With the recent announcement by Prime Minister Narendra Modi to provide equitable healthcare that addresses intra-state disparities and improved health outcomes; the central government has initiated in bringing out the list of 184 poorest performing districts in the country.
According to the announcement by the PM, the government will also work out to allocate additional resources with focused approach to address human development indicators.
What's the government's plan to develop the poorest districts?
By this process, the government aims to reach near to the target set by the Millennium Development Goals (MDG) of reducing under-five mortality rate and Maternal Mortality Rate and other poverty-nutrition indicators.
In terms of policy enunciation, the government intends to put special emphasis on childcare and Sick Newborn Care Units (SNCUs) in these 184 high priority districts.
Over 46 babies died in a week in Odisha:
However, in the same week, the eastern Indian state Odisha grabbed headlines after over 46 babies died in just one week at a government-run paediatric institute-cum- hospital in Cuttack, which is just 30 km away from Odisha's state capital, Bhubaneswar. Such incidents indicated at the prevalence of weak state of health services in this poverty ridden state.
Government's list of 184 poorest districts:
In the central government's priority 184 district, 19 from Uttar Pradesh, 17 from Madhya Pradesh, 10 each from Rajasthan and Bihar, 9 from Maharashtra, 8 each from Gujarat, Karnataka, 6 each from Andhra Pradesh, Assam, Jammu and Kashmir, 5 each from Haryana, Manipur, Chhattisgarh, Punjab and West Bengal, 4 each from Meghalaya and Mizoram, Nagaland and Himachal Pradesh, 3 each rom Kerala and Uttarakhand and 1 each from Pondicherry, Sikkim and Tripura are included.
However, most surprising omission in the list are the districts of Odisha, as none of the districts of the state is included in this focused intervention.
Odisha has earned the dubious distinction of having the largest number of poorest districts in the country as per the report prepared by government agencies in the past. Many are finding it difficult to digest this omission.
Omission of Odisha districts will affect PM's development programme:
Policy and development experts believe that the omission of most backward districts in the prime minister's list will affect the whole development indicators in the macro level in the country and may fuel existing inter-state disparity to grow further.
If one will examine any statistics/data comes up in last one decade or so, the districts in Odisha are doing very bad in terms of health, education, tribal development, poverty indicators.
The pathetic states of Odisha districts:
For example, the Annual Health Survey released by the central government in 2013 states that almost ten backward districts of Odisha have Total Fertility Rate (TFR) between 3.0 to 3.5 against the national average of 2.1.
When, only 26 per cent of pregnant women reported in the state have consumed Iron Folic Acid (IFA) tablet for 100 days or more, and only 22.7 per cent avail full ante natal check up in the state, how poorest performing districts should be excluded.
The IAF supplement to children aged between 6-35 months is as low as 24.0 per cent in the state of Odisha with many districts are reporting very low (lowest among them is 9.9 percent in Bhadrak district), 39.5 per cent women took the benefit of Janani Suraksha Yojana in the state.
The state's achievement on Infant Mortality Rate (IMR) and Maternal Mortality Rate (MMR) has remained abysmally low as compared to national average and other good performing states, (IMR-51 in Odisha against the national average of 40 and MMR at 235 against the national average of 178).
The onus is on the state government and the central government as well:
Health, being a state subject in Indian federal set up, the larger onus remains on the shoulder of the state government. The government of Odisha certainly needs to be pro-active towards ameliorating the health distress in the state.
As it was stated in the recently concluded assembly session, there are almost 17,000 posts including 3,500 doctors are lying vacant in the department.
At the same time, there remains an urgent health policy reorientation by the central government as well. The government should include the poorest districts on suo motu basis in this proposed special intervention programmes.
It will accelerate its endeavour to reach near the Millennium Development Goals (MDG) and promote balanced growth in all parts of the states, and it will get more focus on the eastern part, as being frequently advocated by Prime Minister himself.
(Authors are lead policy and development experts and can be reached at firstname.lastname@example.org)