Rural Healthcare in India (Kurukshetra January 2021)
⪻ Articles ⪼
Rural Healthcare in India
- National Rural Health Mission of 2005 has been rightly expanded to provide healthcare services to the urban poor who are under-nourished and under-served as well.
- Focus states Orissa, Rajasthan, Uttaranchal, Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, and Uttar Pradesh known as the Empowered Action Group States also the socioeconomically backward states.
- North-eastern states, Himachal Pradesh and the then state of Jammu and Kashmir were the focus states.
Coverage and Access for Rural Healthcare
- Three-tier system of sub-centers (SC) , primary healthcare centers (PHC) and community health centers (CHC) .
- SCs are the first point of contact in the primary healthcare system, community in a rural set-up.
- PHCs serve as the first point of contact between the community and a medical officer.
- The CHCs provide specialized medical care through surgeons, obstetricians and gynecologists, physicians, and pediatricians.
- Between 2005 - 2019 an increase of
- 7.8 % in the no. of SCs.
- 7 % in PHCs.
- 59.4 % in CHCs.
- As on March 30,2019, on an avg. , 5,616 people in rural areas were covered by sub-centers, 35,567 people in rural areas were covered by PHCs and 165,702 people in rural areas were covered by CHCs.
- Bihar had the highest avg. population coverage through all such activities.
- There are few states with PHCs without a doctor (e. g. , Chhattisgarh) , or a technician (e. g. , Rajasthan) , or a pharmacist (e. g. , Uttar Pradesh) .
ASHA
- Accredited Social Health Activist.
- A grassroot level health worker who is selected from a village to serve that village.
- A liaison between the local rural community and the public health system.
- Undergo rigorous and continuous training and development to serve the rural community better.
Some Programmes for Rural Health Care
Janani Suraksha Yojana
- Launched in 2011.
- To eliminate out of pocket expenditure for both pregnant mothers and sick infants.
- A cash incentive programme.
- To encourage women to use formal healthcare services for institutional deliveries.
- To reduce neonatal and maternal mortality among poor, pregnant women, especially those in rural areas.
- Focused states also the low performing states are Uttar Pradesh, Uttarakhand, Bihar, Jharkhand, Madhya Pradesh, Chhattisgarh, Assam, Rajasthan, Orissa and Jammu and Kashmir.
- All pregnant women who chose to deliver in govt. health centers like Sub-Centers, Primary Healthcare Centers etc. or accredited private institutions are eligible for this initiative in the low performing states.
- High performing states focus on all BPL/Scheduled Caste/Scheduled Tribe women.
- In rural areas, the cash incentive amounts to ₹ 1400 in LPS and ₹ 700 in HPS.
- This programme provides free drugs, consumables, free diagnostic, free blood, and free diet for 3 days during normal delivery and 7 days for caesarian section deliveries.
- Covers all ante-natal and post-natal emergencies.
Pradhan Mantri Surakshit Matritva Abhiyan (PMSA)
- Launched in 2016.
- To provide quality antenatal care, free of cost and universally to all pregnant women on the 9th of every month in their 2nd and 3rd trimesters of pregnancy.
- Can be availed at all govt. facilities.
- Engages with the private sector to create campaign awareness and participation.
- A minimum package of free antenatal care services is provided.
- By OBGY specialists/Radiologist/Physicians at Govt. Health facilities.
- Voluntary support from private practitioners at Govt. Health facilities.
Special Newborn Care Units (SNCUs)
- Established at district levels and sub-district level hospitals.
- Annual load of more than 3000 to provide care for sick newborns
- Who did not need assisted ventilation or major surgeries?
- At PHC level, this initiative provides newborn care corner which is designated space within the health facility i.e.. , Labor Room and Operation Theatres.
- New born stabilizing units are also provided for resuscitation, oxygen, suction, warmth through trained medical staff for all referral cases from SCs, PHCs and CHCs.
The Rashtriya Kishore Swasthya Karyakaram
- Targets adolescents between the age of 10 to 19 years.
- Constitutes 22 % of the Indian population.
- Investments ensure proper physical, biological, and psychological development along with psycho-social, behavioral, and sexual education.
- To provide friendly healthcare services to improve nutrition, mental health, sexual and reproductive health, prevent injuries and violence, substance abuse and nom-communicable diseases.
The Rashtriya Bal Swasthya Karyakram
- Screens children under the age of 18 for four birth deficiencies.
- Defects at birth, Diseases, Deficiencies and Development Delays including Disabilities.
- Made significant impact on reducing the child mortality rates under the NRHM.
Key Objectives Are
- Assessment of health status of the child
- Early detection of children with defects at birth
- Disease
- Deficiency in nutrition and disability.
- Management of the identified children at primary, secondary and tertiary level
- Effective referral system.
- Involving parents, proper and complete follow-up.
- Health awareness among parents and children.
- Trainings and capacity building of health providers.
- Convergence with stake holder departments (Education, SSA, RMSA, WCD and Social Justice and Empowerment) .
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