Centre-state coordination brings out best output in healthcare delivery: Union Health Minister

New Delhi: Union Minister for Health & Family Welfare Dr. Mansukh Mandaviya recently chaired the seventh meeting of the Mission Steering Group (MSG) of the National Health Mission (NHM).

"Streamlined coordination between Centre and States can bring out the best output in healthcare delivery. The Centre is committed to supporting States through financial and technical resources in efficient and effective implementation of health programmes aimed towards quality healthcare", said Dr. Mansukh Mandaviya.

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The MSG is the apex decision-making body of NHM that takes decisions on policies and program implementation under the Mission. Shri Gajendra Singh Sekhawat, Union Minister of Jal Shakti. Dr. Virendra Kumar, Union Minister of Social Justice & Empowerment, Dr. Bharati Pravin Pawar, Minister of State for Health & Family Welfare, and Dr. V K Paul, Member (Health), NITI Aayog, were among the members who attended the meeting.

Secretaries of Ministries of Government of India, including MoHFW, AYUSH, DoNER, and senior officers from WCD, Drinking Water and Sanitation, Panchayati Raj, Rural Development, Urban Development, Department of Higher Education, Social Justice and Empowerment, Health Secretaries of State Governments and eminent public health professionals also attended the meeting.

Addressing the meeting, Dr. Mandaviya noted that India is the only country in the world with a four-layer health infrastructure in place with a 10-lakh strong ASHA workforce at the grassroots. "These powerful foot soldiers of our health force have played a pivotal role in India's COVID management and COVID vaccination campaigns." He added that strengthening incentivisation of the healthcare workers who work with communities at the cutting edge can give an impetus to various programmes. He underscored moving ahead with a sharpened focus on timely elimination of diseases such Kala Azar, Leptospirosis, etc., as these diseases largely impact the poorest households and communities in the country.

The MSG was apprised of the achievements made under the NHM in the last few years, according to which more than 1.2 lakh sub-health centres and primary health centres have been transformed as Ayushman Bharat-Health and Wellness Centres (AB-HWCs), providing comprehensive primary care with a footfall of more than 100.8 crore.

The Pradhan Mantri National Dialysis Programme (PMNDP) has been implemented at 1,136 centres in 615 districts of 36 states and Union territories by deploying 7,809 hemodialysis machines.

Notification of tuberculosis cases increased from 18.2 lakh in 2017 to 21.35 lakh in 2021 with Rs 1,651.27 crore disbursed (under the DBT scheme) to 62.71 lakh TB patients for nutritional support (since 2018), the statement said, adding that in 2021, the treatment success rate of TB had reached 83 per cent, the highest ever.

The MSG was informed that major interventions in health have led to a reduction in the out-of-pocket-expenditure (OOPE) from 69.4 per cent to 48.8 per cent according to NHA estimates.

It was highlighted that 31 states have achieved replacement TFR according to the NFHS-5 report. Besides, 3.16 lakh human resources, including doctors, nurses, laboratory technicians etc. (excluding ASHA workers), in the states and Union territories are being supported by the NHM.

The Maternal Mortality Ratio (MMR) in the country has declined by 453 points — from 556 per one lakh live births in 1990 to 103 in 2017-19 (SRS 2017-19). Seven states have achieved the SDG target of MMR and the under-5 mortality rate (U5MR) has declined from 126 per 1,000 live births in 1990 to 35 per 1,000 live births in 2019. Eight states have achieved the SDG target of U5MR.

The MSG also deliberated upon costing norms for National Ambulance Services and Mobile Medical Units (MMUs). It was decided to incentivize ASHA for the creation and seeding of ABHA IDs in various IT portals of MoHFW. Additionally, the MSG discussed malnutrition among children, awareness, and capacity for prevention and control of snakebites and reviewed the status of the Prime Minister National Dialysis Programme.

The member Union Ministers appreciated the progress made under NHM through focused programmes and support provided to states over the years. Several suggestions were proffered including refinement and monitoring of fund flow from the state treasury to districts; ensuring the inclusion of left-out populations such as nomads, street dwellers, and various divyang persons in PM-JAY scheme; accelerating filling vacancies of technicians and paramedics in health facilities; incentivizing mechanisms; and enhancing the synergy between Centre and states for timely matching fund allocation from the latter.

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