Committed officers are making a difference at the grassroots level. But experts feel the government is chasing quantity, not quality, says GYANENDRA KASHYAP
After more than two and half years of the launch of the National
Rural Health Mission (NRHM) to provide accessible, affordable and accountable health services to the poor, the programme is plagued with problems. As I traversed 530 kms to Himachal Pradesh, stopping at various places like Nagrota Bagwan and Gopalpur, I realised that the UPA government’s commitment to hike public spending on health to 2-3% of GDP is hogwash. And the objective of ‘Health For All’ is a distant dream.
But first let me focus on the good news. The drizzle that morning had further dipped the temperatures, but that had not deterred the First Referral Unit (FRU) staff to come on time. As I entered the room of A.R. Raghu (Block Medical Officer, Nagrota Bagwan), what caught my attention was the photographs of national heroes. Before I could quiz him on them, pat came his reply, “I draw my inspiration from them.” As we settled down, Raghu explained how adequate funds and attempts to make the local community a partner in achieving the health goals was the real innovation of the scheme.
At the local level, Raghu said that there had been a major turnaround in the past 6-7 months. The reason, according to him, was that “in the first 11 months or so I was humiliated, and had no administrative powers. But thanks to J. S. Chandel (chief medical officer), who played a pivotal role, things have changed. Had you come a few months ago, you would have been able to see the changes for yourself.” Take the case of the availability of funds. “There is no scarcity of funds; all that we need to do is to spend the amount judiciously,” says a confident J.S. Chandel,. Quite true, as a sum of Rs.53.36 crore was received under NRHM in 2005-06; of this, the state spent Rs.34.54 crore. In the current year, the grants-in-aid released for NRHM up to November 2007 was Rs.18.84 crore. At the national level, Rs.4,75,000 crore was allocated under the Family and Welfare Camp in 2007-08, of which Rs.2,98,000 has been utilised.
Getting into specifics, Chandel revealed that the number of girl children per 1,000 male children went up from 815 in 2006 to 846 in the next year. Similarly, the number of OPDs has more than doubled from 6,051 in the first quarter of 2006 to 12,212 in the same period in 2007. To reduce costs in the future, the administrators are deliberately working on the concept of quality circles; they take suggestions by staff and patients, and necessary actions are taken accordingly. “The awareness of the scheme is slowly catching up,” says Chandel.
I saw evidence of this in Gopalpur, where a board with names of 204 medicines available under the scheme was hung publicly. In the area, the blindness control programme was in full swing. Ansali Devi, a patient, had no attendant, and the CMO ordered for necessary arrangements to be made so that she could get her eyes operated. Neeru Ram, an asthma patient, agreed that he gets free medicine from the unit at Gopalpur. Kamala Devi, another patient, was a bit skeptical: “Aaj to muft mein diya hai, kal bhi denge to yaakin ho jayega (Today, I have got free medicines, if I get them tomorrow, I will believe it).”
Added Munsi Ram, “Pehle bahut mushkil tha, buri halat thi. Dawai bahar se kharidna hota tha. Ab to yahin se mil jaata hai (Earlier, it was difficult and the situation was bad. One had to buy medicines from the market. Now, I get it here).” Roshan Khanna, a local contractor in Nagrota, said: “Prayaas aur Niyat dono hi hain. Alochana ke saath saath sarahna bhi milta hai (There are both efforts and intentions. Along with criticism, the scheme is praised too).”
However, this is just one part of the story. The second one relates to tardy implementation, lack of specialists, and inadequate reach. It’s only those who get free medicines and care who benefit. But there are millions who still have no access to the services. For instance, the number of institutional child deliveries has come down from 0.52 lakh in 2005-06 to 0.49 lakh in the next year. Just over 45% of the children are born in hospitals. Most women prefer to deliver at homes.
For Complete IIPM Article, Click on IIPM Article
Source : IIPM Editorial, 2008
After more than two and half years of the launch of the National
Rural Health Mission (NRHM) to provide accessible, affordable and accountable health services to the poor, the programme is plagued with problems. As I traversed 530 kms to Himachal Pradesh, stopping at various places like Nagrota Bagwan and Gopalpur, I realised that the UPA government’s commitment to hike public spending on health to 2-3% of GDP is hogwash. And the objective of ‘Health For All’ is a distant dream.But first let me focus on the good news. The drizzle that morning had further dipped the temperatures, but that had not deterred the First Referral Unit (FRU) staff to come on time. As I entered the room of A.R. Raghu (Block Medical Officer, Nagrota Bagwan), what caught my attention was the photographs of national heroes. Before I could quiz him on them, pat came his reply, “I draw my inspiration from them.” As we settled down, Raghu explained how adequate funds and attempts to make the local community a partner in achieving the health goals was the real innovation of the scheme.
At the local level, Raghu said that there had been a major turnaround in the past 6-7 months. The reason, according to him, was that “in the first 11 months or so I was humiliated, and had no administrative powers. But thanks to J. S. Chandel (chief medical officer), who played a pivotal role, things have changed. Had you come a few months ago, you would have been able to see the changes for yourself.” Take the case of the availability of funds. “There is no scarcity of funds; all that we need to do is to spend the amount judiciously,” says a confident J.S. Chandel,. Quite true, as a sum of Rs.53.36 crore was received under NRHM in 2005-06; of this, the state spent Rs.34.54 crore. In the current year, the grants-in-aid released for NRHM up to November 2007 was Rs.18.84 crore. At the national level, Rs.4,75,000 crore was allocated under the Family and Welfare Camp in 2007-08, of which Rs.2,98,000 has been utilised.
Getting into specifics, Chandel revealed that the number of girl children per 1,000 male children went up from 815 in 2006 to 846 in the next year. Similarly, the number of OPDs has more than doubled from 6,051 in the first quarter of 2006 to 12,212 in the same period in 2007. To reduce costs in the future, the administrators are deliberately working on the concept of quality circles; they take suggestions by staff and patients, and necessary actions are taken accordingly. “The awareness of the scheme is slowly catching up,” says Chandel.
I saw evidence of this in Gopalpur, where a board with names of 204 medicines available under the scheme was hung publicly. In the area, the blindness control programme was in full swing. Ansali Devi, a patient, had no attendant, and the CMO ordered for necessary arrangements to be made so that she could get her eyes operated. Neeru Ram, an asthma patient, agreed that he gets free medicine from the unit at Gopalpur. Kamala Devi, another patient, was a bit skeptical: “Aaj to muft mein diya hai, kal bhi denge to yaakin ho jayega (Today, I have got free medicines, if I get them tomorrow, I will believe it).”
Added Munsi Ram, “Pehle bahut mushkil tha, buri halat thi. Dawai bahar se kharidna hota tha. Ab to yahin se mil jaata hai (Earlier, it was difficult and the situation was bad. One had to buy medicines from the market. Now, I get it here).” Roshan Khanna, a local contractor in Nagrota, said: “Prayaas aur Niyat dono hi hain. Alochana ke saath saath sarahna bhi milta hai (There are both efforts and intentions. Along with criticism, the scheme is praised too).”
However, this is just one part of the story. The second one relates to tardy implementation, lack of specialists, and inadequate reach. It’s only those who get free medicines and care who benefit. But there are millions who still have no access to the services. For instance, the number of institutional child deliveries has come down from 0.52 lakh in 2005-06 to 0.49 lakh in the next year. Just over 45% of the children are born in hospitals. Most women prefer to deliver at homes.
For Complete IIPM Article, Click on IIPM Article
Source : IIPM Editorial, 2008
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dally any further, the deal might just melt down forever – the toughest language the US envoy has used so far. This predictably had the Left hopping mad. For even though it shares power with the Congress in the UPA led by it, the Communists have throughout made the deal the centrepiece of their conditional partnership. Mulford’s warning was met with jeers in the Left ranks, which unanimously condemned the US “armtwisting”. Did the Americans consider India, a sovereign nation or not, was what CPI MP D. Raja, who started the debate, wanted to know. He smelt “intimidation” in the ambassador’s “ultimatum”. Uncle Sam ought to know that India had the capability of developing its own nuclear technology, and had been looking for alternative sources like uranium & thorium. According to Raja, the US was only looking for business opportunities in the guise of offering nuke empowerment. This was sheer blackmail, Raja said.
as already approved, subject only to increases or decreases in the financial resources allocated. The organisation’s historical costs are the base from which budget planning starts. The focus of budgeting process is on the changes anticipated in the last year’s figures. If the government is in a fairly stable environment, this approach may be satisfactory, provided there is a thorough review.
multi-billion dollar business opportunity lies ahead for the global players if they get to bag the deal from Indian airline companies. Now India is obviously at an advantageous position as it can use this opportunity to negotiate other economic and political issues with the countries. “India needs to negotiate issues like transference of basic assembly work & technology. It is time for the country to become partner in aircraft manufacturing, and not remain a customer,” emphasized aviation expert Brij Bharadwaj. Moreover, the presence of Brazilian major, Embraer, Canada’s Bombardier, Russian Sukhoi & French ATR, to name a few, has explored options in India and the country is not merely confined to buying it from the US or EADS. Therefore, India would be in a position where it can seek for something extra in return of this sort of mammoth business deal. It could be anything ranging from asking the companies to set up MRO facilities to investing in infrastructure, providing support-staff, getting planes at a discounted price or any other form of support system. 
been going on for long. But it was not until 1990s when outsourcing has come more into limelight. Traditionally West had always been considered as developed and the largest outsourcing market. But the paradox is that even within developed world, surprisingly the wealthiest continent, Europe, has really not been successful in becoming a major outsourcing market the way the US has become and take full advantage of this booming industry. Europe remained more like a primitive market.
“kid” ahead of the Nevada Caucus. His wife & Democratic contender for presidential nomination, Hillary Clinton, said that electing Obama would tantamount to electing “another Bush” to the White House. On the eve of the Caucus, the Hillary camp complained that their supporters in the state’s unions were threatened by the union leaders, who backed Obama. The Obama backers hit back saying they received many telephone calls, which made continuous references to “Barack Hussein Obama.” Nevada saw it all. Still, Obama, the charismatic Illinois Senator who changed the entire arithmetic of Democratic contest, could not defeat the former first lady in Nevada.
to face the hunter’s fire,” aptly defines the problems that most of poor African and Asian countries encounter. And if the World Bank floods these poor economies with aids, they will remain poor in the next century. The world has to realise that poverty, health, money are not problems of Africa. It is their failure to realise their own role to come out from the anarchy and shame. Aids, donations and sympathy from the developed world have never helped them; these have in fact, made them more dependent to godfathers, colonisers and aid giving countries.
worldwide sales for 2007, Ghosn has reasons to be concerned. His most popular turnaround Nissan would be bracing for a tough 2008, with the US economic slowdown looming. The company’s sales for the European region for calendar year 2007 also dipped by an alarming 4.1%. Investors have been looking bearishly at the Renault stock as well, which was trading at €84.55 on January 8, 2008, as compared to its 52-week high of €122.47. Predictably, Ghosn has stepped up his activities in emerging markets, his latest focus being Russia. Renault is inking a deal in February 2008 to take up 25% of ailing Russian car maker AvtoVAZ (with 70% of domestic car making), which has been continuously losing market share to foreign brands (its market share currently stands at 30% compared to over 50% in 2000) and has also been lurching in the dark for a bail out. The value is estimated $1.3 billion. GM & Ford were also in the fray.