Chief secretary JN Singh Thursday pulled up government officials citing the NITI Aayog health index report that placed the state in fourth position.
Addressing a two-day workshop by the state health department on targeted approaches to accelerate health outcomes for the state, Singh expressed his dissatisfaction at the state’s performance, especially on “easy targets” such as improving maternal mortality rate, infant mortality rate, sex ratio and immunisation.
Singh said he would look into the micro-level data and the government would crack the whip on underperformers. “We should have zero ‘death tolerance’. We don’t tolerate a death in our family, why should we tolerate one in that of others? It is our duty to provide best possible services. Do visit a family where a young mother died — you’ll feel the pinch when you see the children crying. Let me put it very bluntly — it is due to neglect by our own management — DDO (district development officers) and downwards. The chief district medical officer, the primary healthcare medical officer — it is due to sheer negligence (on their part). At some point, maybe not now but say five years down the line, someone may file a civil suit, a criminal suit even,” Singh said.
The chief secretary’s dissatisfaction also arose from the mismatch in the amount of money spent vis-a-vis the outcomes. “Our staff position is reasonably good in Gujarat. Given the investment on health that we are putting in, why should not there be responsible results?” Singh asked.
“Kerala is the leader with a huge margin. We may have maintained the rank but nobody is satisfied. Our efforts have to come in a big way. Yesterday in cabinet, CM gave very clear-cut targets. When we are doing well in other places — industries, water management, etc, there is no reason why we should be poor in health and nutrition. Look at the indicators (in the NITI Aayog report) where we lag. For example, Gujarat is one of the worst in the mortality rate of children under five years. This implies that ICDS network has to be very good for the mother to not have anemia and not weigh less,” Singh said. The workshop was attended by district development officer (DDO) and deputy municipal commissioners.
“Health department is sitting in Gandhinagar, they can’t do it all over the state. I’m asking at your level, are you able to track your talatis, your health workers, with all the digital capabilities that you have? Can we not track everybody by geo-fencing or geo-tagging all workers? What is stopping us? Try to institutionalise this within the next 15 days. For example, before a childbirth, a health worker is expected to visit the pregnant mother four times. See if they are or not. Do some sample cases. Whether nutrition being promised by ICDS is reaching the target. The way Kerala has performed, in health services and other, it is is remarkable,” Singh added.
“In the 2016 data, the worst state when it came to sex ratio was Haryana and second-worst was Gujarat. See the figures, your blood will boil! Sex determination must be dealt with very strongly. It is the most rampant in north Gujarat and there has to be targets which we need to be strict about it. What is in your hand is to have maximum number of raids to detect those clinics/doctors conducting sex determination tests,” Singh exclaimed.
Madan Gopal, senior consultant (health) NITI AAYOG, ran the numbers and data and flagged several indicators, such as under five-year-old mortality rate and TB treatment, where the state needs to improve.