By Naba Kishor Pujari
This Article summarises how rural health needs a correctional intervention to see a better prospect in rural health in Orissa. It is based on the examination of NFHS-3 data and has compared the level of response in the health sector in Orissa
‘GOOD HEALTH for All’ has been targeted as the mantra by the World Health Organisation (WHO). In this context, the Finance Minister of India, P Chidambaram has clearly stated in his fiscal budget presentation that “Health, in our government, has never been a soft sector; as it gives birth to a sound and progressive society at large.” Here, the discussion allows much significance because four out of the eight UN Millennium Development Goals are health related and particularly from the perspective of developing countries. They aim at targeting the most marginal healthcare recipients. These are:
- Reduction of child mortality.
- Improvement of maternal health.
- Combating HIV / AIDS, malaria and other diseases.
- Ensuring environmental sustainability.
WHO, in its current report, indicates that Maternal Mortality Rate (MMR) has become a global headache as it remains unacceptably high across much of the developing world. Now it has bid a challenge for us to embark on the pledge of the UN Millennium Development Goals (MDG). India, as a member country in this global declaration, has started its fight against the global disaster but to mount it, the contribution of its states is crucial. Orissa, as one of the backward states in the socio-economic and healthcare profile, must strive to help the country to reach the objective of the declaration.
The trend data of the National Family Health Survey (NFHS-3) report declares that MMR in our country remains 301 (per lakh population), whereas it is 358 in Orissa. The National Infant Mortality rate has been 57 (per 1000 births), whereas the rate in Orissa is 65. It is therefore pertinent to say that infant and MMR reduction has been given utmost priority in MDGs. For the same, the stand of Orissa is significant. So its persistence can be a blockade towards the global undertakings.
Institutional delivery ie birth of a child in a recognised healthcare institution, primarily in a hospital, has been a serious concern everywhere in the country as it is a major health indicator for women. In India, approximately 41 per cent women give birth to their child in a recognised healthcare institution. In the state of Orissa, the number of women with access to healthcare institutions is only 39 per cent. Institutional delivery rate in Andhra Pradesh, West Bengal and Tamil Nadu, is 61, 48 and 90 per cent respectively, whereas in Kerala, it is the highest – 100 per cent.
Basically, the inaccessible or socio-economically disadvantaged communities have not been included in the major welfare schemes of the government yet. However, in this context, initiatives of National Rural Health Mission (NRHM) to provide effective and immediate primary healthcare services in rural area are a welcome step.
As per the available statistics, the situation regarding water supply and sanitation in Orissa is also not good. Out of the 1,36,339 identified habitations (as per the 1994 survey), 12,272 habitations have not been covered so far as the provision of drinking water is concerned. However, in the covered area also, the water is not hygienic enough. The NSSO data shows that 89 per cent of the households in rural Orissa do not have access to toilets despite the fact that the Total Sanitation Campaign (TSC) has begun.
At present, in Orissa, rural healthcare services are provided through the network of 1,42,655 sub-centres, 23,109 PHCs and 3,222 CHCs. Around 24,000 medical students pass out from the medical colleges but it is untoward that there are vacancies of 700 doctors in primary health centres. In most of the community healthcare centres, there is a shortage of surgeons, gynaecologists, physicians and paediatricians, which is against the policy and implementation of the state government.
However, the initiatives of NRHM, for providing doorstep healthcare facilities to the rural households by bringing an architectural correction in the current healthcare delivery practices, are plausible. In this context, we need a grass root level reinforcement of public health infrastructure or increased number of employees by providing strategic capacity enhancement of public health programmes to capacitate the existing healthcare systems and delivery practices.
Grossly speaking, healthcare delivery mechanism and the system as a whole have been sluggish in Orissa in comparison to the national standard. Its efficacy and transparency in supplying improved healthcare delivery has gone down. However, there should be a careful attempt towards attainment of the demand of the people and towards reaching of the global promise. Significantly, ground level health professionals and practitioners are to be trained accurately, and health delivery should arrive at tribal areas and non-communicable places, so as to poise the increased rate of various health indicators.
Source: http://www.merinews.com/article/rural-health-in-orissa---an-appraisal/15766688.shtml