The Hindu
05 September 2007
Bangalore, India

Launched in 2005, the National Rural Health Mission (NRHM) had an ambitious vision: To boost health care for rural population with special focus on 18 States that had weak public health indicators and poor health infrastructure. But in Karnataka, a State without an impressive rural health care system, the Mission is yet to gather steam.

A dissemination session on the Mission, organised here on Tuesday by the Jan Swasthya Abhiyan (JSA) – the Indian chapter of the People’s Health Movement–was intended to make a difference to this scenario by first creating awareness about NRHM, its goals and progress in Karnataka and outside. “Nobody even knows about NRHM here,” observed JSA’s Thelma Narayan, who then went on to offer a ringside view of the project.

Target
Beyond Karnataka, NRHM had originally targeted the states of Arunachal Pradesh, Assam, Bihar, Chhattisgarh, Himachal Pradesh, Jharkhand, Jammu & Kashmir, Manipur, Mizoram, Meghalaya, Madhya Pradesh, Nagaland, Orissa, Rajasthan, Sikkim, Tripura, Uttaranchal and Uttar Pradesh. The Mission was an articulation of the Centre’s commitment to increase public spending on health from 0.9 per cent of the GDP to 2–3 per cent.

Ms. Narayan said the Mission required the training of seven lakh personnel to be social health activists. “Andhra Pradesh today has 51,000 trained activists, but here in Karnataka, we have not even started.”

Stressing on the need for a critical group of people knowledgeable about the Mission, she cited the Peoples’ Rural Health Watch groups set up by the Jan Swasthya Abhiyan in eight States. These groups monitored the Mission progress and filed reports accessible on the internet. She wanted similar groups to take root in Karnataka.

As Dr. Devadasan from the Institute of Public Health said the Mission was introduced in the State only last year. “The funds started flowing only now,” he said.

The Mission had as its goals reduction in Infant Mortality Rate (IMR) and Maternal Mortality Rate (MMR) by 50 per cent, and prevention and control of Communicable and Non Communicable Diseases. But the concerned departments often worked in isolation. There was very little coordination, observed Dr. Devadasan.

Strengthening of the public health centres to ensure round–the–clock services, regular supply of essential drugs were also key elements of the Mission plan. Funding was decentralised, with the district as the core unit of planning, budgeting and implementation.