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Towards a healthy nation
Someone has rightly said, “Health is wealth.” A country, whose people are healthy, can chart a prosperous path. The adage seems to have dawned on the Indian government as it makes substantial allocation for the health sector in its latest budget.
THE HEALTH status of the people has been a primary to the government. There has been some improvement in the quality of health care over the years, but wide inter-state, male-female and rural-urban disparities- in outcomes and impacts- continue to persist.
While population stabilisation is in the Concurrent List, health is a state subject. The reproductive and child health services reach community and household levels through the primary health care infrastructure. Inadequacies in the existing health infrastructure have led to gaps in the coverage and outreach services in the rural areas.
The finance minister, P Chidambaram, has set ambitious goals for 2008-09 and has proposed to allocate Rs 16,534 crore for the health sector (including NER) in the budget. This marks an increase of 15 per cent over the allocation of Rs 14,363 crore in 2007-08.
National Rural Health Mission
The National Rural Health Mission (NRHM) is the key instrument of intervention by the central government. It was launched on April 12, 2005, to provide accessible, affordable and accountable quality health services to the poorest households in the remotest rural regions.
The mission aims at establishing a fully functional, community owned, decentralised health delivery system with inter-sectoral convergence at all levels, to ensure simultaneous action on a wide range of health determinants like water, sanitation, education, nutrition, social and gender equality. Under the NRHM, the focus is on a functional health system at all levels, from the village to the district.
One of the key strategies under the NRHM is a community health worker, i.e. Accredited Social Health Activist (ASHA), for every village to meet the elementary health care needs of the rural masses. About 462,000 such health workers and link workers have been trained and are in place. Nearly 177,924 village health and sanitation committees are functional. More than 300 (323) district hospitals have been taken up for upgradation. The allocation for NRHM has been increased to Rs 12,050 crore.
During 2007 there had been a sharp reduction in Polio Type 1 cases in the country. The drive to eradicate polio continues with a revised strategy with a focus on the high risk districts in Uttar Pradesh and Bihar. Rs 1,042 crore has been allocated for the purpose by the finance minister in the Budget.
National AIDS Control Programme
HIV/AIDS is one of the many other communicable diseases that affect the population in India. Nearly 20,408 AIDS cases were reported in 2007 (December), out of which 87.4 per cent of the infections were transmitted through the sexual contact and pre-natal transmission accounted for 4.7 per cent of infections. About 1.8 per cent and 1.7 per cent of infections were acquired through injecting drug use and contaminated blood and blood products, respectively.
The National AIDS Control Organisation has made efforts to increase access to the services and communicate effectively for behaviour change. The Government has launched National AIDS Control Programme Phase III, with the goal to halt and reverse the epidemic in the country over the next five years by integrating programmes for prevention, care, support and treatment.
An amount of Rs 993 crore has been provided in the budget for National AIDS Control Programme. Studies have shown that the prevalence rate of HIV/AIDS has come down from 0.9 per cent to 0.36 per cent, which is a matter of satisfaction.
Rashtriya Swasthya Bima Yojana
Two major interventions are planned to be started in 2008-09. The first is the ‘Rashtriya Swasthya Bima Yojana’ that will provide a health cover of Rs 30,000 for every worker in the unorganised sector falling under the Below Poverty Line (BPL) category and his/her family. It was launched in Delhi and in the states of Haryana and Rajasthan on April 1, 2008, with Rs 205 crore as the centre’s share of the premia in 2008-09.
National programme for the elderly
The second intervention is for the elderly. A national programme for the elderly with a plan outlay of Rs 400 crore will be started in 2008-09. During the Eleventh Plan period, two National Institutes of Ageing, eight regional centers and a department for geriatric medical care in one medical college/tertiary level hospital in each state will be established.
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