The influence of organisational climate on utilisation of funding streams is represented schematically in Figure 1.
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.
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].
The following table summarises, in a simplified manner, the projected income and utilisation of resources under all sources of funds in 2002-03 under the real growth (RG) and zero real growth (ZRG) scenarios together with comparative information for 2000-01.
Indexes were also excluded if they were used for funding requirements, measured utilisation of services and only used a single variable such as socioeconomic deprivation [ 18- 21].
