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

National Health Programmes: An OverviewCapacity Building Among StaffIt is also important to ensure a system for capacity development of the programme staff. Thetraining may include modules on epidemiology; management, which deals with programmeplanning, particularly micro-planning; geographical information systems; monitoring andevaluation; MIS; and clinical aspects, such as diagnosis and case management. Even thoughtraining activities are currently being implemented under many programmes, these are verticalin nature and are not sufficiently related to developing skills among the trainees. For primaryhealth care personnel, it is advisable to have integrated training covering all the programmesthat have been integrated at that level, with more focus on practical skills.Community Involvement in ProgrammesBecause services under all the national health programmes are included as part of the deliveryof primary health care, the essential principle of community participation is vital for theirsuccess. For the people to feel a sense of ownership of a programme and its activities, it isimportant that, from the identification stage of the need itself, the people be a party to it. Further,detailed programme planning should be done with the people’s involvement. With theconstitutional provision for strengthening local self-government, the Panchayat and Nagarpalika, with elected representatives of the local population, the involvement of the people inrunning the programme has become easier. A number of scientific techniques, such asparticipatory learning assessment (PLA), that may be applied for achieving communityparticipation have been developed by social scientists and anthropologists. Probably thedifferent “societies” constituted under the programmes (blindness, leprosy, AIDS, RCH) may alsohelp in this direction.With progress in the implementation of programmes for diseases/conditions, such as leprosy,blindness, and polio, there is also the need for better rehabilitation services; more emphasisneeds to be placed on “community-based rehabilitation” with the active participation of thecommunity. Similarly, with more and more cases of people suffering from full-blown AIDS, thereis greater need for home-/community-based care of the affected individuals. Better communityawareness and involvement will also be essential in the future.Effective IEC programmes are extremely crucial for achieving community participation.Focus on Specialized Population GroupsIn India, urbanization is progressing at a fast pace. Due to the inadequacies in expansion ofbasic amenities commensurate with the population growth in urban areas, large numbers ofslums have arisen in many cities. Slum populations are most vulnerable to multiple healthproblems, and because there is no proper arrangement for delivery of primary health care inthese areas, the respective national health programmes also do not get the attention theydeserve. Particularly with programmes like TB and leprosy control, in which case detection andprompt and complete treatment are the main strategies to be followed, the slum and migrantpopulations temporarily settling in these areas are likely to be left out. This may pose ahindrance to the achievement of programme goals. Similarly, the tribal, desert and hilly areas,27