(The Gist of Kurukshetra) HEALTHCARE INTERVENTIONS FOR RURAL INDIA [MARCH-2019]
(The Gist of Kurukshetra) HEALTHCARE
INTERVENTIONS FOR RURAL INDIA
Healthcare interventions for rural India
The National Health Policy (NHP) 2017 of India aimed to provide
Preventive and Promotive Healthcare and Universal access to good quality
healthcare services through the mix of public and private healthcare
services. The policy emphasizes reorienting and strengthening the Public
Health institutions across the country, so as to provide universal access to
free drugs, diagnostics and other essential healthcare. The NHP 2017
expressed its vision for Universal Health Coverage and creating affordable
and quality healthcare for all.
The policy is ensuring availability of free, comprehensive primary
healthcare services, for all aspects of reproductive, maternal, child and
adolescent health and for the most prevalent communicable, noncommunicable
and occupational diseases in the population. It also talked about
reinforcing trust in public healthcare system. The Government intended to
achieve various targets by involvement of all possible stakeholders.
Key Initiatives and Interventions Ayushman Bharat:
As part of Ayushman Bharat programme, two major initiatives in
health sector have been taken. First is Health and Wellness Centres and
second is the Notional Health Protection Scheme (NHPM). The goal of this
intervention is to address health needs in a holistic manner in primary,
secondary and tertiary care systems, covering both prevention and health
promotion. The National Health Policy 2017 has envisioned Health and
Wellness Centres as the foundation of India's health system. It is expected
that under this, 1.5 lakh centres will bring healthcare system closer to the
homes of people.
Also that these centres will provide comprehensive healthcare,
including for non-communicable diseases and maternal and child health
services, free essential drugs and diagnostic services. The Interim Budget
2019-20 has allocated Rs.1,200 crore for this flagship programme.
Contribution of private sector through Corporate Social responsibility (CSR)
and philanthropic institutions in adopting these centres is also envisaged.
The National Nutrition Mission: The National Nutrition Mission (NNM)
has been set up with a three year budget of Rs.9046.17 crore commencing from
2017-18. The NNM is a comprehensive approach towards raising nutrition level
in the country on a war footing. It is comprising mapping of various Schemes
contributing towards addressing malnutrition, including a very robust
convergence mechanism, ICT based Real Time Monitoring system, incentivizing
States/UTs for meeting the targets, incentivizing Anganwadi Workers (AWWs)
for using IT based tools, eliminating registers used by AWWs, introducing
measurement of height of children at the Anganwadi Centres (AWCs), Social
Audits, setting-up Nutrition Resource Centres, involving masses through Jan
Andolan for their participation on nutrition through various activities,
NNM targets to reduce stunting, undernutrition, Anaemia (among
young children, women and adolescent girls) and reduce low birth weight by 2
per cent, 2 percent, 3 per cent and 2 per cent per
annum respectively. Although the target to reduce Stunting is at least 2 per
cent p.a., All About UPSC Exams Mission would strive to achieve
reduction in Stunting from 38.4 per cent (NFHS-4) to 25 per cent by 2022
(Mission 25 by 2022).
All the States and districts will be covered in a phased manner
i.e, 315 districts in 2017-18, 235 districts in 2018-19 and remaining
districts in 2019-20.
This is based on convergence and collaboration of all important
sectors considered to be important for healthy growth of the child for first
1,000 days. Thus, it covers all schemes, Beti Bachao Beti Padhao, Swachh
Bharat, Adolescent Care, Prenatal and Postnatal Care, Supplementary
Nutrition, Breastfeeding Counseling, Immunization, Growth Monitoring. Under
Poshan Abhiyan, the Government has fixed targets to reduce stunting,
undernutrition, Anaemia (among young children, women and adolescent girls)
and reduce low birth weight by 2 per cent, 2 percent, 3 per cent and 2 per
cent per annum respectively.
Mission also strives to achieve reduction in Stunting from 38.4
per cent (NFHS-4) to 25 per cent by 2022, Outreach worker or frontline
worker will cover all the aspects of essential healthcare for the mother and
child. Accredited Social Health Activist (ASHA) and Anganwadi Worker (AWW)
are supposed to work in collaboration to improve the institutional visits,
nutrition outcomes, physical and mental growth of the child through home
visits to create awareness for proper utilisation of all the facilities and
benefits provided under this scheme.\
Pradhan Mantri Matru Vandana Yojana:
The Maternity Benefit Programme is implemented from 01.01.2017, in
all the districts of the country. The programme is named as 'Pradhan Mantri
Matru Vandana Yojana' (PMMVY). Under PMMVY, a cash incentive of Rs 5,000/-
is provided directly to the Bank / Post Office Account of Pregnant Women and
Lactating Mothers (PW&LM) for first living child of the family subject to
fulfilling specific conditions relating to Maternal and Child Health.
PMMVY is implemented using the platform of Anganwadi Services
scheme of Umbrella Integrated Child Development Services (ICDS) under
Ministry of Women and Child Development in respect of States/UTs
implementing scheme through Women and Child Development Department/ Social
Welfare Department and through Health system in respect of States/ UTs where
scheme is implemented by Health and Family Welfare Department. PMMVY is
implemented through a centrally deployed Web Based MIS Software application
and the focal point of implementation would be the Anganwadi Centre (AWC)
and ASHA/ANM workers. In the Interim Budget (2019-20), the key highlights
related to health sector provisioning especially for women, children and
poor are as follows:
World's largest healthcare programme, Ayushman Bharat, for nearly
50 crore people.
Jan Aushadhi Kendras providing medicines at affordable prices to
poor and middle class.
Allocation for Integrated Child Development Scheme (ICDS)
increased by over 18 per cent to Rs. 27,584 crore in BE 2019-20.
Maternity leave extended to 26 weeks.
Financial support for pregnant women under Pradhan Mantri Matru
6 crore free LPG gas connections provided under Ujjwala Yojana ;
Ail 8 crore by next year.
India has achieved 98 per cent rural sanitation coverage and 5.45 lakh
villages have been declared "Open Defecation Free".
Aspirational Districts Programme launched for development in 115
most backward districts.
Rs. 1,70,000 crore spent during 2018-19 for cheaper food grains to
poor and middle class.
70 percent of MUDRA Loan availed by Women.
Rural roads' construction tripled under the PMGSY.
Targeted expenditure to bridge urban-rural divide and to improve
quality of life in villages.
The Rural India is exposed to challenges that are having direct
impact on health of women and children living in this area. Focus on primary
healthcare through outreach activity household coverage, availability of
quality public healthcare services and appropriate financial support for
secondary and tertiary care with more accountable and transparent system is
The strengthening of primary healthcare system is required in
order to address the factors that have direct impact on health status of
rural population. The expansion of Public Health Education to create more
professionals is required, as many programme and schemes required skilled
personnel with sound knowledge of socio-economic and cultural aspects of
health and medicine.
To assess the standards of public health services, government
developed Indian Public Health Standards (IPHS) and all the healthcare
facility should be monitored and regulated according to these standards.