Government’s flagship health mission fails on doctor shortage

By Rajeev Ranjan Roy, IANS,

New Delhi : The multi-billion-dollar National Rural Health Mission (NRHM) was launched three years ago, but India’s 650,000 villages continue to face a shortage of doctors and paramedics, says the Planning Commission.


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“There is still a yawning gap between the requirement and availability of human resources in the rural health units at various levels,” says an assessment report of the plan panel.

As of December 2007, for example, only 5,910 specialist doctors were available at community health centres across the country, against the requirement for 21,490, the report said.

“Though there is an improvement over the 3,550 specialists that these community health centres had prior to the launch of NRHM, the pace of implementation needs to be accelerated,” a senior official in the plan panel told IANS.

The plan panel will shortly review the flagship rural health scheme, which was launched April 12, 2005, to provide effective healthcare facilities to the rural population.

The union health and family welfare ministry, the nodal agency for NRHM, has earmarked over Rs.120 billion for the mission in the current fiscal.

The country’s primary health centres (PHCs) are also understaffed. The plan panel says there were 31,381 doctors at these centres by the end of December 2007 as against 20,308 doctors engaged there before the flagship scheme was launched.

“There is a need to accelerate the process of appointment of doctors and nurses at a greater pace. Against the requirement of 66,059 nurses and midwives for the health centres, only 41,313 appointments have been made as against 29,139 such nurses already on the rolls,” said the official.

As per details with the plan panel, 159,181 auxiliary nurse midwives (ANMs) have been appointed under the mission for sub-centres in rural areas against the need of 197,488. There were 133,194 ANMs when the NRHM was launched.

The health mission puts special emphasis on 18 states with weak public health indicators and infrastructure. Some of them are Arunachal Pradesh, Assam, Bihar, Chhattisgarh, Himachal Pradesh, Jharkhand, Manipur, Mizoram, Meghalaya, Madhya Pradesh, Nagaland, Orissa, Rajasthan, Sikkim, Tripura and Uttar Pradesh.

However, health and family welfare ministry officials are satisfied with the progress made under the NRHM so far.

“The appointment of human resources in the category of doctors and other paramedical staffs has been quite satisfactory. The gap as shown by the Planning Commission is being met. By the time the latest feedback arrives for the ministry, there will be no such mismatch,” said an official, requesting anonymity.

Some of the key goals of the mission are reducing infant mortality rate to 30 per 1,000 live births and maternal mortality rate to 100 per 100,000 against 450 per 100,000 live births by 2012 through promoting institutional delivery in the countryside.

An official estimate says half of India’s women still deliver babies at home and accounts for the world’s 20 percent child mortality. The mission has several projects – Janani Suraksha Yojana (save the mother project) and accredited social health activists (ASHAs) – to promote safe delivery and newborn safety.

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