Karnataka government has been asked to identify the health needs of vulnerable sections with special focus on most backward taluks which had weak health indications, under the government of India's National Rural Health Mission (NRHM). The Centre launched the mission in 2005, with the commitment to increase the public spending on health from 0.9 per cent of the GDP (gross domestic product) to 2 to 3 per cent.
For 2007-08, the state's allocation is Rs 1,131.36 crore as the programme implementation grant to implement the State Rural Health Mission (SRHM) and Reproductive Child Health (RCH) programme. The amount was disbursed by the National Programme Coordination Committee of NRHM where the Centre's grant was Rs 234.16 crore and the state government contribution is Rs 667.47 crore.
For the efficient utilization of funds under SRHM, the NHRM had asked the state health department to develop a comprehensive plan to assess the health status of vulnerable sections and tribal population.
The state's five districts located in the North East Karnataka at Gulbarga, Bidar, Koppal, Raichur, and Bellary and two districts in north Karnataka at Bagalkot and Bijapur have worst health indicators than the rest of the State.
The mission aims at reduction in the Infant mortality rate (IMR) and Maternal Mortality Rate and prevention and control of communicable diseases in rural areas. The present level of IMR in the state is 52 per cent per thousand live births. The NRHM has asked the state take steps to address the growing cost of healthcare for the poor, both in the public and private sector.
The State mission authorities will also need to control the cost of civil works within a ceiling of 25 per cent of the funds disbursed. Further, the State needs to take steps to meet the commitment for 10 per cent increase in the budgetary outlay every year.
The mission is yet to take off in Karnataka and is facing problems because of a serious shortage of manpower. The NHRM has asked the government to fill the vacancies of auxiliary nurses and midwives (ANMs) in primary health centres. It has instructed the authorities not to transfer multi-skilled manpower and ANMs for at least a year after training. The SRHM has roped in various voluntary organizations and health experts for implementation of the programme in remote rural areas of the State.
Development of the public hospitals and primary healthcare centres to provide round-the clock services and regular supply of essential drugs are also key features of the mission plan. The State mission has been asked to make sure that there is no replication in the procurement of drugs and asked to follow decentralized mechanism for purchase of medicines.