Jharkhand Health :
Jharkhand – A state rich in Opportunities in Healthcare Revolution
Carved out of Bihar, the state of Jharkhand came into existence on 15th November 2000. Its population has been estimated to be 29.2 million with 78% of the population residing in rural areas. Jharkhand is one of the poorest and most backward states in the country with low per capita income, 54% of the population live below the poverty line. 28% of the population is constituted of scheduled tribes. Literacy rate is also very low, particularly among women (40%). The state consists of 22 districts, 35 sub-divisions and 212 blocks.
Jharkhand has 22 districts spread over an area of 79714 Sq. Kms. The state is divided into 5 regions namely Santhal Parganas, Palamu, Kolhan, North Chhotanagpur and South Chhotanagpur for political and administrative reasons. Each of these regions has its own distinct cultural identity. Jharkhand has a population density of 338 per square kilometer..
Jharkhand is the richest state in mineral resources and plays leading role in its production. The state boasts high output of coal, mica, iron ore, copper china clay, fire clay and kyanite, bauxite, asbestos, feldspar, quartz, etc. Jharkhand has rich forest reserves. It is a leader in the production of lac contributing to about 40% of total output in the country. The state also contributes in the production of Sal, timber, bamboos and sabai grass.
Health Profile of Jharkhand
1. Decadal Growth Rate 25.7
2. Infant Mortality Rate (IMR) 49 Per 1000 lives
3. Crude Birth Rate 26.3
4. Maternal Mortality Rate (MMR) 504 per 1,00,000 live birth
5. % of children with complete immunization 41% (A2Z-USAID 2005 DEC)
6. Crude Death Rate 9.1 per 1000 population
7. Couple Protection Rate 28
8. % Of pregnant women with any ANC 40
9. % of safe delivery 40
10. Total Fertility Rate 2.83
The above table shows the performance of the state in a few crucial indicators. There has been a marked improvement in certain areas as compared to the performance when the state came into existence in 2000. Department of Health and Family Welfare, Government of Jharkhand has taken some fundamentally strong initiatives to help bring about this change. ‘Catch up’ round is one such initiative which has helped improve the IMR and MMR indicators.
Initiatives Undertaken by the Government
Following are some of the innovative initiatives implemented by the state in order to improve the performance and increase the accessibility of the health care services to the entire population.
• Recruitment on contractual basis of 2400 medical officers and 2200 paramedical staff
• Organization of the Catch up Round to address the issues of the left outs and the drop outs in routine immunization
• Setting up of Village Health Committees (VHC) in all the villages to strengthen the Sahiyya movement
• Mapping exercise of all local health sector NGOs, CBOs, Charity based organizations and Faith based hospitals operating in the state
• Setting up of a State Fund for Medical assistance to the Below Poverty Line (BPL) population, with a yearly allocation of Rs. 15 million ($ 2.9 million)- 2002
• Doubling of the Health Budget in order to bridge the infrastructure gap (2005-2006)
• Introducing effective and sustainable Public Private Partnership models in the management of public health facilities
• Mukhya Mantri Janani Swasth Suraksha Yojana (MMJSSA)- A Voucher based scheme to improve the Infant Mortality Rate (IMR) and Maternal Mortality Rate (MMR) by promoting Institutional delivery
• Kala azar eradication- A unique intervention as a part of public private partnership involving various Faith Based Organizations (FBOs) to provide Institutional care and support to the Kalaazar patients
• Malaria Control: Postmen as Drug Distribution Centres (DDC)- Postmen shall distribute Chloroquin Phosphate tablets, as a part of first aid, to patients having fever.
Infrastructure Gaps
Although many initiatives have been undertaken by the state government to envisage the millennium development goals (MDG) and state vision, most of them are in strengthening the physical infrastructure. One crucial indicator in the improvement of health profile of the state is the willingness of citizens to access treatment facilities at primary health centers, dispensaries and government hospitals. Since there is a clearly visible lack in communication of initiatives and maintenance of patient medical records, prospective beneficiaries avoid sing government facilities for minor ailments which become fatal later on. Similarly, there is a poor response to preventive healthcare mechanism by these people due to the same reason.
In order to establish a strong communication mechanism and patient doctor relationship, a revolution in the communication and data management system needs to take place.
