In his opening remarks at the Third Meeting of the Mission Steering Group (MSG) of National Rural Health Mission (NRHM) in New Delhi, the Indian Minister for Health & Family Welfare, Dr. Anbumani Ramadoss said the NRHM has now completed two years and during this time the health sector in the country has seen far reaching changes.
The process of change is a gradual one and it is necessary to move cautiously, taking the various stakeholders into account.
Hon?ble Ministers for Rural Development, Shri Raghuvansh Prasad Singh, Panchayati Raj, Thiru Mani Shankar Aiyar, Minister of State for Health & Family Welfare, Smt Panabaka Lakshmi were present at the meeting. In addition, Shri Naresh Dayal, Secretary (HFW), Secretary, Panchayati Raj, Secretary (AYUSH) and other members of MSG were also present.
The following is the text of the Health Minister?s speech:
?I welcome you all to the third meeting of the Mission Steering Group of NRHM. As you are aware, NRHM has now completed two years. Over the past two years, the health sector in the country has seen far reaching changes. We are all fortunate to be part of the process of architectural corrections being carried out in the sector. The States have demonstrated remarkable enthusiasm in accepting the sector wide paradigm change introduced under NRHM and are at various stages of implementation of the strategies.
Over these two years, we have established an unprecedented momentum for change in the health delivery system in the country. We have initiated a series of initiatives, which lead to comprehensive rejuvenation of the health system. The initiatives cover the entire range of activities in the matrix from infrastructure to manpower to logistics & management to decentralization to community participation etc. As you would be aware, the NRHM is a flagship programme of my Ministry. The aim of NRHM is to provide accessible, affordable, accountable, effective and reliable primary health care facilities. The Mission seeks to rejuvenate the health delivery system through comprehensive upgradation of infrastructure, augmentation of manpower and expansion of capacity for training various stakeholders. The Mission seeks to hand over the planning, execution and evaluation of the health programmes with the community based organisations. The health facilities are being made responsive to the community through the Rogi Kalyan Samitis and untied funds are being given to all levels of health facilities and we hope to comprehensively rejuvenate the health system in near future.
I would like you to recall the formative stages of NRHM when the strategies were being conceptualized. That was sometime in December of 2004. The officers from my Ministry had a series of consultations with the various stakeholders in the health sector. We talked to the States, public health experts, development partners, medical colleges, industry experts and other departments in the Government of India and then arrived at a vision for the Mission. The related Departments strongly supported the sector wide paradigm of the Mission and we formally launched the mission in April of 2005. Even after that the consultative process continued. All stakeholders have used various platforms provided for under the Mission to add value to the strategies. There have been a large number of review meetings, orientation workshops, discussion sessions with various stakeholders. In fact the states and other stakeholders have been so closely associated with the formulation of the basic strategies under the Mission that the Mission is indeed truly a pan India effort. To that extent it is an unprecedented initiative.
In the first two years the States have set-up the basic framework of the Mission including the State Health Mission and the District Health Mission, etc. Simultaneously the orientation programmes for all the participants in the sector have also continued through out the formative years of the Mission. A very large number of training sessions and orientation workshops have been organised at Delhi, in States and also at Mussorie to build capacity amongst the health Departments of all States to carry the Mission forward. The efforts under taken by my Department in such a short time to bring on board such a large number of participants in various States is clearly unprecedented in the history of any programme in the county. I must also thank all the States for the active participation in the designing of the NRHM strategies as well as effective and timely implementation of the same.
The process of change in the health sector is a gradual one and it is necessary to move cautiously, taking the various stakeholders into account. The process is heavily dependent upon the capacities of the stakeholders to maintain focus and persist with the initiative in the wake of daunting challenges of logistics, working conditions and lack of support structures etc. It is therefore very necessary to have continuous dialogue with all the stakeholders.
All the related Departments of the Government of India have been a strong source of support for us in the formative years of the Mission.
There have been regular consultation with all Departments and Intersectoral issues are being addressed more acutely than ever before. I would like to congratulate out friends from the related Departments for this achievement.
The era of rigid, vertically designed health programmes, without any horizontal intrasectoral and Intersectoral linkages is over. All health sector initiatives have to view health as a continuum of preventive, promotive and curative care. The cross linkages with collateral determinants of health including nutrition, drinking water, sanitation, education and women?s empowerment etc also have to be addressed. In this process some of the basic features of the health programmes need to be re examined. The range of work of various cadres, the skills required at various levels, reporting channels, budget lines, all need to be rationalized to respond to the sector wide approach.
The Secretary (HFW) has been communicating the guidelines on various issues to the States and with the Secretaries of Rural Development, Panchayati Raj, Water Supply etc. This has accelerated the shift towards synergistic policy making rather than duplicating the efforts in a compartmentalized manner.
I also take this opportunity to thank the public health experts who are the members of the Mission Steering Group for the continuous guidance given by them. They represent the most important resource pool under NRHM and I would seek their continued assistance in the management of the Mission, Their role has not become all the more significant at this stage when we need a feed back form the field and also need to design mid course corrections in various strategies.
The results of all the hard work have now begun to show on the ground level. Across the entire country, the States are showing a renewed interest in the health sector. All the states are talking about the far-reaching changes for which the groundwork has been undertaken. The Panchayati Raj Institutions in the States are being involved very closely in the process of change and the state plans are now reflecting the concerns of the districts and blocks as articulated by the representatives of respective local areas. This is a very healthy change and a very major one too. From the era of normative funding for vertical schemes from the Government of India we have now moved on to funding on basis of state Programme Implementation Plans. I feel very encouraged with the enthusiastic response shown by all the States. We get regular progress reports from the states and I notice a clear movement towards a sector wide rejuvenation.
There is however, no time to loose. The country is developing at a scorching pace. The health sector has to keep up with the requirements of the working class and the expectations of the population from the health services have to be fulfilled. The quality of service, the range of services in maternal and childcare as well as general curative and preventive promotive services all need the immediate attention. There are also issues relating to improving the capacity for fund utilisation by the states. In the past there has often been a problem of delayed reporting of the fund utilisation by various programmes. I take this opportunity to urge all of you to continue the good work and ensure that the Mission comes to the expectations of all concerned.
I welcome all the delegates to the meeting and look forward to fruitful interaction from my colleagues on the dias as well as the public health experts who are members of the MSG?.