Madhya Pradesh Needs to Invest in Health

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The theme of World Health Day on 7 April was 'Invest in Health – Build a Safe Future'. The above theme is more relevant in Madhya Pradesh, central part of India. The State urgently needs to invest in health to help save lives of its own people especially women and children.
The State of Madhya Pradesh has the highest rates of malnutrition among the children in India. As per the latest National Family Health Survey 60 % of its children in age group of 0 – 3 years are under nourished. Similarly as per the growth monitoring drive undertaken by the state 78,000 children in the state are severely malnourished, meaning they need immediate care. Though the state has set up nutritional rehabilitation centers in some of its districts to provide for medical and nutritional care and support to the parents of severely malnourished children but need is of more efforts in this direction or else many may die.

Madhya Pradesh has the highest infant mortality rate and 3rd highest maternal mortality ratio in the country. 76 out of every 1000 children born in the state die before their first birthday and approximately 24 women die everyday in the state. Though the state has introduced many schemes to help combat the same, but due to bureaucratic hassles and corruption the schemes are not yielding the desired results for children and women. As per state's health department web site Madhya Pradesh for its population of 60.38 million (as per 2001 census) has the following health infrastructure:

- District hospitals 48
- Civil hospitals 54
- Community health centers 270
- Primary health centers 1149
- Sub health centers 8834
- Sanctioned beds in district hospitals 8945
- Sanctioned beds in civil hospitals 2775
- Total licensed blood banks by state 41

A NGO namely Collective of Advocacy research and training which advocates on the issues of maternal and infant survival has been calling the issue to attention. They had undertaken an analysis of rural health infrastructure versus the population in the state. As per their statement there is just 'one bed per 5.6 villages' in the state which is alarming!. It is not only the issue of beds or buildings. Even where there are structures or health centers they lack basic minimum facilities as needed and defined by rules and are not sufficient enough to save lives or provide for better health care to its people.

As per Reproductive and Child Health District level household survey (2004) data, out of the 386 primary health centre's surveyed in the state only 224 had drinking water facility. This means that only 58.3 percent primary health centre's had drinking water while others have no such facility. Similarly in case of community health centre's out of the 46 surveyed only 10 had facility of drinking water. In case of vehicles like ambulances out of the 386 primary health centers surveyed only 35 had vehicles which were in running condition and out of 46 community health centre's surveyed 31 had vehicles in the running condition.

Infrastructure investment does not only mean building equipments etc. Human resource which is core in health needs to be focused upon. Not only to fulfill the vacancies of doctors, para-medics, nurses but also providing them with facilities to provide care for the people. When one raises concern on the issue of health there are numbers of different issues which impact lives of people including women and children in the state which needs attention. Probably state needs to revamp and transform its health system and look at the whole issue more holistically. The State needs to peg health of its people as priority number one, transform on immediate basis which is not only limited to public proclamations and announcing schemes but also delivering results at ground level.

anil gulati

(All views expressed in this piece are personal opinions of the writer)