Health Policy of Chhattisgarh

Health Policy of Chhattisgarh

The Chhattisgarh State Integrated Health and Population Policy 2006

• The Chhattisgarh State Integrated Health and Population Policy 2006 reiterates the commitment of the State to promote health for all and to provide quality health care services, especially to those in remote and difficult areas.
• The Policy aims at sustainable human development by ensuring that every citizen has adequate access to basic essentials of life, reducing socioeconomic disparities, improving the quality of life and stabilising the population.
• Securing the rights of disadvantaged and marginalised groups would be given the highest priority with the aim of eliminating discrimination and responding to the aspirations of the people, so that they can successfully contribute to national reconstruction and social change.
• Women’s empowerment and gender equity would be one of the cornerstones of this policy.
• To achieve the goals of National Population Policy 2000 and National Health Policy 2002, the Chhattisgarh Integrated Health and Population Policy takes a holistic view of population stabilisation and improving reproductive and child health services with special attention to decentralised governance.
• Towards this end the Policy will strengthen the Panchayati Raj Institutions (PRIs) and build its capacities to fulfil this role.
• The Chhattisgarh State Integrated Health and Population Policy recognises the pivotal contribution of socio-economic determinants of health. It understands the need for basing health policy on a comprehensive health care approach which integrates issues related to the social determinants with measures for improving health care services. Achieving health equity as part of building a more equitable society would therefore be a major goal of this policy.
• The National Rural Health Mission (NRHM) 2005 with its stated goal – “to promote equity, efficiency, quality and accountability of public health services through community driven approaches, decentralisation and improving local governance” has brought back the primacy of Health for All and comprehensive primary health care and provides a platform to foster desired inter-sectoral co-ordination that is essential to address social determinants and improved health care services in an integrated fashion.

VISION

• The Chhattisgarh Government commits itself to achieving the highest attainable level of physical, mental and social health through processes that shall empower local communities and be affordable to the State and its citizens, be equitable and gender sensitive and which would reduce poverty in the State.
• Universal access to comprehensive quality primary health care with adequate referral linkages would be the key strategy through which this vision would be realised. This is already enshrined in the State’s Vision 2020 document.
• The State shall respond to the health needs of the people and will be guided by principles of transparency, accountability and community participation involving stakeholders from the public, private and non-government organizations to create a society enjoying healthy productive lives in harmony with their social responsibilities and contributing to a national resurgence.
• The State is committed to achieving population stabilisation, through a life cycle approach by promoting informed choice, empowering women and communities and paying special attention to reproductive and child health issues of disadvantaged populations living in remote areas.

GOALS & OBJECTIVES

The policy objectives are as follows:

1. To ensure universal access to comprehensive primary health care
2. To ensure equity in delivery of quality health care services
3. To ensure adequacy of health infrastructure and health systems and to develop human resources for health care.
4. To achieve population stabilisation through vigorous implementation of quality reproductive health care including family planning and other relevant social development measures by adopting an inter sectoral strategy

Strategic Directions

For achieving its objectives the Policy identified certain strategic action points:

• Decentralized planning and implementation –The policy suggests delegating charge to Panchayati Raj Institutions of all health facilities and functionaries in their areas and ensuring participation of women in decision making.
• Community Participation -Promotion of Village health committees, self help groups, youth clubs and their involvement in problem identification, planning, implementing and monitoring of health care programmes is suggested.
• Comprehensive Primary Health care -Access to preventive and curative care services through a trained health volunteer in every habitation and access to hospitals within 2 hours is proposed.
• Equity in Health care -This approach would also aim at gender equity and endeavor to provide highest quality of reproductive health as a part of life cycle approach and seek active partnership with NGOs to reach out to underserved sections.
• Improved Quality and Standards of Care -The policy proposes to develop parameters for different levels of health care in consultation with health professionals which would be upgraded periodically to ensure health outcomes and patient satisfaction. Appropriate legislation to guarantee and make these above means into health rights would be adopted.
• Behaviour Change Communication (BCC) –Societal change with regard to behavioural norms on health by locally relevant BCC programmes is suggested.
• Inter sectoral Coordination – To address the social determinants of health; priority areas are nutrition, water, sanitation, poverty alleviation programmes.

Strategy (priority areas)

The Policy also identified areas which it thought should be given special focus. They are as follows:

• Nutrition – Energizing ICDS (Integrated Child Development Scheme), mid-day meal programmes and nutritional education programmes.
• Social Security for Health – Compulsory social insurance and health guarantee schemes covering all primary and secondary health care needs.
• Mainstreaming Gender and Women’s Empowerment – Improving women’s access to and control over resources and increase their role in decision making and collaborate with State Commission for Women for safeguarding their civil rights.
• Tribal Health – Programme designed keeping in mind the cultural and health practices among the different tribes in addition to protecting their livelihood and access to natural resources as over 30% of the population is tribal.
• Involvement of Private Sector and Civil Society – Promote public private partnerships (PPP) in a variety of services and specialties and ensure better access for the medically underserved and vulnerable groups to these services.

Health Care Vision 2022 of Chhattisgarh State

• The health of the population is a product of many factors and forces like, employment, per capita income, health education, literacy, women’s age at marriage and the prevalence of communicable diseases amongst others.
• Chhattisgarh has one of the highest death rates amongst the states in the nation at 9.6 per 1000 and has a birth rate of 26.7 births per 1000.
• Some of the diseases that affect the population of Chhattisgarh are anemia, sickle cell, malaria & typhoid.
• Some of the main reasons for health issues in Chhattisgarh can be identified as the degradation of natural environment, lack of health facilities, illiteracy, lack of proper nutrition and lack of proper source of employability.
• According to International Institute for Population Sciences (IIPS) survey which was conducted for 652 villages of state out of the 20378 total Villages of Chhattisgarh, only 251 villages have Primary health Centres and there are only 137 Community health centers to cater to these villages.
• Of these primary Health centers, only 6.8% have Lady Medical officers and only 40% have more than 4 beds. For Chhattisgarh to progress and achieve its vision it is important that it has a healthy population.
• The major action agenda for achieving the vision would be to improve access to affordable health care services to the population as whole.
• The strategies could be

1. Greater emphasis on public health education and prevention. The wide dissemination of health and nutrition related information through traditional channels should be supplemented by an ambitious and persistent programme of public health education through the print, television, radio and electronic media.
2. Each village to have a fully equipped Primary health Care Center.
3. It needs be ensured that quality medicines at low cost are easily available and internationally banned medicines are neither prescribed nor distributed.
4. A public health insurance scheme should be formulated and implemented to cover every citizen of the state. Health Insurance should be a fundamental birth right.
5. A programme for training and development of medical and para medical staff for all Primary and sub health centers needs to undertaken to meet the shortage of medical professionals in villages.
6. More medical institutes be set up for churning more doctors
7. At least one Multi speciality clinic in each district be set either by government or PPP mode to meet the special health needs of the population
8. Technology can be used to provide e health care services in remote areas.
9. Proper preemptive control measures to be put in place for serious diseases & epidemics

Chhattisgarh State some State Specific Scheme

Baal Hriday Suraksha Yojana

• Started on 15th July 2008, it provides grant for children with heart ailments
• Institution involved – Apollo S.R. Hospital- Bhilai, Ram Krishna Care Hospital,-Raipur, Escort Heart Centre- Raipur, Apollo Hospital-Bilaspur.

Chhattisgarh Rural Medical Course (CRMC)

• Chhattisgarh is a state with high forest cover and many of these areas are conflict-affected, underserved areas are high where doctors are not available to work and lack of adequacy in other staff also.
• Currently the major strategy that is able to contribute towards outreach in these areas is the Mobile Medical Units, where 74 MMUs are operational
• A package for medically underserved areas with special incentives and promotional support for doctors is drafted and a pilot proposal on this is submitted for approval as part of this PIP. This comprises a block headquarter based health department colony, transport facilities to peripheries, insurance schemes and family support for education etc.
• In addition to this a special strategy for areas in conflict situation is also envisaged as many areas within Dantewada and similar districts are facing such a situation.
• State is also planning to deploy the diploma holders in modern and holistic medicine trained in the state as part of a 3-year medical course in rural PHCs this year.

Prerana Scheme

• Jansankhya Sthirata Kosh (National Population Stabilization Fund) is an autonomous body of the MoHFW, Govt. of India has launched PRERNA, a Responsible Parenthood Strategy in 2008 in seven focus states namely Bihar, Uttar Pradesh, Madhya Pradesh, Chhattisgarh, Jharkhand, Odisha, and Rajasthan.
• The strategy recognizes and awards couples who have broken the stereotype of early marriage and early childbirth and helped change mindsets.
• In this scheme, the girl should have been married after 19 years of age and given birth to the first child at least after 2 years of marriage.
• The couple will get award of Rs. 10000/- if it is Boy child or Rs. 12000/- if it is Girl child.
• If birth of second child is at least after 3 years of first child birth and either parent voluntarily accept permanent method of family planning within one year of the birth of the second child couple will get additional Rs. 5000/- if boy child and Rs. 7000/- if girl child. The scheme is only for BPL families.