Health Policy Issues and Health Programmes in ... - Amazon S3

Inaugural Sessionhealth policy. I must thank USAID for its full cooperation and support in the task offormulating this health policy because at the initial stage, when we were thinking about howwe would accomplish this gigantic task, we asked for USAID to offer us technical assistanceand they responded whole-heartedly, without batting an eyelid. Immediately, they offeredsupport through the POLICY Project. We thank USAID, Mr Victor Barbiero, Ms SheenaChhabra, and The Futures Group, in particular, for extending their full support andcooperation, which is making these workshops possible.As many of our preceding speakers have mentioned, many of our indicators in Uttaranchal,while they are better than in other states on many fronts, show that we still do not perform sofavourably. As already mentioned, only 41% of our children are fully immunized; 18% of ourmothers receive the full complement of three antenatal check-ups; 21% of births in Uttaranchalwere delivered in a medical facility. Among the births delivered at home, only 17% wereassisted by a health professional. And, as Ms Chhabra just mentioned, 41% of married womenhave reproductive health problems and 69% of them have not sought any advice or treatment.21% of women have an unmet need for family planning. 42% of children three years of age inUttaranchal are underweight, 47% are stunted, and 8% are wasted.Many of these problems, of course, have their roots in the big problem of access. We have a veryscattered population. More than 50% of our population live in villages of less than 200 peopleand over 80% of our population lives in villages of less than 500. So reaching out to suchscattered population itself is a big challenge. To top it all, as we are placed today, we havetremendous insufficiency of both manpower and willingness of many of our public sectorhealth providers to live and work in the remote and inaccessible areas. There is a question ofincentives for these providers to be addressed, and I think these workshops and the healthpolicy will look at it very, very seriously. There are organizational issues also.Of course, there is a question of equity. As has been brought out by the National Family HealthSurvey (NFHS), even today and even in Uttaranchal, where there is a common presumptionthat in the hill areas there are no private health providers, more than two-thirds of our peopleaccess health care services from the private sector and even those below the poverty line (BPL)are going to the private sector—the majority of them. So obviously it brings us to the issue ofequity and also quality and, of course, financial risk protection for the poor. We have sessionson insurance and equity, and I hope these sessions will address the issue. This is also closelylinked to issues of consumer and patient satisfaction because, ultimately, we need a satisfiedpatient when it comes to curative health services.We have to look at our institutions and our institutional arrangements governing the healthsector, and I hope that the workshop will throw up various alternative models. Finally, I thinkthis workshop will bring out the best because we have experts who are nationally acclaimedand experts from institutions that have a lot of respect; it will bring to Uttaranchal the bestpractices that are prevalent in other states and other countries.5