and maintain the focus on the attainment of universal coverage, as well as making healthcare financing more accountable to the public, particularly in regards to inefficiencies and better utilisation of public funds and resources.
The PILs have sought injunctions of the court for setting up of an integrated ring sewage system encircling the Lake; release of funds by the Government of India to undertake measures to check pollution and to inaugurate a High Powered Committee to monitor proper utilisation of the allotted funds.
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