source; sikkim.nic.in
Wednesday, October 20, 2010
Expert group on universal health coverage set up
source: The Hindu
K. Srinath Reddy, president of the Public Health Foundation of India
It will develop blueprint to achieve ‘health for all' by 2020
Recognising the importance of defining a comprehensive strategy for universal health coverage, the Planning Commission has set up a high level expert group to develop a blueprint and investment plan for meeting the human resource requirements to achieve ‘health for all' by 2020.
The 15-member high level group on universal health coverage, chaired by K. Srinath Reddy, president of the Public Health Foundation of India, is mandated to rework the physical and financial norms needed to ensure quality, universal reach and access to healthcare services, particularly in underserved areas and to indicate the role of private and public service providers.
“The expert group, constituted with the approval of Prime Minister Manmohan Singh, will also explore the role of a health insurance system that offers universal access to health services with high subsidy for the poor and a scope for building up additional levels of protection on a payment basis,” Syeda Hamid, a member of the Planning Commission, told The Hindu.
The expert group will suggest critical management reforms in order to improve efficiency, effectiveness and accountability of the health delivery system, among other things.
The other members of the expert group are: Abhay Bhang (Society for Education, Action and Research in Community Health), A.K. Shiva Kumar (member, National Advisory Council), Amarjeet Sinha (senior IAS officer), Anu Garg (Principal Secretary-cum-Commissioner (Health and Family Welfare department, Orissa), Gita Sen (Centre for Public Policy, IIM Bangalore), G.N. Rao (Chair of Eye Health, L.V. Prasad Eye Institute, Hyderabad), Jashodhara Dasgupta (SAHYOG, Lucknow), Leila Caleb Varkey (Public Health researcher), Govinda Rao (Director, National Institute of Public Finance and Policy), Mirai Chatterjee (Director, Social Security, SEWA), Nachiket Mor (Sughavazhu Healthcare), Vinod Paul (AIIMS), Yogesh Jain (Jan Swasthya Sahyog, Bilaspur), a representative of the Ministry of Health and Family Welfare, and N.K. Sethi (Advisor (Health), Planning Commission).
October 20, 2010
Millennium Development Goals & India
PTI External Affairs Minister S. M. Krishna delivers his speech on 'Millennium Development Goals' at United Nations in New York recently.
India's vast population, its diversity, the variability of services and the differing baselines across regions complicate the achievement of the MDGs.
The Millennium Development declaration was a visionary document, which sought partnership between rich and poor nations to make globalisation a force for good. Its signatories agreed to explicit goals on a specific timeline. The Millennium Development Goals (MDGs) set ambitious targets for reducing hunger, poverty, infant and maternal mortality, for reversing the spread of AIDS, tuberculosis and malaria and giving children basic education by 2015. These also included gender equality, environmental sustainability and multisectoral and international partnerships.
The 10th anniversary of the declaration was used to review progress and suggest course corrections to meet the 2015 deadline. The glittering banquets, the power lunches and the rhetoric at the formal meetings, attended by many celebrities, ambassadors of different nations, international charities and the media, in New York belied the stark reality in many poor countries. While the declaration and the MDGs were a clarion call and mobilised many governments into concerted action, a review of the achievements to date and projections for 2015 suggest some success and much failure. Most rich nations failed to meet the targets on promised aid. While progress has been made, much more needs to be done.
Government's claims
The Government of India claims that the country is on track to meet the MDG targets by 2015. It argues that the number of people living below the poverty line has reduced. It claims that child and maternal mortality rates are reducing at a pace commensurate with its plans. It maintains that many government-sponsored schemes have increased public resources in several key sectors. The Mahatma Gandhi National Rural Employment Guarantee Scheme has increased rural employment. The Sarva Shiksha Abhiyan, a national policy to universalise primary education, has increased enrolment in schools. The Reproductive and Child Health Programme II, the Integrated Child Development Services and the National Rural Health Mission have resulted in massive inputs in the health sector. It states HIV rates are low and that deaths due to tuberculosis and malaria show downward trends. It asserts that the Rajiv Gandhi National Drinking Water Mission and the Total Sanitation Campaign address crucial MDGs.
It is, however, difficult to endorse the government's confidence and optimism. Experts argue that the poverty reduction claims are the result of a sleight of hand, which employs debatable measurements and methods for assessment. The existing rates of malnutrition, affecting half of all children under 5, do not support the claims of hunger reduction.
While many agree with the figures for reduction in maternal mortality, they feel the target set is unachievable, as are those for reduction of child mortality and for universal primary education. Gender equality remains elusive. The emergence of an extremely drug-resistant tuberculosis and the high incidence of malaria in certain regions are worrying.
The impressive growth and the creation of wealth with economic liberalisation have not resulted in social development, what with stagnation in key social indicators, particularly among the disadvantaged. There has been an uneven expansion of social and economic opportunities with growing disparities across regions, castes and gender. While India's Gross Domestic Product argues for its middle-income nation status, it also hides massive poverty and much inequity. The challenge to convert India's commitments and resources into measurable results for all its citizens, especially those belonging to socially disadvantaged and marginalised communities, remains gigantic and unmet.
Illusory measurements
The Millennium Declaration, unlike many other documents, set out measurable aims instead of the usual vague platitudes of many international agreements. The MDGs focus on specific and measurable outcomes. However, employing proxy and surrogate variables to measure the country's success may not reflect actual progress. The focus on the massive inputs related to the National Rural Health Mission (NRHM) while discussing child and maternal mortality, for instance. Most NRHM documents describe in detail particulars of the increased funding, new infrastructure, additional health personnel and the many new initiatives. However, they are silent on their impact on the health of people. The Janani Suraksha Yojana (JSY), a conditional cash transfer scheme for safe motherhood, is operative and is part of the drive to increase institutional deliveries. The impressive number of women who have given birth to children in hospitals and the amounts utilised under the scheme measure its success. However, the system does not collect and collate data on the number of safe deliveries, the number of live births and measures of the health of mothers and babies. Data on the person who actually conducted the delivery, post-delivery complications, duration of stay at health centres and the status of the mother and child are not available. System failures related to transport, functioning of facilities, referral and emergency obstetric care are not rare but go undocumented.
While there is no doubt that the NRHM has made a positive impact on primary and secondary health systems, we need proof of improved functioning in addition to evidence of enhanced infrastructure and increased personnel. Specific measurements of outcomes will allow for course corrections and targeted inputs.
Similarly, while enrolment rates have improved, the question of retention of girls in primary education is yet to be established, posing a threat to meeting the targets for universal education. While the figures for hunger reduction look better, those for malnutrition in children suggest otherwise. The figures for poverty reduction are contested. Patriarchy is firmly established and shows little signs of change, especially in rural India, making gender equality and justice elusive. Many reports suggest that environmental sustainability of many development projects is not adequately evaluated.
While there are many gains, the question to be answered is: “Is India on track to meet the MDGs in 2015?” Its vast population, its diversity, the variability of services and the differing baselines across regions complicate the achievement of the MDGs. There is evidence that while some States are on track, many others lag behind and will lower the country's overall achievement. This demands a more detailed assessment of the impact of the many schemes introduced rather than the use of only input variables to predict MDG outputs.
Rhetoric-reality divide
India's vast geography and its diversity are major reasons for significant variations across regions. They mandate the need for separate targets, governance, a focus on public health and changes in social structures. The variability across regions mandates dedicated goals and specific targets tailored to regional baseline rates, for both specific regions and marginalised populations. Periodic assessments of specific outputs required to meet the MDGs are necessary rather than highlighting of new inputs. The many new schemes need to audit their actual, rather than their presumed, impact.
Any survey of regional data clearly documents that poor outcomes are in regions with poor governance. While the NRHM divides the country into high-focus and non-high focus States, the inputs to improve the situation are not directed at improving governance. The federal structure means that improving local governance is the responsibility of individual States. Many States have not fully exploited the increased funding and the newer schemes. Good governance is an effect multiplier and will have a much greater impact on the country's MDGs than just increases in finance, infrastructure and health personnel. Corruption is a deadlier disease which needs urgent attention than most of the medical conditions affecting the people.
The focus on improvement in health continues to employ perspectives of curative medicine rather than concentrate on public health approaches. Clean water, sanitation, nutrition, housing, education, employment and social determinants seem to receive a lower priority despite their known impact on the health of populations.
Feudal social structures continue to oppress millions of people. Health and economic indices of the Scheduled Castes and Tribes show much lower rates of health and greater poverty. Patriarchal society places much burden on girls and women, especially in rural India. Without changes in social structures, improvements in health and economic status will remain a distant dream for the many millions who live on the margins of a resurgent India.
The 10th anniversary assessment of the MDGs and its rhetoric left many wondering if they were just warm words, business as usual. Millions live in poverty, hunger is common, half the children under-five are malnourished, maternal mortality is unacceptably high, and a significant number of girls will not receive primary education. The sense of urgency, born of the moral conviction that extreme poverty is unacceptable in our inter-connected world, should not be lost. The time for action is now.
(Professor K.S. Jacob is on the faculty of the Christian Medical College, Vellore.)
source; the hindu
Tuesday, October 19, 2010
Retailing companies are not particularly known to be high margin businesses. In fact during times of economic downturn, they are amongst the worst affected. But a recently released report on the sector shows that there is money to be made in retailing, provided you can find your niche. As seen in the chart, retailing of items such as jewelry, watches and apparels offer the maximum return on capital. This is due to their potential to be branded. On the other hand selling commodities like books and grocery items have never been a very profitable business.
Data source: Technopak report, 2010
 |
U.N. panel urges ban on endosulfan
File photo a man showing his skin condition reportedly caused by endosulfan in Mangalore. A key U.N. panel has urged governments to ban the pesticide that can cause nerve damage to humans and wildlife. Photo: Sudipto Mondal
The 31 scientists on the Persistent Organic Pollutants Review Committee want endosulfan placed on a list of chemicals that should be phased out of use.
A spokesman for the U.N. Environment Programme that hosts the panel says governments will decide whether to follow the recommendations at a meeting of signatories to the so-called Stockholm Convention on pesticides in April 2011.
Michael Stanley-Jones said on Tuesday that some 60 countries have already banned endosulfan, including the United States which is not party to the Stockholm Convention.
Endosulfan is used on some fruits and vegetables as well as cotton.
source; the hindu
World's shortest man in Nepal
World's shortest man in Nepal
Making a mark : Famous teen.
A Nepalese teenager, Khagendra Thapa Magar, who is just 25.8 inches tall has entered the Guinness Book of World Records as the world’s shortest man. He celebrated his 18th birthday recently. Magar, the son of a fruit seller from rural Nepal, who dreams of marrying and travelling the world in his wife’s handbag, will receive his official Guinness World Records certificate in a short ceremony. In Pokhara, a lakeside town popular with tourists, shouts of recognition greeted the teenager wherever he went, and Magar’s father said his son was enjoying the attention.
source:the Hindu
Subscribe to:
Posts (Atom)