Health infrastructure in Orissa woefully lacking

New Indian Express,Bhubaneswar,23.03.2010

Even as Orissa continues to struggle with high infant and maternal mortality rates, the latest evaluation report of the National Rural Health Mission has revealed the failures of the State health apparatus.



Beset with a high MMR of 303, the State has to ensure earnest implementation of Janani Suraksha Yojana (JSY). But the report revealed that though the number of institutional deliveries under JSY has increased substantially to reach 3.09 lakh in 2008-09, the State is yet to gear up the facilities to meet the load. It has got only 39 primary health centres (PHCs) to work 24x7 so far against the target of 1282 PHCs by 2010.


Only 38 facilities have been operationalised as First Referral Units (FRUs) as against the target of 254 by the year 2010.


Unicef in its State of Children report - 2009 has blamed the lack of FRUs for high MMR in Orissa as haemorrhage after delivery has been identified as the major cause of high maternal mortality in Orissa. Blood storage units are woefully lacking, finds the report.


Skill-based training is moving at a snail’s pace as only 22 doctors have been trained in life saving anaesthesia skills (LSAS) and 24 in comprehensive emergency obstetric care (EmOC) so far against the target of 254. Only 856 Staff Nurses/ANMs/ LHVs have been trained while the target was 6388 by the year 2010.



The report has emphasised the need of ensuring proper supervision of the quality parameters like partograph, skills on delivery and newborn care along with availability of drugs, etc. Given that 68 percent pregnant women in Orissa are anaemic, the State Health department has been able to hold only 20 percent (1 lakh out of 5 lakh) of planned Village Health and Nutrition Days (VHNDs) in 2008-09.


Neonatal Mortality Rate (NMR) - infant deaths within four weeks of life per 1000 live births - in Orissa is 49 and accounts for 69 per cent of the IMR and the early NMR (infant deaths within one week of life per 1000 live births) is 37 accounting for 76 percent of the NMR. The report lamented the fact that there was only one new born care unit in the State when it has the highest neo-natal mortality rate in the country.


The findings also indicate that care-seeking for children with acute respiratory infection here declined from 67.8 to 63.4 percent and only 22 percent of families are aware of the symptoms. Further, only 16 districts out of 30 have implemented the Integrated Management of Neonatal and Childhood Illness (IMNCI) so far.