NATIONAL RURAL HEALTH CARE MISSION - AN APPRAISAL
By Dr Sibichen K Mathew
This is an attempt to provide a critique of the National Rural Health Care Mission (RHM) through a brief analysis of the salient features of the system in the context of earlier health programmes and in the context of the multi dimensionality of the health problems in rural India. The objective is to examine to what extent the new scheme addresses the hitherto unresolved anomalies in the sector and the challenges in implementation. It is felt that strengthening the existing governmental machinery with adequate training, finances and leadership and its network with ‘independent’ grass root level organizations would help in effective implementation. The note also suggests the relevance for an area specific strategy for implementation and recommends that necessary freedom be given to respective regions for formulating appropriate initiatives without compromising the overall objective of the mission.
It may be quite unpleasant to start with a statement that the mission is , in fact, ‘an old vine in a new bottle’. However it also has its own positive connotation when one interpret the statement that it is also indicative of the consistent policy perspectives of the government and its long-standing desire to strengthen the rural health services. The latter view cannot be rejected as the commitment and the efforts of the government are strongly evident from the series of schemes, programmes, committees and policy initiatives in the post independent India...................
............................................As suggested earlier there is a need to have a micro perspective in implementing the RHM programmes giving maximum flexibility at the regional levels to decide on the priority areas. Considering the unique and diversified socio cultural contexts within India, it is imperative to supplement the efforts of RHM by suitable enlightenment on the social determinants of health in India as proposed by WHO. Research projects focusing on the above area would definitely help in strengthening the formulation of health policies and programmes focusing on rural poor.
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