On a very optimistic note, the director of the State Health Mission, under the National Rural Health Mission recently declared that all the Primary Health Centers in the state will be made functional 24 x 7 with delivery services before Christmas. This is indeed a loud claim on the part of the SHM director. With the primary objective of providing effective health care to the rural people throughout the country, the National Rural Health Mission was launched in the year 2005. It is mentioned in the policy document of the Mission that special focus should be given on the states, which have weak public health indicators. In this aspect, special guidelines are being provided by the Indian Public Health Standards for the health sub-centers like the Primary Health Centers, Community Health Centre and District hospitals. The guidelines are a set of uniform standards envisioned to uplift the quality of health care delivery in the country. From the look of things, it seems the director of the SHM has been taking a proactive role. It is learned that the SHM is taking stock of the ground situation, more particularly from the hill districts of the state. Reports of health surveys conducted by different agencies are being fed to the SHM. One remarkable analysis is the ‘gap analysis’ based on the report of the field surveys. The gap analysis according to director of SHM is to bridge the gap in health care related issues. Emphasis is being given to child birth and its delivery systems. This is indeed a practical step taken up by the SHM, which is in sync with the guidelines.
Having said that, there are hurdles that the SHM have to cross for the Mission to achieve its objectives. The director has categorically mentioned the success stories of Thoubal and Churachandpur District hospitals. As for Thoubal District, needless to say that it is under the close scrutiny of the authorities by virtue of being located at the home constituency of the state chief minister. Churachdpur District hospital was declared as one of the best district hospitals by a team of doctors from Ram Manohar Lohia Hospital who visited the hospital. Now, the hospital is facing the same problem that we all face in Manipur, which are water scarcity and the erratic power supply. The same reason may be cited for the nonfunctional operation theatre of Senapati District hospital even after its inauguration. Though there are also other infrastructural deficits that have become synonymous with most of the public institutions in the hill districts of Manipur. According to the guidelines given by IPH Standards, without delving too deep into the specifics, the PHCs should provide 24 hours emergency service and 6 hours of OPD. The PHCs should give care on maternal and child health care along with family planning on a priority basis. Health care facilities including the monetary cost of investigations, medications, CS delivery as when required and all other related services should be given free of cost to the public under the NRH Mission. Besides, distribution of manpower in tandem with the guidelines is another major hurdle for the SHM. It is a known practice among the employees to lobby for a place of posting of their choice. Moreover, the NRHM funds from Delhi are directly transferred to the state nodal agency as per the Scheme’s guidelines. Maintaining administrative transparency and accountability of the funds are the two big hurdles that the Mission must cross to reach its destination. Actualisation of the tall promise that 85 PHCs in the state will have 24 x 7 child birth delivery system before Christmas this year is not going to be that easy. The accomplishment of the Mission will only be certain when pregnant women, in dehumanising condition, are no longer seen lying on the corridor floors of the government hospitals in Imphal. The success of the Mission will be a priceless Christmas gift.