The Niti Aayog’s joint working group (JWG) has suggested the Uttar Pradesh government to establish a fully staffed autonomous entity within 18 months for bulk procurement and distribution of medicines across the state. The action point, reviewed by The Indian Express, has been decided recently by the JWG for the state government in a document titled ‘Action Plan for Uttar Pradesh’. It has set up various targets in several sectors, including health and education.
According to the action plan, the autonomous entity for medicine procurement and distribution should be formed in six months, its staffing should be done in six months after the formation, its IT system should be established in three months once the staffing is over, and the procurement system should be established in three months after the set-up of IT system. Therefore, total 18 months would be required to establish the bulk procurement and distribution system of medicines in UP, according to action plan.
In health sector, the JWG has suggested the state to issue a policy for opening medical and nursing colleges within two months and establish telemedicine units within six months to deliver medical services in remote areas.
The JWG was formed after NITI Aayog vice-chairman Arvind Panagariya-led 17-member delegation held day-long deliberations on the way forward for Uttar Pradesh with Chief Minister Yogi Adityanath and other top state officials in Lucknow on May 10. The JWG was set up with six members — three members each from NITI Aayog and the state government – and was asked to “prepare a road map and identify action points for the development of UP”.
The action plan has also told the UP government to eliminate diseases like Kala Azar and Lymphatic Filariasis (LF) in 2017 only. According to NVDCP, the LF has been a major public health problem in India next only to malaria. Kala Azar is presently endemic in around nine districts of Uttar Pradesh – Balia, Deoria, Ghazipur, Gorakhpur, Kushinagar, Jaunpur, Sant Ravidas Nagar, Sultanpur and Varanasi. “The number of cases (in UP) reported during 2013 was 11 which increased to 131 in 2015 due to increased surveillance,” said the National Vector Borne Disease Control Programme (NVDCP) in its 2017 plan for Kala Azar elimination. However, it is Bihar that contributes more than 70 per cent of total cases of Kala Azar currently in the country.
According to action plan, Leprosy and Measles should be eliminated from UP by 2018 and 2020, respectively. It has also suggested digitisation of all records of medical staff within one year; introduction of screening for Non-communicable Diseases (NCDs) within two months; full vaccine and deworming coverage; health service delivery with a single line of control and accountability within two months.
Keeping in mind that UP has one of the highest Maternal Mortality Ratio (MMR) in the country — according to Sample Registration System(SRS), it was 285 per 1,00,000 live births for the combined region of Uttar Pradesh and Uttarakhand in 2011-13 – the JWG action plan has asked the UP government to go on a “mission mode to reduce MMR”. It has suggested the state government to take specific steps in this regard – early and digital registration of pregnancy; prescribing and standardising labour room practices within one month; starting 24 hour helpline for pregnant mothers within one month; training 10 thousand skilled birth attendants within one year.
The JWG action plan has also focused heavily on pushing the state government to “engage with private sector with public health goals”. It has suggested that primary healthcare centres (PHCs), community healthcare centres (CHCs) and NCD wings in district hospitals can be run on public-private partnership (PPP) mode. According to the action plan, digital payment of “health subsidies and incentives” should be “linked with Aadhaar cards” within one year.
Recommendations for education sector
According to Unified-District Information System for Education (U-DISE) Flash Statistics 2015-16, UP has the worst worst pupil-teacher ratio (PTR), with a teacher for every 39 students, at the primary level in India. Therefore, the JWG action plan has stated: “Rationalise teacher deployment. Use digital means to reduce discretion. It is recommended that state should recruit teachers equivalent to retirement/annual attrition so that recruitment is in order and promotions are done in a timely and ordered manner.”
Moreover, the JWG action plan has also asked the state government to “activate” block resource coordinator (BRC) and cluster resource coordinator (CRC) for “academic monitoring and mentoring of teachers”. The state has also been advised to “develop comprehensive teacher professional development plan” within one year; strengthen District Institute of Education & Training (DIET) and State Council of Educational Research and Training (SCERT) by filling up their vacancies through promotions and deputations within one year; use State Level Achievement Survey (SLAS) data and analysis to “feed into and shape teacher training, focus on weak points and lagging districts”.
According to Annual Status of Education Report (ASER 2016) released by Pratham Education Foundation on January 18, 2017, UP is one of the states where the student absenteeism is very high – in the range of 50 to 60 per cent. Moreover, as per this report, the share of out of school children (age 6-14) was the highest in UP with 5.6 per cent.
To reduce the number of out-of-school children, drop-outs and absenteeism, the JWG has suggested several measures to the state government: start a “special campaign” to enroll out of school children at primary and upper primary level; training teachers to ensure retention of those enrolled; special focus on districts with dropout rate greater than 10 per cent; activate gram panchayats and school management committees for reducing absenteeism.
The action plan has also asked the state government to consider integration of basic (primary) and secondary schools from the next academic session.