National

Monitoring, support system for NRHM urged

NEW DELHI: The Common Review Mission (CRM) for the National Rural Health Mission (NRHM) has called for developing a monitoring and support system that is able to respond and reach out to assist in areas and States showing limited progress.

It has also recommended for drafting guidelines for integration of the activities of various programmes and the general health services. To integrate all the disease control programmes, the way forward is to build the preventive, promotive and curative care for communicable, chronic diseases and non-communicable diseases into the definition of fully functional health facilities. Thus, one needs to develop their standard treatment guidelines, their essential drug lists, referral systems, capacity building and logistics, the review mission has said.

The common review mission was set up as part of the Mission Steering Group’s mandate of review and concurrent evaluation. It conducted its appraisal in November 2007.

Besides, stressing on the need for timely release of funds to the States for various components of the NRHM, especially the Janani Suraksha Yojana, the review focuses on the importance of working with the States to evolve a common nomenclature for the facilities such as Primary and Community Health Centres for a better planning process and budgetary allocations.

But according to the review mission report, the Yojana is challenged by the slow rate of growth in infrastructure and personnel to meet the demand generated by the shift to institutional deliveries.

There needs to be a systematic examination of the compensation package and incentives being provided to the various health service cadre, and the opportunities for advancement in their careers along with a fair transfer and posting policy. These are some of the most sensitive indicators of good governance and a system of measuring and rewarding these needs to be built up, the review points out.

On revival of training institutes, the review says pre-service training institutions for generating multipurpose workers, both male and female, and their supervisory staff, which have gone into dysfunction in the last decade, need to be revived, expanded and strengthened.

On the positive side, the review says that there was a general trend towards strengthening the services provided by the public health sector, with increasing access and improvements in quality, reflected in increasing utilisation of the facilities. This increased utilisation can be attributed to the overall increased attention and investment that the public health system is getting.

Actual devolution of facilities to panchayats is a feature found only in West Bengal, Kerala and Nagaland while the role of the panchayats was found to be proactive and valuable in Tripura and Tamil Nadu.

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