The Hindu : National : Health Mission needs fine-tuning, say States

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Wednesday, Nov 03, 2004

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National

Health Mission needs fine-tuning, say States

By Gargi Parsai

NEW DELHI, NOV. 2 . The Centre's proposed National Rural Health Mission needs to be fine-tuned if the State Governments' suggestions are to be taken into account. All the 15 States which attended the consultations here today, concurred with the proposal but differed on how to go about it. Chhattisgarh and Uttaranchal did not attend.

At the end of the day-long consultations presided over by the Minister for Health and Family Welfare, A. Ramadoss, only one demand was unanimous: more funds to strengthen the primary health centres (PHCs), the community health centres (CHC) and the sub-centres — all of which form part of the proposed Health Mission.

`Lack of doctors'

The Empowered Action Group (EAG) States, including Bihar, Uttar Pradesh, Rajasthan, Madhya Pradesh and Jharkhand, bemoaned the lack of doctors at the PHCs, CHCs and the lack of buildings for the sub-centre, while the Northeastern States sought mobile faculties for better reach.

Seeking partnership with States, Mr. Ramadoss said the Accredited Social Health Worker (ASHA) would be at the centre of the Mission. The worker would be trained for over a year. A sum of Rs. 10,000 has been earmarked for her. She is proposed to be paid on the basis of the "cases" she brings in whether for immunisation, institutional deliveries or sterilisations.

The proposed budget is estimated to be between Rs. 6,000 crores and Rs. 8,000 crores over five years.

"Money is not a major problem. It is efficient use of money that is,'' said the Secretary, P.K. Hota, doubling as an interpreter for the Ministerduring the presentations of the northern States.

`Keep teachers out'

The Bihar Minister, Shakuni Chaudhry, wanted teachers to be kept out of the proposed scheme so that they could concentrate on education and wanted the Zilla Parishad Chairman to head the District Missions rather than District Collectors.

The Uttar Pradesh Revenue Minister, Ambika Prasad Chaudhry, felt it was not proper to abandon earlier schemes and just go in for a new Mission. He wanted the Centre to re-think on the proposal of not giving any salary to ASHA. Unlike Bihar, he wanted teachers to be involved.

The Madhya Pradesh Health Minister, Gauri Shankar Sejwar, did not concur with the idea of replacing Trained Birth Attendants, Anganwadi Worker and Health Worker with ASHA alone.

The Rajasthan Minister, Digambar Singh, said indigenous midwives should be trained alongside ASHA "as you cannot do away with home deliveries."

He felt a monthly allowance of Rs. 250 was insufficient to keep doctors in rural areas which lacked facilities for their residence and children's education.

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