Rural Healthcare in India (Kurukshetra January 2021)

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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.

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) .

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.

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.

Launched in 2016.
To provide quality antenatal care, free of cost and universally to all pregnant women on the 9^th of every month in their 2^nd and 3^rd 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.

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.

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.

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.

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) .

✍Examrace Team at Aug 20, 2021