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LATEST NEWS UPDATES | Govt on warpath with plan panel-Kounteya Sinha

Govt on warpath with plan panel-Kounteya Sinha

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published Published on Aug 21, 2012   modified Modified on Aug 21, 2012
-The Times of India

The idea of a single National Health Mission to address the health challenges of the country's rural and urban population, as envisaged by the Planning Commission, is in the eye of a storm.

The Union health ministry has made its stand clear that a uniform approach can never work.

The letter written by the ministry to the Commission says that the health facilities in rural areas conform to a uniform pattern, while in urban areas it varies widely not only from state to state but also for different category of local bodies within a state such as megapolises, metros or municipal towns.

Experts say a single health mission will just widen the health gap between urban and rural India.

The disparity is already telling.

Consider, the infant mortality rate (IMR). In urban India, IMR stands at 31 per 1,000 population, while in rural it is 51 per 1,000 population — 65% higher in rural than in urban areas.

When it comes to under five mortality rate, it is 38 in urban and 66 in rural (74% higher in rural areas). In terms of neonatal mortality rate, it is 89% higher in rural India - 19 in urban and 36 in rural.

The total fertility rate (TFR) is 1.9 in urban India and 2.8 in rural areas (47% higher). The number of beds in government hospitals located in urban areas is 6.1 lakh, while it is 1.6 lakh in rural settings.

Around 80% of all doctors, 75% of all dispensaries and 60% of all hospitals (both government and private) are located in urban areas even though it contains only 31% of India's population.

The availability of qualified physicians is 11.3 per 10,000 in urban areas, while in rural it is 1.9 per 10,000 population.

Experts told TOI, "A single health mission can never work as the problems faced by urban and rural are completely different. There can never be a single budget, nor a common strategy."

Some Commission officials themselves say that "a single mission will make this disparity more acute".

The health ministry has informed the Commission that it has strong reservations against the panel's proposal for a National Health Mission, saying, "the way it has been articulated is fraught with the danger of neglect of rural areas which requires more attention".

The ministry says that it was categorically decided in a recent meeting taken by principal secretary to the PM that that there will be a National Health Mission with two sub-missions — National Rural Health Mission (NRHM) and National Urban Health Mission (NUHM). While the implementation structure will be common for both, the resource allocation and strategy both for rural and urban areas will be according to their respective needs.

The ministry has said that the suggested re-structuring of the central sector schemes needs a fresh look.

It has been suggested that all the central sector programmes would be consolidated to six schemes that include AYUSH (ayurveda, unani, siddha and homeopathy) and health research and 24 centrally sponsored schemes under the National Health Mission.

The ministry's letter says this would create substantial confusion and will be unwieldy.

The ministry therefore has suggested that the programmes under the department of health can be brought under six different schemes including National Health Mission.

The NHM will have four different components of NRHM, NUHM, communicable diseases and non-communicable diseases.

"The programmes of department of AYUSH, AIDS control and health research should be completely separate," the health ministry says.

The ministry has also expressed serious worry on the panel's draft chapter that indicates a total public investment on health in the 12th Plan to be only 1.5% of GDP as against earlier plans to raise total health expenditure to 2.5% of GDP by the end of 2017.


The Times of India, 21 August, 2012, http://timesofindia.indiatimes.com/india/Govt-on-warpath-with-plan-panel/articleshow/15578756.cms


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