Remember ME - You Me and Dementia

Tuesday, April 22, 2008

Unicef chief criticises India's rural health mission

The head of health at Unicef India points to India’s poor maternal mortality rate and unacceptably high malnourishment among children as evidence that the National Rural Health Mission is not yielding results.

To be effective, the Indian government’s flagship health programme, the National Rural Health Mission (NRHM), must be goal-oriented and needs “very good managers who can work on a Gandhian mission and vocational commitment to improving rural health,” says Marzio Babille, head of health at Unicef India.

Half of the country’s women still deliver babies at home, and 20% of the world’s child mortalities occur in India, Babille pointed out in an interview to the media while attending a national-level conference in Udaipur.

The NRHM, carried out and controlled by the Ministry of Health, was launched in 2005 to improve and upgrade healthcare facilities in rural India.

Babille said that projects under the NRHM such as the Janani Suraksha Yojana (save the mother project) and Accredited Social Health Activists (ASHAs) scheme had not been very successful. In 2007, only 52% of the eligible 7.5 million women received the benefits of the Janani Suraksha Yojana (JSY). Under this scheme, the government pays a certain amount to a woman who gives birth to a baby in hospital. Despite this incentive, half of India’s women deliver at home without any medical attention, causing high maternal mortality in the country.

ASHAs are not well trained and are overburdened. While India had the manpower, it does not have trained manpower, Babille said. He was critical of the fact that people do not know much about the programmes, and the authorities have done little to make them popular.

India has also not done much to improve malnourishment among children. “In the last seven years, malnourishment levels among Indian children have gone down by merely 1%. While 47% of children were malnourished seven years back, currently it is 46%,” he said.

According to a recent report by Unicef, every year 2.1 million children in India do not survive to celebrate their fifth birthday. This means one out of every five children under the age of five dying worldwide is an Indian. Babille said building capacity, integration of the NRHM and the Ministry of Women and Child Development’s Integrated Child Development Scheme (ICDS), as also better awareness campaigns, were required to improve the health situation in India.

Babille singled out Madhya Pradesh, Assam and Orissa for doing well in the field of rural health and said Uttar Pradesh needed to do more.


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