National Rural Health Mission : A Critique

AMBITIOUS projects launched with fanfare often flounder at the implementation stage. The National Rural Health Mission is a case in point. The Centre launched it in 2005 and has spent Rs 30,000 crore since. But the Public Accounts Committee of Parliament, headed by Murli Manohar Joshi of the BJP, has dubbed it a fiasco and a joke, and asked the Health Ministry to restructure the project. The project has not flopped in a state or two, but in most of the 18 states where it is being implemented. Health centres in villages, says the PAC, are used as cow sheds, foodgrain godowns or community halls.

Still worse, expired medicines are given which can do more harm than good to patients. It is widely known that medicines banned in advanced countries for negative side-effects are available over-the-counter in India. The PAC auditing finds out that in Orissa, West Bengal and Jharkhand medicines were purchased without quality checks. There is a shortage of not just doctors and specialists but even nurses and mid-wives in the rural areas. Diagnostic services and laboratories are woefully inadequate. Expensive medical machines and equipment, wherever available, even in city hospitals, remain in disuse for long periods due to lack of repairs and funds.
These are some of the harsh facts of India’s ailing health sector which might dismay the city-bred intelligentsia, but the rural health staff and villagers know it well. These facts re-emphasise the obvious, which is, India is growing fast, while change is very slow in Bharat. How can the result be otherwise when the government spends just 1.1 per cent of the GDP on health against the recommended 3 per cent? A large part of the poor spending is grabbed by vested interests well-entrenched in the system. A badly funded and governed healthcare system is unlikely to meet the challenge of providing an ordinary citizen a basic need: access to quality and affordable healthcare.