A better management of health-related initiatives has been recommended by the National Rural Health Mission (NRHM) second Common Review Mission. However, it admits to some improvements having taken place in this sector.
Outpatient cases, institutional deliveries, impatient cases, diagnostic services, emergency transport services have all registered an improvement in a majority of the States.
Over 50,000 nurses and ANMs have been added on contract under the National Rural Health Mission, besides nearly 15,000 specialists, MBBS doctors and Ayush doctors, says the report.
Such large-scale addition of human resources has translated into improved availability of health care services for people in rural areas.
According to the report, 13 states were visited by six member teams as part of the review mission in November-December 2008.
Public health experts, NGO representatives, development partners, senior public servants etc. were part of these independent teams that spent ten days in two districts of the selected states.
Assam and Mizoram in North Eastern region, Bihar, Uttar Pradesh, Madhya Pradesh, Orissa, Jharkhand, Chhattisgarh and Rajasthan from among the high focus States, four States namely, Karnataka, Maharahstra, Kerala and Tamil Nadu among the non-high focus States were covered in the current Common Review Mission.
The report says that there is large-scale evidence of poor people coming to government facilities on much larger scale than before. Attempts are being made to reduce the shortages of human resources, physical infrastructure, equipments etc.under the National Rural Health Mission, the report added.
The report has recommended a fast expansion of medical and nursing education in high focus states for provision of adequate number of health human resources.
Similarly, more efforts at building capacities among community leaders in the management of health programmes and in seeking inter-sectoral convergence with other determinants of health like water, sanitation, education and nutrition etc. is required.
The mission found that states with better baseline like Kerala, Tamil Nadu and Maharashtra have been in a position to make quicker use of untied funds.
It felt the need for more flexibility in funding along with better management for enabling the areas of infrastructure, human resources and supplies to catch up with the achievements in institutional deliveries.
In the field of public-private-partnership, most of the states have NGO and private sector collaboration. A need was felt to deepen such partnerships in the states like Kerala, Madhya Pradesh and Uttar Pradesh. NRHM has definitely given a boost to community participation in the health sector.