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Times of India
30 July 2010
Lucknow, India

Uttar Pradesh has another reason to hang its head in shame. In the latest survey report released by the ministry of health, under the National Rural Health Mission, UP has been ranked the lowest among all states, with a shortfall of over 5,800 rural healthcare centres.

According to the data, while states like Rajasthan, Chhattisgarh, Gujarat and Jammu and Kashmir have bettered their performances in the rural health sector – the states now have surplus primary and community health centres. Like UP, others states like Maharashtra, Bihar and Jharkhand have also performed dismally in the nationwide survey.

Primary health centres are established and maintained by the state governments under the minimum needs programme and basic minimum services programme. In UP, senior government officials say, a huge gap exists between the demand for PHCs and their availability. Former director general health and family welfare, UP, IS Srivastava, said: “UP has a huge shortfall of paramedics, doctors and basic health workers. The state government tries to bridge the gaps but it is a slow process.”

Interestingly, in Uttar Pradesh, the number of PHCs has been established according to 1991 census data. With a gap of over 20 years since the data was compiled, the norms prescribed have become redundant, and have thus, affected primary health services in rural areas. A senior UP health directorate official said: “The concerns of the sector have been voiced in Planning Commission meetings on several occasions. If UP has to better its infrastructure, the permissions have to come from the Union government.” According to existing norms, primary health centres act as referral units for six sub centres and are equipped with four to six beds for patients.

India has a total of 4504 PHCs and 20,534 sub-centres. While norms prescribe that 14 paramedical and other staff support one medical officer in a primary health centre, in UP, the figures are below the set numbers. The NRHM was launched in 2005 with an aim to provide accessible affordable and accountable quality health services even to the poorest households in the remotest rural regions.

After a preliminary assessment, the difficult areas with unsatisfactory health indicators were classified as special focus states – a total of 18 across the country – to ensure greatest attention where needed. Under the mission, the thrust was on establishing fully functional, community owned and decentralised health delivery systems to ensure simultaneous action on a wide range of determinants of health like water, sanitation, education, nutrition and social and gender equality.

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