Interventions to reduce maternal and infant mortality rates, comprehensive health care for children studying in government schools, special incentive regime to retain professionals in government stream are among the slew of reforms being initiated to improve health outcomes of all sections, especially the vulnerable groups.

Concerned by the slow progress of health-related Millennium Development Goals, the government initiated the measures which aim to revitalise the primary health system by carving out 360 Community Health and Nutrition Clusters (CHNCs) across the rural areas. It was also being contemplated to make one-year's rural internship compulsory for MBBS graduates and two-year mandatory assignment with secondary hospitals for post-graduates.

With health parameters of the Scheduled Castes and Tribes showing to be twice as bad as that of general population and with nearly half of all children below five and women in reproductive age being under-nourished, the reforms would focus not only on improving maternal and child health but also address nutritional deficiencies on a sustainable basis, Secretary (Health), P.V. Ramesh told The Hindu here on Thursday.

Landmark changes

Describing the new measures as “landmark changes”, he said they were aimed at improving the overall healthcare delivery.

Each CHNC would provide integrated primary health services covering a population of one to two lakh people. At the centre of the CHNC would be the first referral unit—a Community Health Centre (CHC) or an Area Hospital—that would support four to 10 Primary Health Centres (PHCs).

Each cluster hospital would also house a Cluster Health Officer (CHO) who would coordinate and monitor the functioning of all PHCs and sub-centres within the cluster.

Apart from rationalising the service areas of all health institutions to ensure equitable geographical access to all citizens, it was planned to make every PHC function round-the-clock by the end of 2011. Each PHC would also be mobile with the medical officer visiting all sub-centres on a fixed day twice a month.

With the Primary Health Centres becoming almost non-functional, the new model would establish a direct link between the Primary Health Centres, sub-centre and the village, Mr. Ramesh added.

In a bid to provide a clear career path to every employee and ensure accountability across the operational spectrum, a Human Resources Directorate is proposed to be established.