NRHM - towards better Health Care Services

By - Khagendramani Pradhan,*Journalist

With a view to provide universal access to equitable, affordable and quality health care to the people together with bringing dramatic improvement in the health system and health status, National Rural Health Mission (NHRM) was launched by the Government as a flagship program. The mission has set a goal to facilitate increased access and utilization of quality health services by involving the Panchayati Raj institutions and community in management of primary health programmes and infrastructure. Besides, it also aims to develop a framework for promoting inter-sectoral convergence for promotive and preventive health care.
The objective of the mission is re-defined to reduction of child mortality along with controlling and prevention of communicable and non-communicable diseases, including locally endemic diseases. The mission further emphasizes on universal access to public services for food and nutrition, sanitation and hygiene with special focus on services addressing women and children’s health and immunization. Besides facilitating access to integrated comprehensive primary health care, it also focuses on promotion of healthy lifestyle.

A Case Study
To augment this mission in Sikkim, State Health Mission and State Health Society have been formed under the chairmanship of the Chief Minister and Health Minister respectively. Similarly four District Hospitals have been brought under the purview of District Collector and Zilla Adhyakshas. All the 24 primary health centres of the State have been registered as hospital management society under the chairmanship of Block Development Officers.
Under the mission, 452 Village Health Sanitation Committee has been formed under the panchayati raj institution and have been provided a sum of rupees ten thousand per committee to undertake village level health activities. Similarly, to generate awareness and to provide basic health care services even in the remotest of places, around 555 Accredited Social Health Activists (ASHA) have been appointed so far in equal number of villages of Sikkim by the Gram Panchayats who shall be working in close connection with the ANM and AWW in health related issues.
Considering the topography and the prevailing health scenario in the State, Mobile Medical Unit (MMU) scheme has been introduced under National Rural Health Mission to fulfill the void of rendering health services in difficult areas. The MMU ensures the availability of health care services to the people of remote areas which shall visit the localities in planned schedule. Apart from the four MMUs that have been operational in all the four district hospitals, providing all the 24 primary health centres with such mobile units is in the pipeline under NHRM, which is expected to be brought into service during the year 2008-09.
By the end of 2012, i.e the Mission Period, efforts are being made to equip all the 4 district hospital, 24 Primary Health Centres and 147 Primary Health Sub Centres to be upgraded to Indian Public Health Standards (IPHS) providing specialist, qualified staff and additional staff as per the norms along with required infrastructures, equipments and drugs in order to ensure universal access to equitable, affordable and quality health care to the people of Sikkim.
Major achievements in North Eastern States
 42051 ASHAs have been selected against the target of 44857.
 Rogi Kalyan Samities have been constituted in 55 Districts Hospitals, 161 CHCs & 1095 PHCs.
 8 new GNM Schools have been approved for assistance under NRHM.
 Funds to the tune of Rs. 1 crore each have been provided to 54 District Hospitals in the NE States. Strengthening of 5 district hospitals in Assam and Champai District Hospital in Mizoram have been approved as per requirements.
 State Hospitals viz. S.T.N.M. Hospital at Gangtok, Sikkim and State Civil Hospital at Aizawl, Mizoram are being assisted for upgradation. The State Civil Hospitals at Itanagar and Pasighat have also been assisted to the tune of Rs. 1 crore each.
 Of the 7643 Sub-Centres, 6003 are functional with Joint Accounts and 2488 have 2 ANMs in position.
 Of the 1109 PHCs, 793 have been made operational 24X7, 273 have Ayush MOs co-located in the PHCs and 245 have 3 Staff Nurses in position.
 Under Janani Suraksha Yojana Scheme the number of beneficiaries during 2005-06, 2006-07 & 2007-08 (Till October 07) were 23219, 217311 and 238000 respectively.
 All the states of northeastern region have achieved the goal of elimination of leprosy (i.e. Prevalence Rate of less then 1 case per 10,000 population).
 An amount of Rs 1026 Crore has been approved for the State PIPs of all the eight NE States for various activities under NRHM. During 2007-08.
 Upgradation of Gauhati Medical College, Guwahati Assam has been taken up.