Wednesday, Apr 13, 2005
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By Our Staff Correspondent
NEW DELHI, APRIL 12. G overnments have "grievously erred" in designing the country's health programmes. "We have created a delivery model that fragments resources and dissipates energies. Most importantly, we have paid inadequate attention to the public health issues and the possibilities of social and preventive medicines,'' the Prime Minister, Manmohan Singh, said here today.
Launching the ambitious National Rural Health Mission here today, he stressed upon the need to bridge the income, education and the health gap of the people. They were interconnected in their causes and their solutions were mutually reinforcing.
The National Rural Health Mission, that will get Rs. 6,713 crores for 2005-06, attempts a major shift in the governance of public health by giving leadership to the Panchayati Raj institutions in all matters related to health at the district and sub-district levels. It aims to increase the outreach of the health system to village and even household levels through the provision of a voluntary trained female community health activist called ASHA. The Mission will cover all the States in the country with special focus on 18 States which have a weak health infrastructure and demographic indictors.
"Over the years, governments had addressed this issue with some success. However, the experience was somewhat uneven. Some States had recorded impressive achievements on the healthcare front, the Prime Minister said while calling upon the less developed States to learn from the experience of the southern and western States in dealing with the challenge of affordable healthcare.
There had been a fatal flaw in the approach that had gradually abandoned a comprehensive health care and a public health perspective for focussed attention on selective diseases. The Indian health system was, perhaps, guilty of many sins of omission and commission.
He highlighted the need for a decentralised, district-based management to provide an operational platform to harmonise all services and mobilise collective action on health goals through the opportunities provided by the Panchayati Raj institutions. He hoped that the architectural correction that the Mission proposed by empowering district-level institutions would offer a new way out for effective rural healthcare.
The strengthening of the primary or community health centre would be the key step to empowering public health infrastructure. A significant step was the setting up of Indian Public Health Standards that would specify personnel, management and equipment norms, including those for community control based on which these hospitals would need to be built up.
The Prime Minister said his Government was committed to raising health spending from 0.9 per cent of the GDP at present to two per cent in the coming years. The Government would adhere to the commitment and call upon the State Governments to ensure their timely utilisation after the architectural corrections were immediately affected.
The Union Health and Family Welfare Minister, Anbumani Ramadoss, said the public health infrastructure would be strengthened under the Mission through the construction of sub-centre buildings and the upgrading of public health centres and community health centres.
An untied fund of Rs. 10,000 would be provided to every sub-centre to cater to the unmet needs reflected in the village health plan. Besides decentralisation, the Mission also focused on the promotion of alternative systems of medicine.
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