Lack of water at the Asegaon primary health centre in Mokhada,a remote part of Thane,had led to doctors refusing postings there. It was on the brink of closure when an initiative by a village health committee ensured the PHC got 24 × 7 water supply. At a meeting of villagers,Eknath Nikhade,20,from Osarveera village suggested fitting a pipeline to the PHC from a well at a farm 2 km away.
Some months ago,Nilesh Jagtap,sarpanch of Belsar in Purandar taluka,decided along with other committee members to give their land for a primary health centre near Pune.
In five Maharashtra districts,community boards monitored under the National Rural Health Mission have been frequently taking up initiatives such as these. Larger issues that require the state governments intervention,however,are yet to be resolved. Five years since the state rural health mission was set up,the government is yet to form a committee to monitor the implementation of the programme,a reply to an RTI query by The Indian Express has disclosed.
Names for the committee had been finalised and the proposal submitted as far back on August 8,2010,says Dr Satish Pawar,joint director of NRHM,Maharashtra,when contacted.
Community-based monitoring was introduced as part of the NRHM to ensure that the services reach those they are meant for. In Maharashtra,Sathi-Cehat has been identified as the nodal NGO for community-based monitoring and coordination with the government. Nitin Jadhav,coordinator of the state-level community based monitoring programme,said work was concentrated initially in the districts of Pune,Thane,Amravati,Nandurbar and Osmanabad. Another eight districts,Aurangabad,Chandrapur,Gadchiroli,Solapur,Kolhapur,Nashik,Beed and Raigad,will be monitored next and CBM committes have been set up.
At the core of the CBM committees are tracking,reporting and recording the state of public health services in villages. Village health report cards are prepared with colour-coded ratings for good,bad and average,says Jadhav.
The panels also hold public hearings. It was following hearings in Amravati district that beneficiaries of the Janani Suraksha Yojana were paid their due of Rs 700.
The system,however,does not provide guaranteed health services. says Dr Abhay Shukla,member of the national advisory group of NRHM. Issues such as procurement of medicines,their distribution and shortage of staff,including Class III and IV personnel,need to be tackled by policymakers at state level,he said.
There are barely 1,583 doctors to provide services under NRHM in the villages. As per the RTI reply,505 doctors are on contract and 988 are in regular service. NRHM officials admit that the requirement,however,is 4,000-plus. When swine flu was at its peak in 2009,NRHM officials say,there were hardly any trained physicians who knew how to use the ventilators at the rural hospitals.
Officials say that setting up a state-level committee has taken time due to the change in chief ministers in the last couple of years. The panel needs to have 35 members,with 25 MLAs,and is to be headed by the Chief Minister. A coalition government necessitates inclusion of members from all parties; this is what has reportedly delayed the panel.
The NRHM director and the chief secretary take up various issues that need to be resolved.
To monitor NRHM at state level is required,yet to be set up.
Have community-based monitoring units; these are Pune,Thane,Amravati,Nandurbar and Osmanabad.
Conducted by these monitoring committees so far.
Will be covered next: Aurangabad,Chandrapur,Gadchiroli,Solapur,Kolhapur,Nashik,Beed and Raigad .
23 and 17
Community-run units at block levels in these two sets of districts. The structure includes 78 and 52 units at PHC level,23 and 17 at block level,and finally 500 and 255 village-level committees.
Rs 1379.61 crore
Sanctioned under NRHM ,10-11,up from Rs 519 crore in 2006-07