Rural healthcare scheme likely

To be implemented in 17 states initially, the scheme will be funded by the central govt

A new package for rural health that has a significant cooption of private practitioners in rural areas was unveiled in the Prime Minister's Office by the health and family welfare ministry today.

This is the first major step in putting in place a new delivery system for health in the rural areas, as promised in the national common minimum programme.

The initial phase of the rural healthcare mission is to be implemented in 17 states by January 2005. The states include Uttar Pradesh, Bihar, Madhy Pradesh, Jharkhand, Rajasthan, Uttaranchal, Orissa, Chhattisgarh, Jammu and Kashmir and the North-eastern states.

Once cleared, the package will be announced by Prime Minister Manmohan Singh on November 14. It is a multi-sectoral programme encompassing population stabilisation, reproductive and child health, immunisation and a few new rural development initiatives.

The rural healthcare mission will be funded through the existing allocation of Rs 6,000 crore for the family welfare department, Rs 2,000 crore for the health department and Rs 2,000 crore for Ayush (Indian system of medicines).

"The rural healthcare mission needs no additional funding at this point and will use the existing infrastructure of various sub-centres to deliver the programme," Health and Family Welfare Minister Anbumani Ramadoss told Business Standard.

The rural healthcare mission is to be funded entirely by the Centre, Ramadoss added.

The government plans to use 145,000 sub-centres (the most peripheral point of contact between the primary health care system and the community), 23,000 primary health centres and 3,200 community health centres for implementing the programme.

The rural healthcare mission will use the male health worker or a male nurse at the sub-centre level for every 3,000-5,000 people. a ratio of one worker for every 4-5 villages.

At the village level, the woman worker will be designated the "daughter-in-law" of the village in charge of the village's pregnant women.

The woman worker will be identified by the panchayat and women's help groups and will receive a honorary remuneration of between Rs 1,500 and Rs 2,000 a year. She will aim at making access to the sub-centres and the primary health centres easy.

The programme would be monitored at the district level by using e-logistics records, official sources said.

The success of the programme, however, depends on inviting the participation of private doctors. A practitioner at the village or town level will be identified and accredited before he is inducted into the programme. The practitioner will be paid a remuneration, be insured and the government will facilitate the provisions of medicines to him for common ailments.

In states such as Bihar where private practitioners out number the government health service providers, the programme hopes to induct about 30-40 private doctors per district.

The investment in health slated to grow by 2-3 per cent of the gross domestic product in the next five years, the ministry is looking at about Rs 28,000 crore to be pumped into the various schemes under the mission.