Raghu argues that if the grandoise health scheme has to meet its objective of reaching out to 5,70,000-odd villages across the country, and provide better health care facilities to the poor, the various healthcare services need to be rendered free. At present, the cost differential between home deliveries and institutional ones – Rs.200 compared to Rs.2000, respectively) – is too high, and this is a prime reason for the decline in institutional deliveries. There is a need to optimally utilise the resources.
Lack of medical staff is an issue. Despite an increase in OPDs, the employee strength in Nagrota remains the same, 153. In the absence of adequate number of specialists, the problems relating to implementation are heightened. The same is true for other FRUs; there are no general surgeon posted in many places, and several patients are refused because of a lack of specialists.
H. Dhiman, a gynaecologist at Dera Civil Hospital, agrees: “We do not have doctors; there are only 9 in Kangra district.” According to him, NRHM is a failure. Too much money has been spent with too little returns, and there is fight between quality and quantity. “Consider the case of Palampur, where there are 14 specialists and patients go there primarily because of the services they provide. If we have adequate number of specialists, we too can provide the needed services. The programme is successful in Khundiyan and Samot because of local donations. If you provide adequate services, people donate.” But then how does he explain the success of Nagrota? “If you have people like Raghu and Kulbhushan Sood (Head, Dera), success is assured.”
Pravin Sharma (MLA, Palampur), too is aware of the deficits of the scheme. He explains, “First of all, the current centres, sub centres, PHCs, and FRUs should have adequate facilities and specialists, and then only the new ones should come up.” The reach of the programme is still inadequate and, according to Kuldeep Guleria, a local journalist, “the media has played an active role to promote the scheme, but remote areas still face the same old problem. The programme is active when there is political pressure.”
In the end, it’s always the political will at both the central and state levels that matters. Only a change in attitude among the Indian policy makers can provide health for all Indians.
Lack of medical staff is an issue. Despite an increase in OPDs, the employee strength in Nagrota remains the same, 153. In the absence of adequate number of specialists, the problems relating to implementation are heightened. The same is true for other FRUs; there are no general surgeon posted in many places, and several patients are refused because of a lack of specialists.
H. Dhiman, a gynaecologist at Dera Civil Hospital, agrees: “We do not have doctors; there are only 9 in Kangra district.” According to him, NRHM is a failure. Too much money has been spent with too little returns, and there is fight between quality and quantity. “Consider the case of Palampur, where there are 14 specialists and patients go there primarily because of the services they provide. If we have adequate number of specialists, we too can provide the needed services. The programme is successful in Khundiyan and Samot because of local donations. If you provide adequate services, people donate.” But then how does he explain the success of Nagrota? “If you have people like Raghu and Kulbhushan Sood (Head, Dera), success is assured.”
Pravin Sharma (MLA, Palampur), too is aware of the deficits of the scheme. He explains, “First of all, the current centres, sub centres, PHCs, and FRUs should have adequate facilities and specialists, and then only the new ones should come up.” The reach of the programme is still inadequate and, according to Kuldeep Guleria, a local journalist, “the media has played an active role to promote the scheme, but remote areas still face the same old problem. The programme is active when there is political pressure.”
In the end, it’s always the political will at both the central and state levels that matters. Only a change in attitude among the Indian policy makers can provide health for all Indians.
The Snapshot
In 2007-08, Rs.475,000 was allocated for the purpose in Nagrota; of this, Rs.298,000 has already been utilised this fiscal
In Himachal Pradesh, the number of girl children for every 1,000 male children went up from 815 in 2006 to 846 in 2007; the number of OPDs on an annualised basis doubled
Administrators take suggestions from staff and patients in a bid to improve health services; the concept of quality circles is catching up
The Problems
The number of institutional child deliveries has come down from 0.52 lakh in 2005-06 to 0.49 lakh in the next year
Lack of medical staff is an issue; in many cases, there are no general surgeons to treat the patients
Too much money is being spent under the scheme to get too little returns; there is a constant fight between quantity and quality
In 2007-08, Rs.475,000 was allocated for the purpose in Nagrota; of this, Rs.298,000 has already been utilised this fiscal
In Himachal Pradesh, the number of girl children for every 1,000 male children went up from 815 in 2006 to 846 in 2007; the number of OPDs on an annualised basis doubled
Administrators take suggestions from staff and patients in a bid to improve health services; the concept of quality circles is catching up
The Problems
The number of institutional child deliveries has come down from 0.52 lakh in 2005-06 to 0.49 lakh in the next year
Lack of medical staff is an issue; in many cases, there are no general surgeons to treat the patients
Too much money is being spent under the scheme to get too little returns; there is a constant fight between quantity and quality
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