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If it delivers on its promises, the planned National Rural Health Mission (NRHM) could change the face of rural healthcare in India. The mission seeks to integrate different vertical health programmes, decentralize healthcare service delivery at the village level and improve
inter-sectoral action. It is an articulation of the commitment of the government to raise public spending on health from 0.9 per cent of GDP to 2-3 per cent of GDP, over the next five years.

The most important hurdle will be getting different states to take ownership of the entire process. Health is a state subject in India and most of the financial outlay (up to 85 per cent of government spending) is made by the state governments. Appointing personnel, filling vacancies, ensuring district-level coordination, and enabling community and panachayats, institutions to have a role in planning and monitoring services are all functions that require the active participation of the state government. The poor in India have always lived in hope; the National Rural Health Mission has become a new hope for them. It will take a concerted effort between the state and central governments, a partnership between the government and the non-government sector, a common commitment to standards by providers and managers, and faith in the people's ability to make plans and monitor them for this hope not to be betrayed.

Lack of Human Resources

The multi-billion-dollar National Rural Health Mission (NRHM) was launched three years ago, but India's 650,000 villages continue to face a shortage of doctors and paramedics, says the Planning Commission. "There is still a yawning gap between the requirement and availability of human resources in the rural health units at various levels. As of December 2007, for example, only 5,910 specialist doctors were available at community health centres across the country, against the requirement for 21,490," the report said. Though there is an improvement over the 3,550 specialists that these community health centres had prior to the launch of NRHM, the pace of implementation needs to be accelerated. The plan panel will shortly review the flagship rural health scheme to provide effective healthcare facilities to the rural population. The union health and family welfare ministry, the nodal agency for NRHM, has earmarked over Rs. 120 billion for the mission in the current fiscal. The country's primary health centres (PHCs) are also understaffed. The plan panel says there were 31,381 doctors at these centres by the end of December 2007 as against 20,308 doctors engaged there before the flagship scheme was launched. There is a need to accelerate the process of appointment of doctors and nurses and other paramedical staff at a greater pace.

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Dr. Gursharan Singh Kainth started his career as Lecturer at Post Graduate Dept. of Economics, Government College, Gurdaspur, and later at Khalsa College; Amritsar, specializes in Quantitative & Development Economics. Has the distinction of serving Punjab Agricultural Univ, Ludhiana, for more than 2 decades and remained Director-Principal of Saint Soldier Management & Technical Institute, Jalandhar. Currently, heading GAD Institute of Development Studies, Amritsar, a self-financed research institute. Has been honoured with various awards, including Guru Draunacharya Samman, Vijay Rattan Award, etc.
Article posted on December 14, 2008.