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Giving a broad overview of the various ongoing activities
in the health arena at the 8th Editor’s Conference on Social Sector
Issues organized by the Press Information Bureau, the Union Minister for Health
& Family Welfare, Dr. Anbumani Ramadoss said that the National Rural Health
Mission (NRHM) has set a new standards of partnerships with States where it is
the States that determine what is needed to resolve the crisis of the public sector
health system. The mission has delivered
on every front and across social segments. The
impact has been felt across States in the form of improved healthcare and greater
access to healthcare. The following are the highlights of various activities
referred to by the Minister in his speech: Healthcare is one of the seven thrust areas under the
National Common Minimum Programme (NCMP). The special emphasis given to the Health
Sector in the NCMP has been very clearly reflected in terms of financial allocations
made since 2005-06. The NCMP has inter-alia
focused on increased public spending on health to atleast 2-3% of GDP over the
next 5 years with focus on primary healthcare. Accordingly, a National Rural Health Mission
(NRHM) has been launched in April, 2005 to effect an architectural correction
in the healthcare delivery system with the convergence of six Programmes including
four disease Control Programmes namely National Vector Borne Disease Control Programme,
Revised National TB Control Programme, National Leprosy Eradication Programme,
National Programme for Control of Blindness; besides Iodine Deficiency Disorders
Control Programme and Integrated Disease surveillance Project. Reaching quality healthcare to every household is a
daunting challenge in a country of over a billion people living in cities, towns,
villages and hamlets. The NRHM is a serious effort to address this challenge.
The Mission has made significant progress, especially after the approval of the
detailed framework for implementation of NRHM by the Union Cabinet in July 2006.
In partnership with States and through state led innovations, NRHM is rapidly
expanding accessible, affordable and accountable quality care for every household
in the country. NRHM has set a new standard of partnerships with States
where it is the States that determine what is needed to resolve the crisis of
the public sector health system. The philosophy of NRHM is to move from distrust
to trust, and the program is about partnerships and service provision. NRHM has
made available human resources, physical infrastructure, equipment, capacity building,
resources, skill and upgradation resources on an unprecedented scale. Over the
last 3 years the Mission is being implemented with meticulous planning, transforming
the nation’s healthcare system. This has resulted in a paradigm shift in the
delivery of healthcare, especially in the rural areas. Healthcare for the rural masses now has a new
meaning, with the structure based on four pillars – access, affordability, equality
and quality. NRHM has delivered on every
front, and across social segments. The impact has been felt across States in the form of improved healthcare
and greater access to healthcare. National Vector
Borne Disease Control Programme (NVBDCP) - Vector Borne
Diseases start off as innocuous, caused
by a mosquito bite, but when not treated in time, turns fatal. The Ministry has spared no effort to curtail
vector borne diseases such as Dengue, Chikungunya, Malaria and Japanese Encephalitis
and has launched the NVBDCP in this direction. Revised National
TB Control Programme (RNTCP) – The Revised National TB Control Programme has been launched to contain the spread of Tuberculosis in the country.
Under it, the Directly Observed Treatment Short Course (DOTS)
strategy was launched in the country in May 1997. The goal of the RNTCP is to decrease mortality
and morbidity due to TB and cut transmission of infection until TB ceases to be
a major public health problem in India. The results are quite visible. National Leprosy
Eradication Programme (NLEP) – Leprosy has affected humanity since 600 BC and existed
in the civilizations of ancient China, Egypt & India. The age-old social stigma
associated with the advanced from the leprosy lingers in many areas, and remains
a major obstacle to self-reporting and early treatment. The Government of India has undertaken the
National Leprosy Eradication Programme by training not only to improve the care
available to the affected through Multi Drug Treatment but also to remove the
stigma attached with the disease. In 2005
Leprosy has been eliminated as a public health problem at national level. National Programme
for Control of Blindness (NPCB) – The Plan of Action to implement National Programme for Control of Blindness
during the 10th Plan has been prepared in line with Global Initiative
“Vision 2020: The Right to Sigh” . Revised
Scheme focuses on development of comprehensive eye care services targeting common
blinding disorders including cataract, refractive error, glaucoma, diabetic retinopathy
and Corneal Blindness. School health programme is also being taken up under the Programme.
National Iodine
Deficiency Disorder Control Programme (NIDDCP) - In India there are more than 500 million people suffering from
Iodine deficiency, 54 million from goiter, and two million from cretinism. It
is Iodine Deficiency that causes goiter as well as cretinism, which retards physical
and mental development and causes other health problems. The Government has put a complete ban on non-iodised
salt for direct human consumption in the entire country under the Prevention of
Food Adulteration Act from May 2006, in order to prevent and control IDD. To spread awareness among people to consume iodized
salt only, a film of 10 minutes duration on consequences of nutritional iodine
deficiency disorders and benefits of consumption of iodized salt has been distributed
to all States/UTs. Integrated
Disease Surveillance Project (IDSP) - The Ministry of Health & Family Welfare
has launched the IDSP in 2004 to provide
dedicated positions at State and District level for disease surveillance activities.
It is a decentralized, State based Surveillance Programme in the country. It is intended to detect early warning signals
of impending outbreaks and help initiate an effective response in a timely manner.
Total Budget for the project from 2004-09 is Rs. 408.36 Crores.
This programme is carried out in collaboration with NRHM, NVBDCP and the
National Informatic Centre (NIC). Under
the scheme contractual position of one Epidemiologist, one Microbiologist and
one Entomologist at each State/District headquarters
are proposed to be provided in addition to six Field Investigators in each District.
Baseline survey has been completed for District Laboratories of Phase I
& II and Procurement Plan for Laboratory equipments has been prepared. The Pradhan Mantri Swasthya Suraksha Yojana (PMSSY)
has been initiated with the objective
of correcting regional imbalance in the availability of affordable/reliable tertiary
healthcare services and also to augment facilities for quality medical education
in the country. The PMSSY has been initiated with the objective of correcting
regional imbalance in the availability of affordable/reliable tertiary healthcare
services and also to augment facilities for quality medical education in the country.
Under the PMSSY, it has been decided to set up 6 AIIMS-like institutions, one
each in the States of Bihar (Patna), Chattisgarh (Raipur), Madhya Pradesh (Bhopal),
Orissa (Bhubaneshwar), Rajasthan (Jodhpur) and Uttarakhand (Rishikesh). Under
the scheme, 13 existing medical institutions spread over 10 states are being upgraded.
Follow up action is being taken on all the projects under the scheme. Avian Influenza Avian Influenza has appeared in different
parts of the country in the past years and that was contained immediately.
International Partnership Conference on Avian Influenza was inaugurated
in New Delhi in December 2007 by the Hon’ble Prime Minister in which vision and
roadmap on the concept of one world and one health for pandemic preparedness and
human security was adopted. In the current crises in West Bengal the Ministry
has undertaken several steps to prevent the spread of the diseases.
Enhanced surveillance, monitoring, IEC and preparedness of health facilities
to address problems are some of the issues being addressed. National Cancer
Control Programme (NCCP) – It is estimated
that at any given point of time there are 20-25 lakh cancer patients in the country
and every year about 7 lakh new cases come up. It is estimated that 50% of the cancer cases
can be cured if detected early. The National
Cancer Control Programme being implemented by the Govt. of India focuses both
on providing treatment facilities and early detection. Under the programme more and more Regional
Cancer Centres (RCC) are being recognized and geographical gaps in the availability
of cancer treatment facilities are being filled up in the country. Side by side early detection and IEC activities
are also taken up. Polio Eradication
Programme - India has made impressive
progress towards polio eradication by implementing polio eradication strategies
on a scale and intensity that is unprecedented in the history of eradication.
Of the 35 states and UTs, 33 have stopped indigenous transmission. Only UP and
Bihar remain endemic for polio in the country. In both these states there has
been an intensification of the programme by increasing the frequency of polio
immunization campaigns during 2007. In line with the recommendations of the India
Expert Advisory Group (IEAG) on Polio, monovalent oral polio vaccines (mOPV1 and
mOPV3) are being used in endemic areas of UP and Bihar. The strategy is to sequentially
target polio type 1 first while keeping the polio type 3 suppressed. National AIDS
Control Progamme (NACO) – HIV/AIDS
being an important health problem, the Ministry of Health & Family Welfare
has been implementing the National AIDS Control Programme (NACP). Based on the estimated prevalence rate of 0.36%
it is presumed that there are 2 to 3 million HIV infected persons in the country.
The programme components includes setting
up of integrated counselling and testing centres, prevention of parent to child
transmission, and sexually transmitted infections; care and support through Anti
Retroviral Treatment (ART), national paediatric initiatives meant for children
affected by HIV. In order to reiterate the Government’s multisectoral
response to prevent the spread of HIV and to facilitate a strong multi-sectoral
response to combat it effectively, a National Council on AIDS (NCA) has been constituted,
under chairmanship of Hon’ble Prime Minister with representation of 33 ministries
and departments. Private sector, civil society organizations, PLHA networks and
government departments would all play crucial role in prevention, care, support,
treatment and service delivery. PNDT Act - In order to check female infanticide, the Pre-Natal
Diagnostic Techniques (Regulation and Prevention of Misuse) Act 1994 has been
amended to make it more comprehensive. It has been renamed as ‘Pre-Conception
and Natal Diagnostic Techniques (Prohibition of Sex Selection) Act’. Punishment
under the Act has been made stricter to discourage people from violating the Act. Trauma Care
Programme - With a view to provide immediate treatment
to the victims of road accident, the Ministry of Health & Family Welfare has
been emergency trauma care facilities in State Government Hospitals located on
National Highways under the Scheme-“Assistance for Capacity Building”, under which
financial assistance was provided upto a maximum of Rs. 150 lakhs per hospitals
or actual requirement of the hospital, whichever was less, during the Xth Plan.
However, during the XIth Five Year Plan, a revised new
scheme at a total outlay of Rs. 732.75 crores has been approved for developing
a network of Taruma Centres along the Golden Quadrilateral, North-South and East-West
corridors of the National Highways, keeping in view the fact that instead of random
selection of hospitals as had been done in the past, the scheme should focus on
development of a network of trauma care facilities along the selected corridors
of National Highways and also to bring down the morbidity and mortality on account
of accidental trauma in India.
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The Impact of NRHM has been felt across states in the form of improved healthcare and greater access to healthcare: Dr. Ramadoss
