The International Advisory Panel (IAP) has commended the impressive performance and dramatic results achieved under the National Rural Health Mission (NRHM) in India in a short span of six years and has termed this health movement as an extraordinary model in public health management.





The panel led by Professor Jeffrey D Sachs, director, Earth Institute, University of Columbia along with their team of experts, commended the impressive performance and dramatic results achieved under NRHM in a record short span, terming NRHM an extraordinary model in public health management.





Speaking at the 8th meeting of the Panel in Delhi, Professor Jeffrey Sachs informed that they have in fact decided to develop five model districts, one each in Assam, Uttar Pradesh, Andhra Pradesh, Bihar and Rajasthan to see effects of concentrated efforts with higher budget allocations and flexible management systems. Prof Sachs underscored the need for higher investments in health sector and said that in his meetings due with the Planning Commission, his team would strongly advocate the need for higher budgetary allocations.





Chairing the Panel meeting, union minister for health and family welfare Ghulam Nabi Azad said that over the past six years, funds to the tune of Rs.55,000 crore have been released under NRHM and thereby improved the infrastructure facilities, augmented human resources and quality of care,





The minister said the OPD and IPD patients in health facilities had also increased. Under the Janani Suraksha Yojana (JSY), the coverage of beneficiaries has gone up from 736 thousands in 2005-06 to more than 10 million during 2009-10. National IMR has dropped by 3 points in the 2009 and in some high focus States, it has dropped by 4 points, making the Millennium Development Goal’s quite achievable, he added.





Azad acknowledged that the recommendations of the mid-term evaluation report on the National Rural Health Mission prepared by the IAP have immensely helped provide useful inputs for improving the programme implementation.





Elaborating on future plans, Azad said that at the policy level it has been decided that deliveries in public health facilities shall be completely free of cost and full antenatal care will be ensured. “Two critical mechanisms of maternal death reviews and name based tracking of every pregnant woman and child immunized have been initiated to bring down the maternal and infant mortality and morbidity. The name based tracking system will result in creating a database of all the pregnant women with their address and telephone numbers. They could be contacted and monitored in respect of their ANC, Institutional Delivery and Post Natal Care. Similarly, the immunization of the children could be monitored to identify dropouts and full immunization ensured. The Mother and Child Tracking system is already operational in Gujarat, Rajasthan and Tamil Nadu whilst the other States are in the implementation phase,’’ the Minister informed.





The Minister added that 264 districts have also been identified in the country on basis of poor health indicators for focused attention. Though, these districts constitute only about 35 per cent of the population of the country, they account for nearly 70 per cent of the infant and maternal deaths, high population growth, low immunization coverage and an overall weak health system. Micro plans for each of these districts factoring the critical gaps in infrastructure, equipment, drugs and supplies, and human resource for health have been prepared. To increase availability of doctors, specialists and super-specialists, short term, medium term and long term policy decisions have been taken to facilitate increase in the intake of medical students and setting up of new medical institutions in the country.





“Modalities for further enhancing skill sets of ASHAs are also being worked out. More than 4.5 lakhs Village Health and Sanitation Committees have been constituted in order to strengthen the community led mechanism to ensure greater convergence and address the social determinants of health like water, sanitation, nutrition, education etc,’’ he said.