Talk about the government’s efforts to encourage community involvement and public-private partnerships in the healthcare and sanitation sectors, and assess how they have improved service delivery and ensured the sustainability of projects.
According to UNICEF's The State of the World's Children 2019 report, malnutrition was the primary reason behind 69 percent of deaths of children below the age of five in India. Further the report mentioned that every second child in India (<5 years) is affected by some form of malnutrition. ThisRead more
According to UNICEF’s The State of the World’s Children 2019 report, malnutrition was the primary reason behind 69 percent of deaths of children below the age of five in India. Further the report mentioned that every second child in India (<5 years) is affected by some form of malnutrition. This includes stunting with 35 percent of the children, wasting with 17 percent and 2 percent overweight. Among adults, 23% of women and 20% of men are considered undernourished in India. On the other hand, 21% of women and 19% of men are overweight or obese.
Reasons for prevalence of malnutrition in India
- Insufficient access to food: Though food grains yields in India have increased over the last two decades, people’s access to food grains have not increased proportionally due to population growth, poverty and inequality, and food wastage.
- Poverty: Poor families tend to select low-quality food that costs less impacting their nutrition profile.
- Infectious diseases: Poor sanitation practices and lack of access to quality healthcare facilities are the major causes for spread of infectious diseases such as measles, diarrhoea that make the children tend to lose their ability to absorb nutrients, leading to undernutrition.
- Maternal Health: One in five women are underweight in India. Women who are themselves undernourished or have a pregnancy at an early age, are at a greater risk of delivering low birth- weight babies, who are nutritionally disadvantaged right at birth.
- Socio-cultural factors: In most of the poor households, women and preschool children especially girls receive less food than the economically active male members. Rapid succession of pregnancies adversely affects the nutritional status of the mother.
To address the issue of malnutrition, the government has come up with a National Nutritional strategy that aims to reduce all forms of malnutrition by 2030, with a focus on the most vulnerable and critical age groups. National Nutrition Mission is an important component of the strategy. The mission aims to reduce stunting, under-nutrition, anemia (among young children, women and adolescent girls) and reduce low birth weight by 2%, 2%, 3% and 2% per annum respectively by 2022 and strive to achieve reduction in stunting from 38.4% (NFHS-4) to 25% by 2022 (Mission 25 by 2022). Broad contours of the approach adopted by the mission include:
- Inter-sectoral convergence for better service delivery: Ministry of Women and Child which ensures the convergence of various programmes Anganwadi Services, Pradhan Mantri Matru Vandana Yojana (PMMVY), Scheme for Adolescent Girls, Janani Suraksha Yojana (ISY), National Health Mission (NHM), Swachh-Bharat Mission, Public Distribution System (PDS) and Mahatma Gandhi National Rural Employment Guarantee Scheme.
- Use of Information Communication technology (ICT): For real time growth monitoring and tracking of women and children. Also Community Mobilization and Behaviour Change & Communication, awareness Advocacy and Information Education Communication will be done.
- Intensified health and nutrition services for the first 1000 days: The 1,000 days from the start of pregnancy until the child’s second birthday offer a unique window of opportunity to shape healthier and more prosperous futures. The right nutrition during this 1,000 day window can have an enormous impact on a child’s ability to grow, learn, and rise out of poverty.
- Jan Andolan: The mission is envisaged to become a public movement by educating people on nutritional aspects and strengthening human resources.
An effective implementation of the strategy and the mission would help reduce the burden of malnutrition in India.
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Government Initiatives to Promote Public-Private Partnerships and Community Engagement in Healthcare and Sanitation The Indian government has undertaken several initiatives to promote public-private partnerships (PPPs) and community engagement in the healthcare and sanitation sectors. These initiatiRead more
Government Initiatives to Promote Public-Private Partnerships and Community Engagement in Healthcare and Sanitation
The Indian government has undertaken several initiatives to promote public-private partnerships (PPPs) and community engagement in the healthcare and sanitation sectors. These initiatives aim to enhance service delivery, improve efficiency, and ensure the sustainability of interventions. This analysis examines these initiatives and evaluates their impact.
Public-Private Partnerships in Healthcare:
Objective: To leverage private sector expertise and resources to improve healthcare services and infrastructure, complementing public health efforts.
Key Initiatives:
National Health Mission (NHM):
Objective: The NHM integrates public and private sector efforts to enhance healthcare delivery, especially in rural areas.
Recent Examples:
PPP Models in Diagnostic Services: PPPs have been used to set up diagnostic centers and mobile health units, improving access to essential diagnostic services in remote areas.
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY):
Objective: A flagship health insurance scheme providing coverage for secondary and tertiary care hospitalizations.
Recent Examples:
Empanelled Private Hospitals: AB-PMJAY includes private hospitals as empanelled partners, expanding access to quality healthcare services for beneficiaries.
Healthcare Infrastructure Projects:
Objective: To build and upgrade healthcare facilities with the help of private sector investments.
Recent Examples:
PPP Hospitals: Initiatives like the PPP model at the Rajiv Gandhi Super Specialty Hospital in Delhi have improved hospital infrastructure and services through private sector collaboration.
Public-Private Partnerships in Sanitation:
Objective: To improve sanitation infrastructure and services by combining public sector oversight with private sector efficiency and innovation.
Key Initiatives:
Swachh Bharat Mission (SBM):
Objective: Aims to eliminate open defecation and improve solid waste management through community participation and private sector involvement.
Recent Examples:
Innovative Waste Management Solutions: PPPs in waste management have led to the development of efficient waste processing plants and recycling facilities. For example, the waste-to-energy plant in Delhi is a successful model of private sector involvement.
Solid Waste Management Projects:
Objective: To address urban waste management issues through public-private collaboration.
Recent Examples:
Kolkata’s Waste Management Project: A PPP has improved waste collection and processing in Kolkata, demonstrating the effectiveness of private sector involvement in urban sanitation.
Community Engagement in Healthcare and Sanitation:
Objective: To involve local communities in healthcare and sanitation initiatives, ensuring better service delivery and sustainability.
Key Initiatives:
Jan Aushadhi Scheme:
Objective: To provide affordable medicines through public pharmacies, with community involvement in managing these stores.
Recent Examples:
Expansion of Jan Aushadhi Stores: Community-managed Jan Aushadhi stores have increased access to essential medicines in underserved areas.
Community-Led Total Sanitation (CLTS):
Objective: To engage communities in sanitation improvements, focusing on behavioral changes to eliminate open defecation.
Recent Examples:
Success in Rural Areas: CLTS initiatives have been successful in several states, including Uttar Pradesh and Bihar, where communities have built their own toilets and improved sanitation practices.
Health and Sanitation Committees:
Objective: To empower local communities to oversee and participate in health and sanitation projects.
Recent Examples:
Panchayat-led Initiatives: In many states, Panchayats have played a crucial role in implementing SBM activities and health programs, leading to better community ownership and sustainability.
Impact Evaluation:
Service Delivery Improvement:
Enhanced Access: PPPs and community engagement have expanded access to healthcare and sanitation services, particularly in rural and underserved areas. For instance, the integration of private hospitals under AB-PMJAY has improved access to quality medical care for many beneficiaries.
Sustainability of Interventions:
Innovative Solutions: Private sector involvement has brought innovation and efficiency to sanitation and healthcare projects. The waste-to-energy plant in Delhi and mobile health units are examples of sustainable solutions developed through PPPs.
Community Ownership: CLTS and community-managed health schemes have demonstrated increased sustainability due to strong local ownership and participation.
Challenges:
Coordination Issues: Effective collaboration between public and private sectors can be challenging due to differing priorities and operational approaches.
Quality and Compliance: Ensuring consistent quality and compliance with standards in PPP projects requires robust monitoring and evaluation mechanisms.
Conclusion
The Indian government’s initiatives to promote public-private partnerships and community engagement in the healthcare and sanitation sectors have led to significant improvements in service delivery and sustainability. PPPs have introduced efficiency and innovation, while community engagement has fostered greater ownership and sustainability. However, addressing challenges related to coordination and quality assurance is crucial for maximizing the benefits of these initiatives and ensuring long-term success.
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