Need of training for health professionals on National Rural Health Mission

Training plays a key role in health manpower development and management of health care system. Since NRHM is a new concept, due weight-age has to be given to various components of the Mission. For the efficient and effective performance of medical and paramedical workers a certain level of competence in the form of knowledge, skill and attitude are essential. Various aspects of training activities to be included in training programmes have been discussed in the paper.     

An innovative National Rural Health Mission capacity development initiative for improving public health practice in India

National Rural Health Mission (NRHM) foresaw improved health management in India through sustained capacity development of in-service health personnel and their post-training duties in the public health system. Acknowledging the urgency of addressing this issue, the Indian Government, under the NRHM, launched a 1-year Post Graduate Diploma in Public Health Management (PGDPHM) to impart public health management knowledge and skills to these professionals in the state health services. Four institutes partnered this program in 2008, its first year. Between 2008 and 2011, this expanded to 10 institutes and 386 students have graduated the program. The program offered across all these institutes is uniquely identified as against other Health Management courses being offered across the country. The NRHM context in its content and pedagogy is its prime feature. The program offers multiple opportunities to encourage states and the central government to clearly delineate a much needed specialized public health cadre in India. The efforts of this program emphasize on improved public health practice and are a unique pathway to a better health system. Its multidisciplinary facets are aimed at addressing the mismatch of demand and supply of health professionals who could contribute effectively to strengthening the public health system in India through proficient public health practice.     

The National Rural Health Mission (NRHM): a critical overview

This paper explores the forces that led to the conceptualisation of the National Rural Health Mission (NRHM) including the role of the Common Minimum Programme and the Structural Adjustment Programme. The paper analyses the key components of the NRHM in terms of the theoretical frameworks of decentralisation, integration of programmes, primary health care, community health workers and standards.     

山东、宁夏农村居民卫生服务需要、需求研究

目的：通过对山东和宁夏的2地农村居民卫生服务需要和需求分析，了解目前2地农村地区居民的健康状况，从而为卫生政策制定提供数据支持和理论依据。方法：采用分层随机抽样的方法抽取样本，对于数据的社会经济学特征、慢性病患病率、四周患病率、就诊率、住院率、应就诊未就诊率和应住院未住院率主要采用描述性分析方法：山东和宁夏2组间。不同的性别组间采用卡方检验的方法。结果：慢性病的患病率按照人次计算。山东为19.98％，宁夏为25.93％。明显高于2003年第三次全国卫生服务总调查的12.05％：2地四周患病率分别为27.70％和35.36％，就诊率分别为9.79％和12.30％，住院率分别为4.92％和5.60％，2地住院率都高于第三次卫生服务总调查的3.40％：2地的应就诊未就诊率分别为67.10％和67.20％，应住院未住院率分别为6.33％和11.67％。结论：卫生服务需要程度高，高于全国平均水平（慢性病患病率），需要转化成需求的比例低，4周内应就诊而未就诊比例高达60.00％以上，在农村居民中医疗服务利用的门槛还需降低。     

Rural health focus: organising CPD for rural hospitals

Rural and Remote Health is committed to the task of providing a freely accessible, international, peer-reviewed evidence base for rural and remote health practice. Inherent in this aim is a recognition of the universal nature of rural health issues that transcends both regional interests and local culture. While RRH is already publishing peer-reviewed material, the Editorial Board believes many articles of potential worth are largely inaccessible due to their primary publication in small-circulation, paper-based journals whose readership is geographically limited. In order to augment our already comprehensive, international evidence base, the RRH Editorial Board has decided to republish, with permission, selected articles from such journals. This will also give worthwhile small-circulation articles the wide audience only a web-based journal can offer. The RRH editorial team encourages journal users to nominate similar, suitable articles from their own world region.     

Study of Rogi Kalyan Samitis in Strengthening Health Systems Under National Rural Health Mission,District Pune,Maharashtra

Background:

With objective of health systems strengthening, as visualized under National Rural Health Mission (NRHM); one key strategic intervention is up-gradation of health service delivery facilities so as to provide sustainable quality care with accountability and people''s participation, which required the development of a proper management structure called Rogi Kalyan Samitis (RKS). It is the State''s attempt to make health everyone''s business by de-mystifying health-care delivery at district and sub-district levels with reference to facility based health-care delivery by encouraging citizen''s participation in management bodies.

Objective:

The study was an attempt to define ‘functional Health Systems’ with a focus on strategic issues concerning RKS operations.

Materials and Methods:

A mixed-method, multi-site, collective case study approach was adopted. In-depth interviews of key-stakeholders were conducted. Qualitative data were analyzed thematically and coded inductively.

Results:

RKS is yet to bring out quality component to the health services being provided through facilities. This can be attributed to structural and managerial weakness in the system; however, certainly NRHM has been consistent in creating a road-map for benefitting local community and their participation through RKS.

Conclusion:

The progress of the RKS can further be enhanced by giving due priority to critical areas. Furthermore, the results emphasize an urgent need for devising strategies and actions to overcome significant systemic constraints as highlighted in the present study.     

从战略评估看农村妇女对基本生殖健康服务的需求

目的:了解农村妇女对生殖健康服务的利用现状,从管理者、服务提供者尤其是妇女需求的视角,提出改善生殖健康服务的建议。方法:采用定性研究的方法,在云南省盈江、永胜、西山两县1区的县/区、乡、村三级生殖健康服务机构的管理者、服务提供者和社区群众进行3个小组访谈及48人访谈(涉及人数71人),并对各级服务机构进行观察,收集调研现场的有关数据。结果:农村妇女对产前检查、产后访视和避孕服务等预防性服务,以及孕产期危急情况的治疗和管理、常见生殖道感染的诊治、节育术后的随访等基本生殖健康服务的需求是可及、综合、质优并负担得起。结论:根据回应农村妇女的需求、现行政策的支持与保证、现有的服务系统可以运作等原则,提出生殖健康教育和促进;多部门合作,提供综合、方便、经济、能满足不同人群需求的服务;促进男性在生殖健康服务中的参与和责任等建议。