June 20, 2001

'31'

    The Empowered Action Group (EAG) set up to facilitate preparation of area-specific programmes in eight States, namely, Bihar, Jharkhand, MP, Chhatisgarh, Orissa, Rajasthan, UP and Uttaranchal, which have lagged behind in containing population growth to manageable levels, held its first Business Session on June 18, 2001 under the Chairmanship of the Minister for Health and Family Welfare, Dr. C.P. Thakur. The participants included, among others, representatives of the EAG States; Union Secretaries of Health, Family Welfare, and Indian Systems of Medicine & Homoeopathy; and the representatives of key Central Ministries/Departments of Women & Child Development, Rural Development, Elementary Education & Literacy; and the representatives of Voluntary Health Association of India, Family Planning Association of India, ICMR, NIHFW, and IIPS, Mumbai.

    Detailed presentations were made by the member states reflecting upon the areas of concern, the measures taken by the State Governments to achieve systemic reforms and their expectations from the various Ministries of Government of India to emerge from the socio-demographic backwardness. It was agreed that the EAG needs to strengthen the systems of governance and monitoring. However, the greater need is to involve the community successfully through local empowerment and convergence. In a federal structure like India, there is need to strengthen the Centre-State coordination before direct interventions can be made at district levels.

    The EAG decided to accord particular attention to the States of UP and Bihar where the situation appeared to be rather acute. The data from rapid household surveys have indicated that the services are nearly non-existent in large parts of Uttar Pradesh and Bihar. For example, the couple protection rate (percentage of couples practicing any spacing/terminal method of family planning) was less than 30 per cent in 34 (out of 70) districts in Uttar Pradesh and 29 (out of 37) districts of Bihar. Similarly, in 21 districts of Bihar and 14 districts of Uttar Pradesh, less than 30 per cent pregnant women only were reached with ante-natal services. The EAG also decided to hold a special Session at Patna.

    The EAG resolved to work with the participating States in formulating their action plan for improving service delivery. It was agreed that the plans will be prepared on the basis of the following guiding principles :

• It was noted that the problems in the EAG States are less to do with the availability of funds than the issue of governance. Therefore, proposals for resolving the systemic issues relating to key areas such as human resource management, logistics management, mainstreaming of the ISM practitioners, integration of numerous health societies at State and district levels, regular release of funds to operational levels, joint planning/training for the field staff of the cognate departments, greater autonomy to the districts and within districts, to hospitals and PRIs, will be integral parts of the plan.

• Within a State, incremental investments (that may be provided by the EAG) will be focussed at bridging the intra-state demographic divide. A key objective in this regard would be to ensure, through a systemic re-structuring of manpower in association with physical improvement, that the district and sub-divisional hospitals in the backward districts in a State provide the full range of RCH services including 24-hour availability of emergency obstetric services.

• The new States -- Chhatisgarh, Jharkhand and Uttaranchal -- may include in their plans, proposals for strengthening their planning and monitoring infrastructure.

• A major proportion of the funds available under the Rural Connectivity Scheme, Drinking Water Supply Scheme, the SJGSY Scheme and other Centrally Sponsored Schemes of the Department of Rural Development, will be directed to the backward districts. Proposals for utilisation of the Central assistance for these schemes will be integral to the State plan.