The Hindu : National : 11th Plan to meet needs of AIDS-hit people

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Saturday, Jun 17, 2006

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11th Plan to meet needs of AIDS-hit people

Aarti Dhar

NEW DELHI: To improve the primary health care system, the 11th Five-Year Plan will initially lay emphasis on integrated district health plans and later on block-specific health schedules. These will ensure the involvement of all health-related sectors and emphasise partnership with non-governmental organisations.

The Planning Commission's approach paper says the Plan will take care of the special needs of people living with AIDS, particularly women. This will be given the highest priority.

The health care delivery system needs oversight at all levels and requires both strong policies and institutions. However, given the socio-cultural and economic diversity, interventions have to be evidence-based and area-specific.

Shortcomings

Past shortcomings notwithstanding, the approach paper believes that it can reach the Millennium Development Goals for Infant Mortality Rate (IMR) and the Maternal Mortality Rate (MMR) by the end of the 11th Plan.

But, this will require action on may fronts — enabling pregnant women to have institutional deliveries and receive nutritional supplements besides connecting public health centres and community health centres by all-weather roads so that they can be reached quickly in emergencies, and expanding access to clean drinking water and sanitation.

The 10th Plan aimed at providing essential primary health care, particularly to underprivileged and underserved people.

It also sought to devolve responsibilities and funds for health care to the panchayati raj institutions.

However, progress towards these objectives has been slow and the 10th Plan targets on MMR and IMR have been missed. Rural health care in most States is marked by absenteeism of medical staff, low skill levels, shortage of medicines, inadequate monitoring and callous attitudes. There are neither rewards for service providers nor punishments to defaulters.

Shortage of doctors

There is a severe shortage of trained personnel. Across States 6-30 per cent posts of doctors remain vacant. Random checks showed that 29-67 per cent doctors were absent during working hours.

This problem of unavailability of doctors can be redressed if doctors trained in the Indian Systems of Medicine (ISM) are mobilised, the paper says.

Currently, there is no sustained dialogue between the two systems of medicine.

There are close to half a million institutionally-qualified ISM practitioners not included in the public sector-supported primary health care. They represent a valuable human resource at village and block levels and could be co-opted into providing primary health care.

The paper cited the examples of Kerala and Himachal Pradesh where the experiment has been a success.

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