Rogi Kalyan Samiti

 

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Public Health is a state subject. Under the National Health Mission, Rogi Kalyan Samitis (RKSs)/Hospital Management Committees (HMCs) are envisaged to be constituted at public health facilities at the level of Primary Health Centres (PHCs),  Community Health Centres (CHCs), Sub-District Hospitals and District Hospitals.

The RKS/HMC is required to be registered under the Societies Registration Act and have an account  in a commercial bank.  It is to be set up at all the Public Health Facilities starting from Primary Health Centre level and above. It consists of members of Local Self-Government Institutions, Non- Governmental Organizations (NGOs), elected public representatives and State Government officials. RKS acts as trustees for the hospitals to manage the affairs of the hospital and is responsible for upkeep of the facilities and ensure provision of better facilities to the patients in the hospital. It would have the authority to raise its own resources by way of user fee and utilize the same for improvement of services rendered in the facility.

Population Control Measures

Population Control Measures

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As per World Population Prospects – The 2012 Revision, the population of India will cross the population of China by 2028. The projected population for India in 2028 will be 1.454 billion, while that of China will be 1.452 billion. The projection of population of India by the year 2060 is not available.

The Government has been focussing on family planning activities as one of the many measures for achieving population stabilization. As a result of the efforts of Government the decadal growth rate of the country has declined significantly from 21.54% for the period 1991-2000 to 17.64% during 2001-11. The Total Fertility Rate (TFR) also declined from 3.6 in 1991 to 2.4 in 2012 as per Sample Registration System (SRS). 23 states/UTs have achieved the replacement TFR of 2.1 or less. Various measures taken by Government of India under Family Planning is given below:-

Strategies for attaining population stabilization:

Interventions under family planning program:

1.      Scheme for Home delivery of contraceptives by ASHAs at doorstep of beneficiaries: The govt. has launched a scheme to utilize the services of ASHA to deliver contraceptives at the doorstep of beneficiaries. 8.85 ASHAs are now distributing contraceptives at the door step.
2.      Scheme for ASHAs to ensure spacing in births: The scheme is operational from 16th May, 2012. Under this scheme, services of ASHAs are being utilised for counselling of newly married couples to ensure delay of 2 years in birth after marriage and couples with 1 child to have spacing of 3 years after the birth of 1st child.
3.      Pregnancy testing kits have been made an integral part of ASHA kit and are being used to diagnose pregnancy early, so as to ensure early registration of pregnancy/safe abortion services.

4.      A new family planning method, i.e. post-partum IUCD (PPIUCD) has been introduced in the program. PPIUCD services are being provided by trained health providers in government hospitals, within 48 hours after the delivery.

5.      Basket of choice has been expanded with introduction of a new IUCD-375 of 5 years effectivity, in addition to the already existing IUCD–380A of 10 years effectivity.

6.      Dedicated counselors (RMNCH counsellors) are placed at high case load facilities for providing family planning counseling to clients.

7.      Celebration of World Population Day 11th July & Fortnight: The event is observed over a month long period, split into fortnight of mobilization/sensitization followed by a fortnight of assured family planning service delivery and has been made a mandatory activity from 2012-13 and starts from 27th June each year.

8.      Other On-going interventions:
·        Assured delivery of family planning services for both IUCD and sterilisation.
·        National Family Planning Indemnity Scheme’ (NFPIS) under which clients are insured in the eventualities of deaths, complications and failures following sterilization and the providers/ accredited institutions are indemnified against litigations in those eventualities.
·        Compensation scheme for sterilization acceptors - under the scheme MoHFW provides compensation for loss of wages to the beneficiary and also to the service provider (& team) for conducting sterilisations.
·        More emphasis on Spacing methods like IUCD.
·        Availability of Fixed Day Static Services at all facilities.
·        Quality care in Family Planning services by establishing Quality Assurance Committees at state and district levels.
·        Contraceptives supply management up to peripheral facilities.
·        Demand generation activities in the form of display of posters, billboards and other audio and video materials in the various facilities.


Following stretagies have been taken by Jansankhya Sthirata Kosh/National Population Stabilization Fund as population control measures:

Advocacy & IEC activities:-
JSK as a part of its awareness and advocacy efforts on population stabilization, has established networks and partnerships with other ministries, development partners, private sectors, corporate and professional bodies for  spreading its activities at the national, state, district and block level.

Prerna Strategy:-
JSK has launched this strategy for helping to push up the age of marriage of girls and delay in first child and spacing in second child the birth of children in the interest of health of young mothers and infants. The couple who adopt this strategy awarded suitably. This helps to change the mindsets of the community.

Santushti Strategy:-
Under this strategy, Jansankhya Sthirata Kosh, invites private sector gynaecologists and vasectomy surgeons to conduct sterilization operations in Public Private Partnership mode. The private hospitals/nursing home who achieved target to 10 or more are suitably awarded as per strategy

Outdoor Air Pollution in India

         

What is the gravity of the problem ?

      Outdoor air pollution has become the fifth largest killer in India after high blood pressure, indoor air pollution, tobacco smoking, and poor nutrition, says a new set of findings of the Global Burden of Disease (GBD) report. The report says that about 620,000 premature deaths occur in India from air pollution-related diseases each year. This is up from 100,000 in 2000—a six-fold increase.

What could be the impact ?

   There is hard evidence now to act urgently to reduce the public health risks to all, particularly children, elderly, and poor. No one can escape toxic air. India will have to take aggressive action to reverse the trend of short-term respiratory and cardiac effects as well as long-term cancer and other metabolic and cellular effects.

What India needs to do ?

1. Make National Ambient Air Quality Standards legally binding in all regions. The national air quality planning and city action plans need a roadmap for each source of pollution and aggressive measures. Penalty should be imposed on cities if air quality standards are violated.

2. Prepare stringent vehicle technology and fuel quality roadmap, encourage in-use vehicle management. The terms of reference of the new committee that has been set up to propose the next Auto Fuel Policy Roadmap does not even include public health in its agenda. Make urgent timelines for Euro V and Euro VI emissions standards. Contain dieselization.

3. Control and cut increase in vehicle numbers by scaling up public transport, non-motorised transport, compact city planning and car restraint measures.

4. Strengthen implementation plans for critically polluted notified areas Account for health cost in decision making. Valuation of acute and chronic illnesses must be linked to decision on air pollution control measures.

5. Put in place a public information system on daily air quality with health advisories and implement smog alert and pollution emergencies measures.

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