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

Inaugural Sessionhad mentioned the issue of the scheme called the Pradhan Mantri Gram Sadak Yojana. Well, weare going about this business of connectivity through that scheme in a very focused manner.But as he very rightly pointed out, in the hilly terrain it is probably not physically possible foreach and every village to be connected. At any rate, in the context of Uttaranchal, it would havevery extreme sensitivities with regard to ecology- and environment-related issues. So howphysical access can be provided is a matter to be seen. In this context, one of the otherannouncements that was made in the address by the government was that within six monthswe would also be preparing a comprehensive connectivity plan—roads that could be from thelevel of national highways to state highways to motor roads to various other types of roads. Inthat process, the point that was mentioned by Mr Pant becomes very important—we need notonly look at that as a matter of all-weather motorable roads, but also where we can have bridlepaths, alternative communication systems like ropeways, and so on. So we take that suggestionon board and we’ll widen it from a master road plan to a communications master plan.Simultaneously, you also mentioned the idea of a growth centre concept, which I think is veryimportant. In the hills, in fact, the chauraha concept (where roads from two to three sides meetand some shops come about and act as a kind of a service centre for some hinterland villages) isa concept that we are adopting for the very wide and large programme of informationtechnology (IT) connectivity that we have submitted to the Government of India. It basicallyconceives of something like 386 centres, which we would be calling communication centres orgrowth centres where these information kiosks, telephone connections, and certain types ofother basic infrastructure activities could become available. We are already fairly advanced inthe process of discussions on this both with the Government of India and with private sector ornon-governmental bodies like ILFS, with whom hand-holding sorts of exercises would be done.In this very context, at another level, there has also been a suggestion that in Uttaranchal weshould revive and reactivate the nyaya panchayat concept, which again fits in with the growthcentre concept, with a cluster of 10 villages and so on. So you see the kinds of things that canbe provided there. That brings me to a thought that I have been expressing for some time, andI wonder whether this workshop could also look at that issue. We have a hierarchy of medicalinstitutions. Right now we are engaged at the highest level of that hierarchy, which is in theform of a medical college, and we are hopeful that the Ministry of Health, Government ofIndia, and the Medical Council of India will be giving us clearance for the college very shortly.They indicated in a recent meeting that they would like the state government to fulfill acouple of other conditions, which the Cabinet has moved very quickly to decide upon. So athighest level we would have that. Then we have, of course, base hospitals, district hospitals,PHCs and CHCs and subcentres, and so on. We did some exercises a couple of years ago andfound that many areas are in a completely uncovered kind of zone, despite theseconventional hierarchies of medical systems. What I have been suggesting is whether we canidentify areas, possibly at the growth centre level or the nyaya panchayat level, that arebeyond certain distances in terms of connectivity and see what kind of a system, in terms oflow-cost infrastructure, we can provide for a dispensary, for a room where a doctor canprovide consultancy, and where a paramedic from the local community can be trained andperhaps also live. We can have doctors coming in from higher levels in the hierarchy on a7