India launches national rural health mission
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《英国医生杂志》
The Indian government announced a plan to increase staffing levels and improve the infrastructure in rural hospitals last week. It also intends to use village women to track the health needs of their own communities.
The health ministry has ear-marked 67bn rupees (￡0.8bn; $1.5bn; 1.2bn) this year (2005-6) for the National Rural Health Mission, dubbing it a fresh effort to correct "striking inequalities" between urban and rural health services in India. But health activists have said that the plan would require more funding and complementary changes to India's medical education system for it to work.
The mission will raise a cadre of 250 000 women volunteers designated as accredited social health activists over the next three years, virtually one from every village or cluster of villages, across 18 states with weak rural health infrastructure.
The activists would be trained to advise village populations about sanitation, hygiene, contraception, and immunisation; to provide primary medical care for diarrhoea, minor injuries, and fevers; and to escort patients to medical centres.
A force of 250 000 women is to be recruited as health activists for India's rural areas to redress inequalities in health care
Credit: P VIROT/WHO
They would also be expected to deliver direct observed short course therapy for tuberculosis and oral rehydration; to give folic acid tablets and chloroquine to patients; and to alert authorities to unusual outbreaks.
The mission has also pledged higher standards for health care in rural medical centres to be achieved by increasing the number of doctors, improving infrastructure, and ensuring a supply of drugs. But community health activists say that the mission has unrealistic expectations.
"The additional allocation is grossly inadequate," said Abhay Shukla, coordinator of the Centre for Enquiry into Health and Allied Themes in Pune and a member of a task force that advised the health ministry on mission strategies.
Health activists say that the mission appears to rely on funds earlier spent on reproductive and child health. "We had also urged reasonable compensation for the accredited social health activists, but the government wants them as honorary volunteers," Dr Shukla said.(Ganapati Mudur)
The health ministry has ear-marked 67bn rupees (￡0.8bn; $1.5bn; 1.2bn) this year (2005-6) for the National Rural Health Mission, dubbing it a fresh effort to correct "striking inequalities" between urban and rural health services in India. But health activists have said that the plan would require more funding and complementary changes to India's medical education system for it to work.
The mission will raise a cadre of 250 000 women volunteers designated as accredited social health activists over the next three years, virtually one from every village or cluster of villages, across 18 states with weak rural health infrastructure.
The activists would be trained to advise village populations about sanitation, hygiene, contraception, and immunisation; to provide primary medical care for diarrhoea, minor injuries, and fevers; and to escort patients to medical centres.
A force of 250 000 women is to be recruited as health activists for India's rural areas to redress inequalities in health care
Credit: P VIROT/WHO
They would also be expected to deliver direct observed short course therapy for tuberculosis and oral rehydration; to give folic acid tablets and chloroquine to patients; and to alert authorities to unusual outbreaks.
The mission has also pledged higher standards for health care in rural medical centres to be achieved by increasing the number of doctors, improving infrastructure, and ensuring a supply of drugs. But community health activists say that the mission has unrealistic expectations.
"The additional allocation is grossly inadequate," said Abhay Shukla, coordinator of the Centre for Enquiry into Health and Allied Themes in Pune and a member of a task force that advised the health ministry on mission strategies.
Health activists say that the mission appears to rely on funds earlier spent on reproductive and child health. "We had also urged reasonable compensation for the accredited social health activists, but the government wants them as honorary volunteers," Dr Shukla said.(Ganapati Mudur)