National Healthcare Mission (NHM) is refurnishing itself to meet the surging demands of the healthcare sector, says Sanghamitra Ghosh, Mission Director, NHM, West Bengal while speaking to Subhajit Bhattacharya of Elets News Network (ENN)
How is the healthcare mission bolstering the growth of the healthcare industry in Bengal?
The NHM is developing manifold in this state of West Bengal. The prime objective of this mission is to modify certain public interventions which are of national level in a particular program. The entire NHM is evolving everyday to cater to a plethora of issues which are related to public health. We are tailoring several programs to address issues related to public health care. The NHM operates with the joint funding of the State and the Union Government.
What is the prime focus area of this mission?
The mission is refurnishing itself to meet the surging demands of the healthcare sector. It is constantly evolving with the demographic trend and also with the surge in the population. That is the reason the name of the mission also changed the from National Health, Rural Mission to National Health Mission, as we are now zeroing in on the healthcare needs of the urban population also. Now we have very differently designed projects to meet the healthcare related demands of the rural as well as the urban areas. Since its inception the mission started working towards women and child welfare but now the project monitors and handholds all the healthcare needs of a person. The program now revolves around the RMNCH+A (Reproductive, Maternal, Newborn, Child and Adolescent Health.
What are the reasons to lengthen the period of the project?
Previously the entire project was bent upon to uplift the healthcare infrastructure related to the women and children, but later we observed that the entire process is creating a massive gap. For instance the adolescent group in the state was said to be neglected, from the minimum healthcare facilities which are leading them towards an unhealthy motherhood or fatherhood. Now we are trying to break that nexus and concentrate on the adolescent group. Another major development which alarmed us is that the rise in the lifestyle related diseases such as heart related ailments,blood sugar and hypertension. A gamut of projects such as Rashtriya Bal Swastha Karyakram and Kishore Swastha Karyakram were trotted out to meet the rising demands of the adolescent healthcare. We are also taking special care on the communicable ailments such as tuberculosis, leprosy and other vector borne diseases like dengue, malaria and chikungunya. We have special programs for cancer, diabetes and heart related ailments and tailor made healthcare mission for the elderly as we all know that West Bengal is ageing very fastMinor yet important healthcare related projects like iodine deficiency and oral hygiene are other helath issues covered under the mission. As we are catering to the diversed health needs the mission time frame has also been extended.
How the mission is focused on state specific health care problems?
Currently certain diseases are more prent in the state of West Bengal and we have certain specific programs for them. Thalassemia is plaguing the state and it is a big challenge for us and we have specific plans to combat the same. The state government is taking all possible care to cork the rise of this disease within the state and also trying to build a robust infrastructure to meet with the demands of the patients who are suffering from this disease.
How is NHM balancing between the healthcare demands of the urban and rural population?
There is a massive difference between the disease profile of the urban slum dwellers and migrant labourers and the rural population who are living below the poverty line. The skin diseases and pollution related diseases are maximum amongst the urban population but at the same time under the urban health mission we access the disease burden also.
What kind of operational changes were clubbed in when the mission started dealing with urban population? What are the current challenges?
During the previous stage of the NHM, we were dealing with the rural population and village oriented governance, which was uniform and much systematic. In the new phase of the project we are dealing with municipal corporations which have their own capacity and strengths and weaknesses. For us all these 92 MCs are individual entities and we are dealing with them on a case specific basis. This is the biggest hurdle of the urban health mission. More autonomy would usher more problems for the civic bodies to operate within a specific framework.
Why West Bengal as a state is important for NHM?
The state of West Bengal is very important for the National Health Mission because the state is extremely populous and the state has shown remarkable developments in the field of neonatal care. The child mortality dipped over the years. The issue of child mortality is extremely complex and we need a proper community intervention to deal with it.
How West Bengal has shown some splendid developments under NHM?
All the departments worked in harmony which brought parity and added fuel in the progress of all the projects which are implemented under the NHM in Bengal. The synchronisation is very important and we work with different departments such as higher education and animal husbandry which helps us to deal with several zoonotic diseases. We work under a formalised structure, meet regularly and discuss on varied issues which are related to the healthcare of the state.
How is the state government managing to get skilled manpower for the pleathora of projects mentioned
Developing skilled and able manpower is the focus area of the mission. There are two aspects of human resource development under the NHM, one is recruiting the manpower on a contractual basis and also honing their skills. We also train our staffs to meet multiple needs. We are building a strong team of nursing and paramedic staffs. For Critical Care Unit (CCU) technicians training we have tied up with Singapore. We are recruiting massively to complement the health care juggernaut in the state of Bengal.
NHM is building an integrated state of the art mother and child hub. These units will be spread across all the major 15 districts of Bengal such as Murshidabad and Midnapore, Purulia and even in Kolkata
How NHM is focusing on the all round development of the healthcare infrastructure in Bengal?
The mission focuses on the overall development of the healthcare system, particularly the infrastructure development and on the free flow of drug supplies. We are mulling about the idea of starting up 20 to 25 new neonatal units within the state. Also, we are building an integrated state of the art mother and child hub. These units will be spread across all the major 15 districts of Bengal such as Murshidabad and Midnapore, Purulia and even in Kolkata. The state health department is building 41 multi specialty hospitals across West Bengal. We have also created CCU in all the district hospitals.
How the PPP model is encouraged under the NHM?
NHM runs several mobile medical units and also tied up with several NGOs and private organisations to roll out several healthcare related services to the people of the state. We run boat dispensaries in remote areas of Sunderbans and also provide high end diagnostics facilities in hospitals which work under the PPP model. Several fair price shops have also been established within the state by following the PPP model.
How NHM is working towards a proper nutrition policy in the villages?
The mission focuses on the micro nutrition policy by addressing the basic helath needs like folic acid supplementation and iron supplementation for the anganwadi infants. We intervene at a very initial stage, mainly during the puberty and continue it till the woman reaches her menopause.
Often critics say that NHM concentrates on developing the infrastructure and later the entire thing decays because of lack of facilities. Your viewspoint?
The biggest problem that we are facing is that we cant withdraw the existing manpower for training because there is a dearth of serious and skilled manpower. So we are planning for on-site training, where the mentors will develop the skills by reaching a specific location. Also observing the outcome of the projects that we implement in a state helps us to analyse on the loopholes. We are also concentrating on family planning and immunisation.