NRHM scam: CBI quizzes former UP Health Minister

New Delhi, Dec 28 (PTI) Former Uttar Pradesh Minister Anant Kumar Mishra was today interrogated by the CBI in connection with alleged irregularities in expenditure of funds worth about Rs 10,000 crore in the National Rural Health Mission and murder of three top health officials.

Mishra, summoned by the central probe agency today, was grilled for nearly eight hours during which he quizzed on expenditure incurred on various schemes, tendering process and procurement of ambulances for the state during his tenure as the Health Minister there. He was also asked about the funds allocated under the scheme to Lucknow district and also on some developments which have surfaced during the probe in the murders of two Chief Medical Officers -- V K Arya and B P Singh -- which took place during his tenure as the Health Minister of the state, CBI sources said.

The agency had summoned Kushwaha and former Health Minister Anant Mishra here for questioning in connection with the multi-crore NRHM scam and murders of health officials which had led to state-wide furore over allegation of rampant corruption in execution of the central scheme, they said. Kushwaha was questioned yesterday by the agency and is likely to be called again.

The CBI had started probe into the alleged irregularities in spending of Rs 10,000 crore allocated to Uttar Pradesh as central funds under NRHM, after registering five preliminary enquiries following orders of the High Court.

National Vector Borne Disease Control Programme (NVBDCP)

Directorate of National Vector Borne Disease Control Programme (NVBDCP) is the central nodal agency for the prevention and control of vector borne diseases i.e. Malaria, Dengue, Lymphatic Filariasis, Kala-azar, Japanese Encephalitis and Chikungunya in India. It is one of the Technical Departments of Directorate General of Health Services, Government of India.

Tackling AIDS & The Way Forward

Despite being a country with low HIV prevalence, India has the third largest number of people living with HIV/AIDS in the world. The Acquired Immune Deficiency Syndrome (AIDS) is caused by the Human Immunodeficiency Virus (HIV) which weakens the immune system of an individual. HIV attacks the immune system and leaves the body vulnerable to a variety of life-threatening infections and cancers. Thus, the epidemic of AIDS constitutes one of the most formidable challenges to the development and social progress of the nation.

HIV has been found in saliva, tears, nervous system tissue and spinal fluid, blood, semen (including pre-seminal fluid, which is the liquid that comes out before ejaculation), vaginal fluid, and breast milk. However, only blood, semen, vaginal secretions, and breast milk has been shown to transmit infection to others.

The HIV Estimates 2008-09 put the figure of people infected with HIV/AIDS at an estimated 23.9 lakh with an adult prevalence of 0.31 per cent. Most infections occur through heterosexual transmission. However, in certain regions, injecting drug use, men who have sex with men and single male migrants are contributing for the spread of HIV epidemic. The heterogeneous spread of the HIV epidemic is evident from the fact some pockets show high prevalence than the others.

Janani Suraksha Yojana (JSY)

Janani Surakha Yojana is another important component under NRHM. JSY is a centrally sponsored scheme to benefit pregnant women & certified poor families. The Government has introduced the Janani Suraksha Yojana to provide comprehensive medical care during pregnancy, child birth and postnatal care and thereby endeavour to improve the level of institutional deliveries in low performing states to reduce maternal mortality.

The NRHM provides broad operational framework for the Health Sector. Suggestive guidelines have been issued on key interventions like institutional deliveries, immunization, preparation of District Action Plan as well as schemes including ASHA, JSY etc. The States have the flexibility to project operational modalities in their State Action Plans.

It is envisaged that National Rural Health Mission shall be able to effectively improve the availability of and access to quality health care by people, especially for those residing in rural areas, the poor, women and children.

Accredited Social Health Activists (ASHA)

The NRHM covers all the villages through village-based "Accredited Social Health Activists" (ASHA) who would act as a link between the health centers and the villagers. One ASHA will be raised from every village or cluster of villages. The ASHA would be trained to advise villagers about Sanitation, Hygiene, Contraception, and Immunization to provide Primary Medical Care for Diarrhea, Minor Injuries, and Fevers; and to escort patients to Medical Centers. They would also deliver Directly Observed Treatment Short (DOTS) course for tuberculosis and oral rehydration; distribute folic acid tablets and chloroquine to patients and alert authorities to unusual outbreaks. Although these ASHAs would be honorary volunteers, there is a provision to provide them with performance-based compensation for undertaking specific health or other social sector programmes with measurable outputs, thus promoting employment for these volunteers.

If rural women want counselling on important issues such as birth preparedness, importance of safe delivery, breastfeeding and complementary feeding, immunization, contraception and prevention of common infections including Reproductive Tract Infection/Sexually Transmitted Infection (RTIs/STIs) and care of the young child, they may contact the concerned ASHA who shall be happy to provide them with all relevant guidance and assistance.

The general norm as decided under the Programme is ‘One ASHA per 1000 population’. In tribal, hilly, desert areas the norm could be relaxed to one ASHA per habitation, dependant on workload etc.

National Rural Health Mission (NRHM)

Rural Health Care forms an integral part of the National Health Care System. Provision of Primary Health Care is the foundation of all rural health care Programmes. For developing vast public health infrastructure and human resources of the country, accelerating the socio-economic development and attaining improved quality of life, the Primary health care is accepted as one of the main instruments of action. Thus, recognizing the importance of Health in the process of economic and social development and improving the quality of life of our citizens, the Government of India has launched the National Rural Health Mission to carry out necessary architectural correction in the basic health care delivery system. The Mission adopts a synergistic approach by relating health to determinants of good health viz. segments of nutrition, sanitation, hygiene and safe drinking water. It also aims at mainstreaming the Indian systems of medicine to facilitate health care.

The National Rural Health Mission (NRHM), a National effort at ensuring effective healthcare, especially to the poor and vulnerable sections of the society was launched (on 12th April, 2005 for a period of seven years (2005-2012)) throughout the Country with special focus on 18 states viz. Arunachal Pradesh, Assam, Bihar, Chhattisgarh, Himachal Pradesh, Jharkhand, Jammu and Kashmir, Manipur, Mizoram, Meghalaya, Madhya Pradesh, Nagaland, Orissa, Rajasthan, Sikkim, Tripura, Uttarakhand and Uttar Pradesh.

Govt Sanctioned Rs 28 cr Under NRHM For UP To Fight Encephalitis

The Central government has sanctioned an additional budget of approximately Rs 28 crore for Uttar Pradesh under the National Rural Health Mission (NRHM), to fight encephalitis in nine affected districts.

The fund will be used to build intensive care units as well as for creating awareness among people regarding the disease.

The proposal for these ICUs was sent by the state government following the visit of Union Health Minister Ghulam Nabi Azad last month to encephalitis-hit Gorakhpur and Siddharthanagar. The Centre sanctioned the budget last week.

Apart from this, the encephalitis hit region has already got a budget of Rs 5 crore from the Centre for a new encephalitis ward, four ventilators and human resources for the pediatric department of Baba Raghav Das Medical College, Gorakhpur. This proposal was sent by the state government following the visit of Chief Secretary Anoop Mishra to Gorakhpur in September. After Azad’s visit, a Group of Ministers headed by the health minister himself has also been formed at the Centre to come up with an encephalitis eradication programme.

In the proposal sent by the state this time, the Mayawati government had proposed establishment of intensive care units in district hospitals of nine affected districts. “We have proposed ICUs in the district hospitals of all the districts of Gorakhpur and Basti Division as well as Gonda and Lakhimpur Kheri districts, as these areas are affected by Acute Encephalitis Syndrom,” said Dr Ramji Lal, Director General Medical and Health, Uttar Pradesh.

With the funds sanctioned by the Centre, the ICUs will be established in district hospitals of Basti, Sant Kabir Nagar, Siddharthnagar, Deoria, Gorakhpur, Kushinagar, Maharajganj, Gonda and Lakhimpur Kheri. A budget of Rs 23.1 crore has been sanctioned for the ICUs and will include funds for life saving equipment like ventilators.

As of now, in the entire region, only the BRD Medical College has ventilator and ICU facility for AES patients.

The Director General said that ICUs in district hospitals will help ease the pressure from the BRD Medical College and patients will also get facility near their home.

Apart from the establishment of ICUs, the Centre has also sanctioned Rs 4.8 crore for various information, education and communication activities in these nine districts.

NRHM Child Health Uttar Pradesh

National Rural Health Mission is the most looked upon project of government of UP and government of India but the big question is whether it will succeed or not?
The whole of NRHM's success rests on the fragile shoulders of the ASHA, who are barely 8th pass (ok, ok barely 3rd or 4th pass). She is the frontline worker who canvasses the entire program in the community. She has to go into the community for sterilization, child health, maternal health, immunization, house to house for polio program, organize mother and adolescent girls meetings, take the pregnant women to the PHC/CHC for delivery all in for a max of Rs 2000/-.