chanana.ak@nic.in wrote:What should be done to reduce maternal & child mortality, morbidity and under nutrition in states with poor health & nutrition indicators?
[*]The Deptts. whose activities have close linkages with Family Welfare Programs like the WCD, RD, UDH & LSG, Labour, Industry and Agriculture may involve their extension workers in propagating IEC messages pertaining to reproductive and child health care to the population with whom they work.
[*]Opening of service centers/booths in the industrial areas to provide free family welfare services to industrial labor.
[*]Industries Deptt. should make necessary provisions for providing Family Weflare Services to the workers and their families with the help of Medical Deptt.
[*]Sectoral/sub-sectoral policies of various deptts. which deal with programs impinging upon factors contributing to the population stabilization may also be prepared.
[*]Districts/panchayats with very adverse indicators in respect of human development, which constrain the progress of family welfare program may be marked and area-specific strategies may be drawn up.
[*]In certain areas, inhabited by large number of tribal communities, it is not the growth of population which constitutes an issue of concern but the lack of their balanced growth which adversely affects stability of their population. A small Expert Group may be constituted to work out a comprehensive strategy for balanced growth of different tribal groups in such areas as a pre-condition for their population stabilization.
[*]Quality and coverage of family welfare services may be enhanced through undertaking area specific IEC activities to improve utilisation of services.
[*]Possibilities may also be explored for active participation of the community/religious, political and educational leaders in family welfare programs.
[*]Involvement of the industries, organized and unorganized sectors, agriculture workers and labour representatives may be ensured in the family welfare programs.
[*]Penetration into rural areas, urban slums, among vulnerable groups, and cover all areas of unmet need, with better quality and follow-up may also be improved.
[*]A comprehensive statement of the role of Panchayati Raj Institutions in the program of medium-term and long-term population stabilization may be drawn up.
[*]NFHS studies show that more than 50% deaths of infant deaths in India are during the neo-natal period (first 28 days). Since a large no. of these deaths take place at home, improving home based behaviours related to breast-feeding, oral rehydration and new-born temperature management can have a strong impact on child survival. For this purpose, the field female health workers may be directed to aware the mothers and to visit such homes atleast two times in that 28 days period.
[*]Finance Department may be requested to think about levied of additional tax on health injurious products like tobacco and liquor to meet the increased demands for public expenditure on health.
[*]Government may establish a heath care development fund. Contributions to this fund must be fully exempted from income tax.
[*]Public-private partnership will also result into tax benefits for healthcare players and hence can deliver the subsidized healthcare services to rural population. Some of government hospitals in rural areas may be corporatized on no loss - no profit basis.
[*]Significance of following success stories may also be explored for OTHER STATES ALSO: [*]The health and hygiene education programs need to be implemented at village levels. Bajaj Auto has adopted 38 villages in Maharashtra to offer them access to medical facilities at their doorstep. Its well-equipped mobile clinic offers medical tests, treatment and also counseling to the pregnant women and other basic ailments as well. In order to make the process more sustainable, it’s volunteers train women in the village to become health workers to spread the knowledge in the village of hygiene and family planning. The volunteers also provide first aid for minor illnesses like regular viral etc.
[*]Janani – Franchise Clinic Model : Janani is the NGO, which works in the most impoverished states Bihar, Jharkhand and MP. Janani uses combination of social marketing and franchise model to provide quality and low cost healthcare to the poor. Janani has set up various sustainable franchise-clinic models. Some of these clinics are owned by Janani and runs in partnership with doctors, while others are owned and run entirely by doctor-entrepreneurs. Janani has a premier network of rural medical practitioners (RMPs) that has some aspects of a franchise system. Two RMPs, selected from each panchayat (village council), receives a four-day training at a franchise center. On diagnosis front, Janani links franchised RMPs to a franchise of MD and MBBS doctors in urban areas. Janani also provide medicines at subsidized rates. It purchase government subsidized healthcare commodities in bulk for its franchisees. Janani further reduces costs by increasing the volume of patients utilizing its franchised services.
[*]Madilu Scheme: Parallel to JSY, Government of Karnataka is providing Medical Kit to the Pregnant Women encouraging them to go to Government Hospital for delivery under NRHM. This kit contains the necessary Carpet, bed-sheet, Thick Cover for Mother, rubber-sheet, towel, sanitary napkin, Bath Soap for Mother & Child, Washing Soap, Coconut oil, Diapers, Sweater, Cap and Socks for Child, Mosquito Net and other health related things for a period of three months after the delivery.
THESE ARE FROM ONE OF MY RESEARCH PAPERS. IF FIND SIGNIFICANT, PAPER MAY BE FORWARDED.
Dr. Neetish Sharma
Deputy Director (Monitoring),
Planning Department,
Government of Rajasthan, Jaipur
