January 2014

Working for a Healthier Odisha

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Roopa Mishra
Mission Director, National Health
Mission, Odisha

“We are aspiring to develop a truly integrated and more efficient strategy for providing healthcare services to people in the state,” says Roopa Mishra. In conversation with Nayana Singh

Now that NHRM (National Health Rural Mission) is being modified to NHM (National Health Mission), what will be the mandate of the new entity?
From the financial year, 2013-14, NRHM has got a new identity in the form of NHM, wherein new dimensions that had not been addressed earlier have been integrated under one broad ambit. The National Health Mission will have two sub health missions, the rural mission and urban mission. Ever since the mission was initiated, we have been predominantly working in rural areas and in the area of reproductive child health. Today, it is being felt that even the urban areas need that similar kind of (or even more) focused intervention, for which Urban Health Mission has been brought in the frame. Newer aspects of health in the form of Non Communicable Diseases like cancer, cardiovascular, diabetes etc. would be addressed apart from traditional diseases like malaria, T.B etc. Disease Control Programmes were earlier operating as vertical programmes with funding being given by Government of India (GoI) directly for the same. Now all funding from GoI will be received under the NHM under five heads: National Rural Health Mission (NRHM), National Urban Health Mission (NUHM), National Disease Control Programme (NDCP), Non Communicable Diseases Control Programme (NCDCP) and NHM Additionalities (for infrastructure development etc). We are aspiring to develop a truly integrated and more efficient strategy for providing healthcare services in the state.

Please tell us about the ICT initiatives that you are taking to bring further improvement in the state of healthcare?
All the activities of Health Department, be it Drug Management, Food Safety, Vaccine Management, Infrastructure Creation etc., require ICT intervention for stronger implementation and monitoring. NHM, in Odisha, has attempted to develop simple applications that are user friendly and outcome based, helping us to monitor our programmes well.
As a result, modules have been created that are a source of immense data and information, which can be used in many ways. The most important platform which is the core of our maternal and child health administration is Mother Child Tracking System (MCTS) and Health Management Information System (HMIS). E-Swasthya Nirman, e-Blood Bank, Drug Management Information system, Vaccine Logistics Management System etc. are few of the modules developed by NHM Odisha. We are planning to have an integrated platform of convergence wherein the activities of the health department would also be shared with the state flagship programme of ‘Mamata’ under W &CD Department. Online Civil (Birth and Death) registrations as of now are being done at some of the urban areas, but very soon it would be available, in all rural areas of the state as an NHM initiative towards system transparency. Simultaneously, the issue of online Disability Certificates would commence soon, which would be helpful to the citizens and at the same time providing a one stop data platform for all certificates issued.

What is the mandate of e-Swasthya Nirman Initiatives?
Today, institution development is not a standalone activity, it is very much linked to provisioning of quality health care services. Health Department is prioritizing building up of its core infrastructure. In this regard, we have taken a step in which every health facility of the state is being mapped in the “as is” and “to be” basis. E-Swasthya Nirman, a consolidated ICT Application, is of great help as a planning and monitoring module. A range of tasks from issue of work order to physical and financial progress of work can be tracked on this. We want to reach a level where our engineering team is completely dependent on this platform.

What is your view of using the PPP model for developing healthcare infrastructure in the State?
This is one dimension that we are eager to explore, now with urban mission being included in health mission. We will be exploring the PPP model in a big way in the form of Bhubaneswar Municipal Corporation Hospital Network Project. There will be 6 hospitals in the network comprising of primary, secondary and a Greenfield tertiary care hospital. While land would be given by H&UD department, the private partner will build and run the bedded network facilities. The Urban Health Mission will be integrating its urban PHC facilities at the same locations, taking the responsibility of community, preventive and outreach activity as well as drug provisioning for select OPD patients. In fact, there are many untapped areas in the health sector like pharma development, R & D facilities, quality testing labs etc. that could be tapped in the state for PPP ventures.

IMR and MMR have been brought under control to a large extent. Are there some new initiatives that have been directed further to uplift the condition of children or the expectant mothers?
Reproductive Child Health remains the mission’s primary focus. The state of Odisha has taken many steps in this regard, for which there has been steady decline in mortality numbers. There is a need for intensification of activities. A more focused RMNCH+A strategy, looking at reproductive, maternal, neo-natal, child and addressing adolescent health as completely a continuum of care would be the answer. We are also simultaneously focusing on health systems strengthening like human resource strengthening, drug provisioning, strengthening nursing, provisioning of referral transport, quality enhancement at facilities, medical education strengthening etc as instrumental interventions for reducing IMR and MMR and overall improved health outcomes. We are getting prepared to give shape to a 3 year perspective plan from 2014-2017 under the National Health Mission which will set the base for the State’s Health Vision. We would also be focusing on high priority districts. Ten districts (primarily KBK districts) have been identified as high priority districts, in view of mortality and other kind of parameters. They would be having intensified focus of the mission activities in all areas.

A state like Odisha faces diverse issues when it comes to healthcare. What is your vision for making the state healthier?
Mothers and children should not die due to want of health care. We aim at better maternal and child health to begin with. Secondly, out of pocket expenditure on health needs to be addressed. Provisioning of drugs and diagnostic services at all public health facilities is our immediate aim. Thirdly, we need to create a model for urban public health. Fourth area would be to provide a system addressing the need of non-communicable disease burden among public. Last, but not the least, we need to have a control over communicable diseases in terms of prevalence, incidence rate, morbidity and mortality. Ultimately, the vision is to move towards universal health coverage providing enhanced access, more services and reducing health out of pocket expenditure for our people.

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