STATE OF KARNATAKA'S HEALTH
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- STATE OF KARNATAKA'S HEALTH
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VOLUNTARY HEALTH ASSOCIATION OF KARNATAKA
RF_DEV_9_A_SUDHA
Minutes of the meeting held on Saturday August 149 '1993 at the
Board Room, St.Martha's Hospital, Bangalore to work out the
•details of bringing out the Report
- State of Karnataka's
Health.
Meeting started at 12.00 noon.
Members present
Mr.Alok Mukhopadhyay
Dr.C.M.Francis
Dr.S.P.Tekur
Dr.Tharien - President, TNVHA
Dr. S.Pruthvish
Dr. H.Sudarshan
Dr. Upendra Shenoy
Mr. S.M.Subramanya Setty
Dr. Sudha Xirasagar - ISHA
Ms. T.Neerajakshi
Mr. Ramappa C.Hadli
After self introduction Mr.Alok Mukhopadhyay, Executive Director
of VHAI briefed about the context of the Meeting.
He recalled
the offer that came from the Government of Karnataka to bring
out a report of the 'State of Karnataka's Health' on the
occasion of the releasing ceremony of the 'State of India's
Health', which was held on 30th May 1993 at St.John's Medical
College, Bangalore. He appreciated that VHAK Board in consulta
tion with VHAI had committed to take up this endeavour. He
proposed to offer his experience, expertise and help to VHAK.
Mr.Alok Mukhopadhyay shared that VHAI Board was positive when
the same was discussed at the Meeting.
be a participatory process.
He said that it should
Once the contents of the report
are finalised, resource persons may be identified accordingly.
He suggested that a core group may be formed and two young
Researchers or Research Assistants may be appointed for 6 months
to help in collecting the various data and resource materials
to be provided to the authors and also to conduct pilot studies
(sample survey).
The committee agreed for the same.
Dr.C.M.Francis stated that the Commissioner & Secretary to the
Dept, of Health 8. Family 'Welfare Services, Government of Karnataka
had earlier suggested that VHAK should work out a Health Policy
for Karnataka with district planning.
It was suggested that the
two could be combined: State of Karnataka's Health, followed by
a Health Policy for Karnataka State.
This was accepted.
- 2 It was opined to discuss
a) Content
b) Who is willing to take up what
who are not present
including persons
c) Editorial Board
d) Budget
The Committee discussed about the various Resources Centres
from where reliable materials may be collected.
Mr.Alok Mukhopadhyay stated that once the materials are pooled
and authors are identified Dr.Almas Ali who has rich experience
and had given enough time in preparing the State of India's
Health Report could come over to help in processing and
ana lysing.
An Editorial Committee comprising of the following personnel
was set up:
Dr.C.M.Francis
Dr.H.Sudarshan
Dr.S.P.Tekur
Ms.T.Neerajaks hi
Dr.Sudha Xirasagar
The Contents and Resource persons proposed were as follows:
1.
Food:
This would include food in the wider perspective
including food production, distribution, availability,
accessibility and nutrition.
Dr.Vanaja Ramprasad
Mr.Somashekar Reddy
Dr.Almas Ali
Dr.M.K.Vasundhara
It was suggested to formulate sub-topics so that the chapter
ecomes comprehensive
Environment 8. Health
Mr. Yellappa Reddy
Dr. S.R.Hiremath
Mr. Panduranga Hegde
Dr. S.V.Rama Rao
Dr. Nag
Dr. Kusuma
- 3—
3.
Health Systems & Services
(Govt., Voluntary Organisations
8. Private sector)
Dr.S.P.Tekur
Dr.G.V.Nagaraj
Prof. Shanmugam - UM
Dr.Sudha Xirasagar
AIDS and STD may be incorporated under this heading
4.
Indigenous Systems of Medicine
(Alternative systems)
sis will be on systems more prevalent in Karnataka
Dr.Anantharaman,
Dr.Upendra Shenoy
Family We If are 8. MCH
Dr.G.V.Nagaraj
Dr.Sudha Xirasagar,
5.
Health Education (including Health manpower development)
Dr.Jayashree Ramakrishna
5
. .. c
1
J
N I M H A N S
Mr.S.M.Subramanya Setty
?
Dr. Uma Sridharan
Medical and Nursing Education
Community Health Cell
Health Information system
9.
Women 8, Health
Dr. Uma Sridharan
Mr s. Ant h y a Ma d i at h
Mrs. Srilatha Batliwala
Samatha (Organisation)
Health Research
Dr. Saraswathy Ganapathy
Dr. S.V.Rama Rao
(Including Foreign Funding and
Family expenditure)
The relevant resource materials may be collected from
UM, ISEC, NIMHANS, ISHA, IPP
Health Financing
Mrs. Shoba Raghuram - HIVOS,
12. Legal Issues
Mr.M.K.Ramesh
13. Disabilities
Dr. Maya Thomas
Dr. S.Pruthvish
Ms. Indumathi Rao
Action Aid
Dr.Bhatia
- UM
4 -
DroRoSrinivasamurthy,
Dr.Mohan Isaac
Panchayat Raj
Prof. B.K.Chandrashekar,
Mr.R.L.Kapur
^16Health Awareness
It was felt that action to attain and maintain health has
to be taken by the individual, family and community.
This
would depend to a large extent on health awareness of the
people.
A chapter on it would be appropriate.
The Editorial Committee will consider other areas also, as
considered appropriate.
It was suggested that the actual
expenditure and State Budget (in % age) approportioned to
Health by the Karnataka Government, expenditures of various
groups and particularly the family towards Health may be
elucidated by collecting data and conducting sample (pilot)
studies, where the data are not availalbe.
It was opined that the draft should be ready by December.
The
members expressed doubts whether this can be done in such a
short time.
An effort will be made to stick to the target.
It was expected that there may be 22-23 chapters.
The volume
of the report may be ranging from 300 to 350 pages.
BUDGET:
It was estimated that the expenditure may come up to
Rs. 1,50,000/-. VHAI, New Delhi would take up the responsibility
of art work, illustrations, printing and publishing separately.
As we need persons with good qualifications (M.Phil preferred
as they would have experience in Research methodology) and some
experience, it was suggested that the Research Assistant being
employed for the short period of six months may be paid
Rs.3,500/- - 4,000/- p6m.
experience.
depending on qualifications and
It may be necessary to meet the expenditures such as typing,
stationery, etc., of the contributors so that the expenses
do not become a burden on them.
It was suggested that by the end of August initial correspondence
to get the consent of the resource persons should be over.
may also be done by personal contact.
The Meeting came to an end with vote of thanks by Mr.Alok
Mukhopadhyay, Executive Director, VHAI, New Delhi.
This
STATE OF KARNATAKA'S HEALTH
Community Health Cell has been entrusted with the responsibility
of preparing the chapter on "Medical and Nursing Education" and, is
collaborating with other resource persons on the chapters on "Health
Systems and Services in Karnataka" and "Child Health".
Since the last meeting, CHC is actively involved in the work of
"State of Karnataka's Health Report".
As a first step in this
direction, an annotated bibliography of the relevant material available
in the C”C library
has begun.
A list of more than a hundred resource
persons/organisations has been made and letters seeking their active
cooperation has been sent out.
We intend to adopt the format followed by VHAI's "State of
India's Health", with appropriate modifications, taking our priorities
into considerations.
However, as to the chapter on 'Medical and
Nursing Education', it was found that VHAI's approach and orientation
is inadequate to our needs and a separate format will be followed.
CHC has already undertaken a project on Medical Education, and
the separating of material relevant to Karnataka is proposed to be
undertaken.
Data etc., on Nursing Education is to be collected, and
letters to the concerned individuals and organisations have already
been sent.
The general outline of the chapter on "Health systems and
services" is,an attempt will be made to present a balanced picture
of both quantitative and qualitative data.
For this, data collection
2
2
is intended to be made with the help of NGOs and PG studies on
health economics and health education in addition to the updating
with available governmental and other data.
Also, journals,
magazines and newspapers will also be referred to.
Case studies of certain projects are intended to be taken up
for critical analysis.
Special emphasis will be placed on maternal
care, child care, and allied sectors like water, sanitation and
agriculture.
The chapter also covers relevant data about State
health plans, budget allocations, targets and achievements, and
strategies adopted.
A general survey of available private health
services like the nursing homes, pathological laboratories, private
consultants will also be included.
We like to devote the month of October for corresponding,
contacting and the collection of material.
By the end of November
we should be able to compile all available data and wish to prepare
the first draft with appropriate charts, diagrams etc., by December
end, so that the draft can be circulated for discussion and to
identify the lacuane.
Keeping the VHAI report in view, human interest and important
issues like successful alternate NGO efforts, diseases peculiar to
Karnataka, issues on tribal health, etc.
We request the members to
give access to information which you may have and facilitate our
work.
HEALTH SYSTEMS AND SERVICES
01. Primary health care
— 3 evaluational studies.
02. immunisation
surveys
— Bangalore and Chikmagalur.
03. NGCs
— Mallur.
Other reports are too general/
outdated.
taken.
No focus on specific action
Distribution not known .
to development
Linkages
— very ambiguous.
04. Few Government of
Karnataka publications - needs updation.
05. Specific Diseases
covered
— Diarrohea; Handigodu; and Kyasanooru forest
disease.
06. Miscellaneous
— lack of infrastructure.
Child Health
01. Coverage of Immunisation programme.
02. ICDS - reports/evaluation - few.
Medical and Nursing Education
Nursing Education section needs material
Bonded labour.
VOLUNTARY HE ALT FI ASSOCIATION OF KARNATAKA
Minutes of the Meeting of the contributors to the State of
Karnataka's Health Report held on Friday October 15, 1993
at., the Committee Room, Administrative Block, N I M H A N S,
Bangalore - 560 029.
Meeting commenced at 3.00 p.m.
Members present
Dr.C.M.Francis
Ms.T.Neerajakshi
Dr.Jayashree Ramakrishna
Dr.P.H.Reddy
Dr.R.Srinivasa Murthy
Dr.Na taraj
Dr.(Mrs) Jayashree Nataraj
Dr.Kusuma
Mr.S.M.Subramanya Setty
Mr.Prabhu Dandavatimath
Dr.G.V.Nagaraj
Dr.Shoba Raghuram
Ms.Ruma Bannerjee
Dr.M.S.Rajanna
Mrs. Gangamma
Ms.T.Neerajakshi on be’nalf of VHAK 8. VHAI welcomed the
Members and said that though many of the contributors have
consented but could not attend this meeting, have sent
their apologies.
After self int .-c duct ion Dr.CM.Francis gave a brief
historical backc sr-ourd of the initiative to bringout the
State of Karnataka'?; Health Report and which would possibly
help in bringing out the Health Policy of Karnataka.
minutes of the
The
previous meeting held on September 18 were
read out bri'.i ly particularly the portion dealing with
chapters r j the contributors for the same. Corrments and
suggestions from the members were invited.
The following
emerged nut of the interaction.
1. Soc- > Economic Factors affecting Health.
This would give an over view of the Socio-Economic
situati on co place Health issues in the proper perspective.
It wou ,d include population, employment, education, income
and pu .-chasing nower, food, housing, water and sanitation
and disparities between different regions.
2
^r»P.H.Reddy, Director, Population Centre offered to
contribute to this chapter along with his collegue
Dr.Y.S.Gopal.
2o Food.
This chapter would include Food Production, Availability,
Consumption, Adulteration, Contamination use of pesticides
and also nutrition including Mal-Nutrition, Nutrition
supplements and Micro nutrients Prof.Somashekar Reddy,
Dr.Achaiah, Dr.Bhavani Belvadi will contribute to this
chapter. The name of Dr.Jalaja Sundaram was suggested
and regarding food adulteration the Public Health
Institute may be contacted.
3.
(a) Environment 8. Health.
The following persons will be the contributors
Mr.A.N.Yellappa Reddy
Dr.S.R.Hiremath
Mr.Prabhu Dandavatimath
Samaja Parivarthana Samudaya
Dharwad.
Mr.Panduranga Hegde
(b) Occupational Health.
There was no response from Dr.Nag this may be followed up
Dr.Rajmohan also of the Regional Centre may be contacted.
There was a suggestion that Members of the Association of
Occupational Health may be contacted.
4. Health systems & Services.
Dr.S.P.Tekur, Dr.G.V.Nagaraj and Prof.Shanmugam will be the
contributors.
It was suggested Dr.M.K.Sudarshan
HOD of
Community Medicine, KIMS may also be contacted.
This chapter will also deal with STD & AIDS.
5. Indegineous systems of Medicine.
After brief discussion the following persons were identified
for different systems besides Dr.Upendra Shenoy, Dr.Nataraj
Dr.(Mrs) Jayashree Nataraj, Dr.Lucas for Ayurvedic Medicine.
Dr,S.P.T ekur
- Accupressure & Accupuncture
Dr.Nagarathnamma
- Yoga Therapy
Dr.A.Ramdas
- Homeopathy
Dr.G.Prakash
3
Prof. S.A.Huk
- Unani
Dr.M.Kumar
Mr.Dham
- Sidda
- Mangneto Therapy
Dr.H.Sudarshan
Mrs.Gangamma
x
J
Trj_bal Medicine
suitable person may be identified for Naturopathy.
6. Population & Family Welfare.
Dr.P.H.Reddy will contribute this chapter with the
colloboration of Dr.Sudha Xirasagar if she is willing
to do so.
7. Child Health.
Dr.Saraswathy Ganapathy
Dr-.C.Prasanna Kumar
Dr.3.P.Tekur
Dr.Hanumantharayappa
It was suggested Dr.Benakappa and Prof.Nirmala Kesaree of
Davanagere may also be contacted.
8. Health Education and Health Awareness.
a. Health Man power development
b. Health communication
c. Health awareness
The following persons will be contributing
Dr.Jayashree Ramakrishna
Mr.S.M.Subramanya Setty
Dr.Uma
Dr.Rajanna
Dr.Saraswathy Ganapathy
It was suggested the relevant Resource Materials available
at the Regional Health & Family Welfare Office may be
tapped.
9. Medical and Nursing Education
Dr.Shirdi Prasad Tekur
(CHC)
10. Health Information systems.
Dr.Bhatia
4
11o Women & Health
Dr.M.K.Vasundhara
Dr.Saraswathy Ganapathy
Dr.Bhatia
Ms.Janaki Rao
Mrs.Philomena
Dr.K.S.Raghavan
This chapter will also incorporate Reproductive Health
8. Adolscent Girl.
12. Health & Research
Dr.M.K.Vasundhara
Dr.C.R.Chandrashekar
13. Health Financing
Dr.Shoba Raghuram
14. Legal Issues
Mr.M.K.Ramesh
15. Disabilities
Dr.S.Pruthvish
Ms.Indumathi Rao
16. Mental Health
Dr.R.Srinivasa Murthy
17. Panchayat Raj and its impact on Health (Decentralised
Health Care)
Prof. B.K.Chandrashekar
Dr.Makapur
It was proposed that Sri.T.R.Satish Chandran, Ex Director, ISEC
may also be requested to contribute for this chapter.
18. Role of Voluntary Organisation in Health Care in Karnataka.
Dr.H.Sudarshan
Ms.T.Neerajaks hi
C H C
Dr.C.M.Francis recalling the suggestion of a one day's
programme with presentation of each topic, informed that the
same has been fixed for Friday November 19, 1993 at which a
5
contributor of each chapter will present the outline of the
proposed chapter. The programme will commence at 10.00 a.m.
Each presentation will be of about 7 minutes duration to be
followed by discussion by the group.
The meeting is expected
to be over by 4.00 p.m. lunch will be provided. The discussion
is meant to bringout the adequacy of coverage of the topics
and also to ensure that there would be no overlapping or
duplication.
Group Meetings: It was felt necessary that the contributors
of a particular chapter which would be authored by more than
one person to meet before the workshop and finalise the outline.
VHAK was requested to co-ordinate the group meetings.
Schedule: The following schedule to the drafts to VHAK was
suggested and accepted:
1st draft to be ready and sent to VHAK
2nd draft to be ready and sent to VHAK
- 1.1.1994
- 1.2.1994
Final draft to be ready and sent to VHAK- 21.2.1994
All manuscripts in their final form must be received by this
date for editing so as to maintain uniformity of language
etc.,
The Edited manuscripts will be sent to VHAI, New Delhi
on or before 31.3.1994 for printing and publishing.
The contributors are requested to write to VHAK for required
Resource Materials specifying from where the same could be
procured. VHAK would also help in conducting pilot studies
if necessary.
The outline of the chapter to be presented on 19.11.1993
may be sent to VHAK in advance to be distributed.
If any relevant Resource Materials (data, writeups, paper
cuttings etc.) available with the contributor other than their
subjects may be sent to VHAK to be shared with others.
The contributors of chapter Health Systems and Services would
be meeting on Saturday Oct.23, 1993 at 3.00 p.m. in the Office
of Dr.G.V.Nagaraj, Jt.Director, Health & F.W.Services,
Directorate of Health Services, Anandarao Circle, Bangalore
560 009.
Vote of thanks was proposed by Ms .T.Neerajakshi.
The next Meeting (workshop) is scheduled for Friday 19.11.1993
at Seminar Hall, Library Block 1st Floor, NIMHANS, Bangalore
at 10.00 a.m.
VOLUNTARY HEALTH ASSOCIATION OF KARNATAKA
• Sri„Panduranga Hegde
Hulemalagi Brothers
Chowki Mutt
SIRSI - 581 401
Uttara Kannada
2. Prof.B.K.Chandrashekar
Indian Institute of Management
Bannerghatta Road
Bangalore - 560 076
Phone No. Res. 609911
3. Mr.Prabhu Dandavatimath
Samaja Parivartana Samudaya (SPS)
Ashadeep, Jayanagar Cross
Dharwad - 580 001
Phone No. 0836 — 41470
4. Prof.S.T.Somashekhara Reddy
Indian Institute of Management
Bannerghatta Road
Bangalore - 560 076
Phone No. 632450
5. Dr.Kusuma
Snehakunja Rural Health &
Devt. Project
Kasargod
Honavar
Uttara Kannada - 586 342
6. Mrs.Indumathi Rao
Project Director
Seva -in- Action
16, 11th Main, 5th Block
Jayanagar
Bangalore - 560 041
Phone No. 640330
Res.
645288
7. Dr.M.S.Rajanna
Kempegowda Institute of
Medical Science
K.R.Road,
V.V.Puram
Bangalore - 560 004.
Phone No. 603560
Res. 354435
8. Mrs.Gangamma
Mahila Samakhya - Karnataka
276, 2nd Cross
Cambridge Layout
Ulsoor
Bangalore - 560 008
Phone No. 577471
9. Dr.C.Prasanna Kumar
173, 18th Cross
M.C.R.Layout
Vi j ayanagar
Bangalore - 560 040
Phone No. 356806
10. Dr.PoHanumantha Rayappa
Institute for Social and
Economic Change
Nagarbhavi
Bangalore - 560 072
Phone No. 355468
11. Dr.Jayashree Nataraj
Govt. College of Indian
Medicine
Anandarao Circle
Bangalore - 560 009
Phone Mo. 71600
12. Dr.Rangesh Paramesh
Govt.College of Indian
Medicine
Anandarao Circle
Bangalore - 560 009
Phone No. 72848
Res. 358515
13. Smt.Philomena
A I K Y A
377, 42nd Cross,
VIII Block, Jayanagar
Bangalore - 560 082
Phone Lio. 64 3074
14. Dr.Lucas D.S.
324, 2nd Cross, 6th Main
Vijayanagar
Bangalore - 560 040
Phone No. 301174
2
15. Dr.C.R.Chandrashekar
N I M H A N S
P.B.No.2900, Hosur Road
Bangalore - 560 029
Phone No. 642121
16. Dr.Nataraj, R M 0
Govt. College of Indian
Medicine
Anandarao Circle
Bangalore - 560 009
Phone No. 71600
17. Mr.A.N.Yellappa Reddy
Dept.of Ecology 8. Environment
7th Floor, 3rd Stage
M.S.Building
Dr.Ambedkar Veedhi
Bangalore - 560 001
Phone No. 264377
18. Ms.Janaki Rao
MADHYA M
Post Box No. 4610
59» Miller Road
Benson Town
Bangalore - 560 046
Phone No. 586564
19. Dr.P.H.Reddy
Director
Population Centre
2nd Cross, Malleswaram
Bangalore - 560 003
Phone No. 364541
20. Dr.Makapur
Jt.Director (Health Education
8. Training)
Directorate of Health &
F.W.Services
Anandarao Circle
Bangalore - 560 009
Phone No. 70622
21. Dr.K.S.Raghavan
ASTRA - IDL Limited
No.32, Crescent Road
Bangalore - 560 001
Phone No. 266941
22. Dr.Saraswathy Ganapathy
14/33, II Main Road
Jayanagar 8th Block
Bangalore - 560 082
Phone No, 630463
23. Dr.Shoba Raghuram
H I V O S
HIVOS Regional Office
Southern India
98/A, Wheeler Road (Extn)
Cooke Town
Bangalore - 560 005
Phone No. 563678
24. Mr.M.K.Ramesh
A$st. Professor (Sr)
National Law School of
India University
Nagarbha vi
Bangalore - 560 072.
Phone No. 303160
25. Dr.Jayashree Ramakrishna
N I M HANS
Dept, of Mental Health
Education
P.B.No. 2900
Hosur Road
Bangalore - 560 029
Phone No.642121 Extn - 275
26. Dr.R.Srinivasa Murthy
HOD, Dept, of Psychiatry
N I M H A N S
P.B.No. 2900
Hosur Road
Bangalore - 560 029
Phone No.642121 Extn - 22.1^
27. Dr.G.V.Nagaraj
Jt.Director (MCH)
Directorate of Health and
F.W.Services
Rnandarao Circle
Bangalore - 560 001
Phone No. 7-7676
Res. 642574
28. Dr. Uma
51/2 (New 15/2) Lavelle Road
Bangalore - 560 001
Phone No. 214812
3
29. Dr.Bhatia
Foundation for Research &
Education in Health Management
No.223, 39th 'C Cross
Sth Block, Jayanagar
Bangalore - 560 041
Phone No. 642428
30. Dr.C.M.Francis
220, 38th Main 2nd Cross
B T M Layout 2nd Stage
Bangalore - 560 068
31. Dr.S.P.Tekur
Community Health Cell
No.367, Srinivasa Nilaya
Jakkasandra 1st Main
1st Block, Koramangala
Bangalore - 560 034
Phone No. 531518
32. Dr.S.Pruthvish
168/30 (50) 4th Main
Vyalikaval
Bangalore - 560 003
Phone No. 586682
Res.361413
33. Dr.H.Sudarshan
Vivekananda Girijana
Kalyana Kendra
B.R.Hills
Via Chamarajanagar
Mysore District - 571 317
Phone No. 8425 (B.R.HiIls)
Res. 631214 (Bangalore)
34. Dr.Upendra Shenoy
Arogya Vikasa Information
& Resource Centre
C/o. Rashtrothana Parishat
Kempegowda Nagar
Bangalore - 560 019
Phone No. 612732
35, Mr.S.M.Subramanya Setty
Asst. Professor
Dept, of Health Education
N I M H A N S
P.B.No. 2900, Hosur Road
Bangalore - 560 029
Phone No. 642121 Extn. 275
36, Dr.Sudha Xirasagar
I S H A
104 (15/37)
Cambridge Road Cross
Ulsoor
Bangalore - 560 008
Phone No. 574297
37„ Dr.M.K.Vasundhara
No.145, 12th Cross
J.P.Nagar 2nd Phase
Bangalore - 560 078
Phone No. 648655
38. Prof. Shanmugam
No. 676, 9th 'A' Cross
•Vest of Chord Road
II Stage
Bangalore - 560 086
Phone No. 322548
39. Dr.K.T.Achaiah
282, 100 ft.Road
2nd Stage, Indiranagar
Bangalore - 560 038
Phone No. 576284
40 .Dr.Bhavani Belvady
Secretary
Society for the Devt. of
Women and Children
'Ramaleela' 271, M.S.Road
V.V.Puram
Bangalore - 560 004
Phone No. 604043
41. Dr.S.R.Hiremath
Samaja Parivartana
Samudaya
Ashadeep, Jayanagar Cross
Dharwad - 580 001
Phone No. 0836 - 41470
42. Dr.Nag K.N.
No.253/4, Model House
4th Street
Basavanagudi
Bangalore - 560 004
4
43. Dr.Raj Mohan
Regional Institute of
Occupational Health
Bangalore Medical College
Albert victor Road
Bangalore.
50. Dr.Bonakappa D.G.
788, 34 'A' Cross
9th Main, 4th Block
Jayanagar
Bangalore - 560 011
Phone No. 642339
44. Dr.M.K.Sudarshan
HOD, Community Medicine
Kempegowda Institute of
Medical Science
K.11.Road, V.V.Puram
Bangalore - 560 004
Phone No. 603560
Res.628384
45. Dr.Nagarathna
Suhrudaya Clinic
4th Main
Chamaraj pet
Bangalore - 560 018
46. Dr.A.Ramdas
Homeopathy
People's Clinic
Shankar Mutt Road
Bangalore - 560 004
47. Dr.G,Prakash
Principal
Homeopathic College
Magadi Hoad
Bangalore
48,
Prof. S.A.Huk
Unani Medical College
Race Course Road
Bangalore - 560 001
49.
Mr.Dham R.K.
S ecretary
Institute of Health 8.
Cosmic Harmone
C/o.Gandhi Sahithya Institute
Malleshwaram
Bangalore - 560 003
Phone No. 326604
351387
51o Dr.Nirmala Kesaree
Prof. & HOD of Paediatri
J.J.M.Medical College
Davanagere - 577 004
52. Mr. T.R.Satish Chandra
231, Jagruthi
18th Cross
Sadashiva Nagar
Bangalore - 560 080
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?Ol)GH OUTLINE 01'
CONTENT!
EOi< .SECTION ON CHI LU HEALTH AND >/B Hl NG
(Note that all this wi
need to be modified depending on the contents
of other chapters, but J feel the areas mentioned must be covered at
some stage in the report)
-Indicators of child health. IMR, immunization Coverage etc. To
include education, working children and other such ’social' indicators.
- Major programmes for children (and women, where relevant) in the
state. Evaluation of implementation and functioning of.the programmes.
Critique of overlap in programme aims, single focus programmes where
need is for holistic approach. Distribution of ICDS; schools, PHCs etc.
^Perinatal period.
Effect of the ante-natal period, evaluation of
.ante-natal care services. Delivery and neonatal period - practices,
'use of ..services, role of low birth weight/prematurity. Imsbala .ce
between provision of secondary and tertiary services and need for
good primary services. Infant mortality - changes in, relevance of.
- Earty childhood. Patterns of morbidity and deaths. Effect of socio
economic factors. Use of services, adequacy of response to illness.
Gender differences.
- The adolescent period. Socio-cultural perceptions of the period.
Menarche. Needs of the adolescent girlchild. Early marriage and
child-bearing.
- The nutritional status of children. Prevalence of malnutrition,
specific nutritional deficiencies. Over-nutrition in well to do
households. Breast feeding and weaning - observations, traditional
practices, commercialization. Intra-family distribution of food.
- Psychological needs and observed practices.
(All the above areas_ahfluld be discussed in the context of gender differentiation,(female foeticide?), ‘'caste differences, urban/rural
differences, effect of education)
-Education. Need for'pre-sehool and primary, content should be rele
vant .
- Importance of traditional practices - evaluate effect, positive/negative.
-Working' children, destitute and street childten. Need for services,
evaluation of existing services, adoption. —eX .
-Disability.Separate section?
Socio-Economic Factors Affecting Health
P.H, Reddy and Y.S. Gopal
At the outset, the concept of "health" will be clarified.
Expectation of life at birth, crude death rate and infant
mortality rate will be regarded as indicators of health
status of people.
Morbidity can also be taken as an indicator
for health status of people depending upon the availability
of data.
Health status of people depends not only on the avail
ability of health facilities and services, but also on a
nonber of socio-economic factors.
It has been Said that
dispensaries, doctors and drugs account for only 10 per
cent of the health status of people and 90 per cent is
accounted for by socio-economic factors.
Therefore, this chapter will make an attempt to analyse
the association of health status of people with such socio
economic factors as region, religion, literacy, per capita
income, percentage of workers engaged in non-agricultural
activities, female work participation, degree of urbanisation,
sex ratio, household size, population density, dependency
ratio,j/number of hospital beds per 100,000 population, number
of ANMs, LHVs and doctors per 100,000 population,
percentage
of deliveries conducted by trained personnel and eligible
2
couples effectively protected by different family plannirig
methods.^ Thus, this chapter will make a general overview
of the health status of people in Karnataka.
Wherever
necessary and possible, district as the geographical unit
of analysis will be taken.
This is in addition to taking
the state of Karnataka as a whole as the unit of analysis.
Population and Family Welfare
P.H. Reddy and Y.S. Gopal
This chapter will be divided into two parts.
part I
will deal with population growth in Karnataka since the
first Census taken in 1872.
It will also deal with age-sex
composition of the population, sex ratio, population density,
etc.
Trends in birth rate, death rate, infant mortality
rate, in-migration and out-migration will also be analysed.
An attempt will also be made whether these factors vary
by district.
Part II will deal with the history of family welfare in
Karnataka, progress of family welfare programme since its
inception in 1951, couples effectively protected by different
family planning methods, average age of tubectomy acceptors
and wives of vasectomy acceptors, average number of living
children of sterilisation acceptors, average age of IUD
acceptors and changes, if any, in these characteristics over
a period of time.
An attempt will also be made to assess
the impact of the family welfare programme on the birth rate
and the number of births averted by the programme.
VOLUNTARY HEALTH ASSOCIATION OF KARNATAKA
Minutes of the Meeting of the contributors for State of Karnataka's
H alth - Report held on Friday November 19, 1993 at the Seminar Hall
NIMHANS, Bangalore.
Member present;
Dr.Upendra Shenoy
Dr.C.M.Francis
Ms.T.Neerajakshi
Mr.R.K.Dham
Dr.Prabhu Dandavatimath
Air.Shivannagowda Doddamani
Mr.Basavaraj Magdum
Dr.Syed Shahabulhaq
Dr.U.S.Lucas
Dr.Rangesh raramesh R
Dr.Shirdi Prasad Tekur
Mr.Soumya Kumar
Dr.C.R.Chandrashekar
Dr.Y.S.Gopal
Dr.Saraswathy Ganapathy
Dr.3.N.Prakash
Mr.S.M.Subramanya Setty
Ms.Sucharita S.Eashwar
Dr.B.S.Nataraj
Dr.H.Sudarshan
Mr.Ramappa
This meeting was specifically convened for the contributors to present
the outline of the chapters and for the discussion there on.
After the self introduction of the members Dr.Upendra Shenoy,Hon.
Secretary welcoming the members present briefed about the context of
bringing out the Report as some of the members were new.
Dr.Saraswathy stated that it was not possible to work within the time
frame specified.
She also enquired whether the contributors will be
renumerated for their time, energy and expertise.
Dr.S.P.Tekur said
that it has been difficult to meet in group where there are more than
one contributor.
He wanted VHAK to co-ordinate the Group Meetings.
- 2 -
There was a suggestion that State of India’s Health be made available
for all possible contributors,
Ms .Neerajakshi said that since it is
a priced publication the report would be just given for reference
only to the contributors who really need it.
After discussions the schedule was modified as follows:
First draft to be sent to VHAK before before 1.3,1994. Final draft
to be sent to VHAK incorporating modifications necessary on or before
31.3.1994. It was agreed that VHAK will co-ordinate the group meetings.
The proposed chapters were then taken up for presentation of outline
and discussions. The following outline for each chapter emerged after
the presentation by the respective members present and the discussion
that was followed:
1• SOCIO - ECONOMIC FACTORS AFFECTING HEALTH
(10 - 15.printed pages)
Dr. P.H.Reddy
Dr.Y.S.Gopal
Population (brief); House
Employment; agricultural .& non-agricultura; female workers,
non-employment; under employment.
Education: literacy; female literacy
income: per capita; poverty
Purchasing power
Food Jbrief)
Housing, water and asRifcafcia sanitation
Disaprities between different regions (district as the geographical
unit)
Religion; ethnic groups
Urbanisation
2. FOOD AND NUTRITION
(30 - 35 printed pages)
Prof.Somashekar Reddy, Dr.Achaiah, Dr.Bhavani Belvadi and
Dr.Jalaja Sundaram
2.a) FOOD
Food production: Cereals, Pulses, Oil
Milk, eggs, meqt, fish
Food needs/demand
Food security
Availability, utilization, consumption
Purchasing power
Food contamination; adulteration
pesticides; chemicals
- 3 Food
processing
Food storage, wastage
Public distribution system
Drought; poverty alleviation
Boxes on junk foods ; CFTRI
b)
2.
NUTRITION
Nutritional requirements; energy requirements
Nutritional situation in Karnataka - different districts, regions
Malnutrition and poverty/socio cultural factors/availability of
food, Malnutrition - prevalence ; grades
Micro nutrients
“omen and nutritional status
Mai nutrition and vulnerable groups : 0-1 year; 1-5 years;
adolescence; youth; girl child; pregnant; elderly; landless
labourers; slum dwellers.
Approaches and programmes to combat malnutrition
Five year plans
Agriculture/ and health
ICDS
Special and supplementary nutrition programmes
Applied nutrition programmes
Nutritional anaemia - National programme (implementation in Karnataka',
National Blindness control programme (Vit.A deficiency) -Karnataka
Nutrition education; training in nutrition
Tribal nutrition
Marketing (infant; baby foods) : negative impacts
Policy implication, strategies
Recommendations : Long term ; short term
Tables : Calories, kxx Proteins, Vit A, Iron
3.a) 2XV1H2NEMZN ENVIRONMENT AND HEALTH
(15 printed pages)
Mr.A.N.Yellappa Reddy, Dr.S.R.Hiremath & Dr.Prabhu Dandavathimath
Environmental (resource etc) degradation; ecological changes
Deforestation/afforestation
Excessive use of ground water ; fuel
Subsistence cropping; cash cropping
Industries and their impact
pollution (all kinds); action by government; action by
Voluntary Organisations
Sustainable development: rural;urban;tribal
:
*
Disaster
floods, droughts, ete
Box (High tension wires and
health problems)
Quarrying and mixing
Marine (+ravellers) ; birds; national sanctuary
Critical analysis
3. b) OCC'JrA fIOM'aL HEALTH
(Outline to be worked out)
4• HEALTH SYSTEMS AND SERVICES (40
45 printed pages)
Dr.S.P.Tekur, Dr.G.V.Nagaraj, Prof.Shanmugam & Dr.M.K.Sudarshan
(T Historical : Evolution of health care services in different regions
of Karnataka
(^) Health care facilities
Government, private, Voluntary, corporate, industry, co-operative
Hospitals: beds.
Subcentres, PHCs , CHCs, Taluk, District, Teaching, Speciality
Health units, Nursing homes, laboratories
Rural; urban slums - health care services
General practitioners
Doctors - general ; specialists
|
Nurses - general ; specialisation
Dentists - general ; specialisation
4
?
forking in various places
Pharamacists - general ; specialisation {
Technicians (Laboratory, X-ray, etc)
Physio.therapis ts/Occupational Therapists/others
Blood banks (blood transfusion services)
Burns units
Indicators and targets
Crude birth rate; crude death rate
. 1 ,
/ (MvM WUV
IMR; ■£. 5 death rate; maternal mortality rate; perinatal; /
neonatal mortality
z
'
7
Life expectancy at birth
Death rates specific to age, sex, cause
Nationalcontrol/eradcation programmes (Malaria; Filaria;
Tuberculosis; Leprosy. STD, AIDS; Blindness; Diarrhoeal diseases;
Guinea - worm, Goitre)
. Immunization
Infectious diseases, Food poisoning
,
t-C-wv / tip-
Cardiac, pulmonary, kidney disorders; anaemias; cancer •
Five year plans; budget; expenditure on health
Mobile health units
Accidents
Drug controller; Drug production, utilization; quality© control;
supply; rational use of durgs, hospital pharmacies.
Drug stores
Public health laboratories
People’s perception of health services; under services; under
utilization of Government services,
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JAYAJuVA, i\Als BLINSTITUTE
STD/11IV; AIDS
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dr.o.x.Tekur - Accupressure & Accupuncture
iir.iiagarathnaa-nja ~ Yoga Therapy
Dr.3.D.Prakash - Homeopathy
Prof. S• A. i'uk ~ Una rd
B.r. Dham - Magneto Therapy
Lr.upendra Shenoy
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Dr.Kataraj
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Ayurvoda
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Dr.Lucas
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Tribal medicine
Naturopathy
Ayurveda
Unani
Homeopathy
Naturopathy
Yoga
Magneto Therapy
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J
to fce dealt in detaii
*£»■. '.tional medicines: Herbal, Home, Folk
Tribal (
Tioetan j
in brief
Historical background; present state
Hospitals
J
Government
Nursing hones §
Voluntary
Dispensaries
|
Private
Units
2
beds
Education in the various systems
Research d Facilities
|
j
Practitioner : general; specialists
Pharmacies
liurses
to be worked out and then
transferred to other
appropriate chapters
6
Journals, magazines, newspapers coverage, radio doordarshan
Cultivation of modicinal plants; patenting
Production of medicines; drug control; standardisation
Drug utilisation
People’s perceptions and attitudes; utilisation of services
Futures recos.-endations.
6*
1 FAV.iLY '.'.s;LrAd„
Dr.; .ti.Heddy & Or.Y.J.Gopal
(15 printed pages)
6.1) Demographics - Karnataka
Population; growth since 1372; projections for Karnataka; trends
cities ~ Hangalore; Hubli-Dharwad; bangalore - '-'istricts.
Age; Sex; Sex = ratio
Population density
Composition of population
Migration to and from Karnataka
6.2) Family -elfare
M C H Programmes
Family Planning
Methods
Couple protection
Accept©rs
Effectiveness; Number of births averted
Impact on birth rate, etc
Natural Family planning
Folk practices
Critical analysis; reliability of data
Family planning from women’s perspective
7•
CHILD; HEALTH (15 printed pages)
Dr.Saraswathy Ganapathy
Dr.C.Prasanna Kumar
Dr.3.1.Tekur
Dr.iianumantharayappa
birth rate; infant mortality rate; under 5 mortality rate
Life expectancy at birth
Ferinatal care; delivery, neonatal care
Development - intrauterine growth retardation, low birth weight
pre maturity
Artificial reproduction
Lex discrimination; amnioceutesis Gender diferencies in
response to needs
Ka
■1-reast feeding; meaning
Nutritional status
ata 1 nut ri z 1 o n, 11 ic ro nu t ri en t s
Infectious diseases of childhood
Immunization •“ evaluation
~ls:.ases of childhood, .mortality; morbidity
t tychosocial problems
Accidents
street children
Child workers - especially hazardous occupations
School health
Adolesence
I C D S
Traditional practices
kiajor programmes for child health services; critique
-< e cooune nd a t ions
3, Hu.
5’■
_ ..£1'0
PQG®.?,)
Ir.Jayashree Ramakrishna, ».r.N.;;>.Subra<nanya Hetty, Dr.Uma
d‘ro '.«j Janna
Health education for health action
Role of behaviour; effecting changes in habits
Gommunication; health messages
Media - print; newspapers, magazines, in kannada
Mass media: Radio; TV
Folk
Exhibitions
Nos-. 1 -s.l/clinic based health education/ patient education
school health education
Community involvement in health education
fikiidwteefc Child-to-child education
Health education for various groups - farmers, others
Advertisements
Health awareness
‘■'eople’s beliefs and perceptions
Care during pregnancy, delivery, postnatal
Nutritional education
Specific problems ~ gynaecological etc
Taboo and practices
Health awareness among people's representatives; decision makers
jlecomii.endati ons
<=»
9.
^
es»
.j-.j-.-J; .Gtu DuVliLD.■;»•;«: ID HSALi’.-i ( 40 » 45 printed pipes)
ur.Ghirdi - rasad i’ekur
Medical education
Govei nment/priva te
llumoers; lumbers needed
Under graduate/post graduate; input/output; migration
Capitation fee
Supreme Court decisions
Case studies
Social relevance
Dursing education
Government/private
Cumbers; lumbers needed
3.G c/Uertifi cate course/; J5;s
Migration; attention
Capitation fee
Dental education
Goverrepent/private
3DS/MD5; input/outpu t
Capitation fees
Pharmacy
Government/pri vat©
Degree/diploma
Numbers; numbers required
iiealtn Gssistants, Multipurpose worker• -Health visitor
technicians
A-ray, Laboratoryo dental, ECG, others
rood inspectors
Physiotherapists/occupational therapists
Nutritionis ts/di etici ans
Traditional birth attendants - trained
Community health Aorkers/guides/volunteers
•10. HcGLTH INFw;Y.-GTIU-1 SYSTEM ( 10 pages)
(Dr.Ghatia to give details)
Date; sources, collection, utilization; reliability, medical audit
110
HEALTH (20 - 25 pages)
Dr.M.K.Vasundhara, Dr.Saraswathy Canapathy. Dr. -hatia, Ms.Janakirao
Mrs.; hilo';iena, ur.K.S.Raghavan, Ms.weerajakshi
9
Special problems of women’s health
Under nutrition; anaemia
Mortality , morbidi ty
Asternal mortality, delivery
Victims of violence
box ratio, sex determination and discrimination
Girl child - neglect; exploitation; age of marriage; pregnancy
Women in health care services; problems; opportunities
Dr. ..K.Vasundhara <1 Jr.C.R.Ghandrasheksr
Research relevant to the health problems in Karnataka
include research in all systems
\\ Doxes on research institutions
.
\
13.
.
.
-
.
l’i/'Vu--GX,;.G (10 pages;
Dr.GhoLha Haguram
•Government/private/Voluntary/EDI Corporateon/Corporate sector/
Local bodies
House hold expenditure
Health outlays and expenditures; absolute amounts and as
percentage of total plan/budget
breakdown by programmes
Health insurance; state/voluntary/private
Health cess
14. LEGAL
;.J ETHICAL ISSUED (10 printed pages)
Mr .A:.;-',. .Eamesh
Acts: Drugs and cosmetics Act, 1940 - national use of Drugs;
Canned drugs; Public interest litigation; case studies.
Drugs and magic remedies Act, 1954
Prevention of Food Adulteration Act, 1955
Other Acts and Legislation
Advertising: alcohol; tobacco
pollution; laws regarding; implementation
.’Cedical. negligence; Consumer protection ^ct, Case studies
Informed consent
- olicies, law; Weed for change; need for better administration
of legislation; enforcement
Hole of voluntary agencies
Critiquing
“■ 10 «»
13.
16.
il2 ~ .15 printed pagosj
»r.J.Pruthvisn, ..iis.Indumat ,i Rao
Types; numbers
Institutions - -ervice/, training, research
Rehabilitation
..ccidents/injuries - occupational; agricultural, Household
koad/traffic; case studies
Aids and ap Hances
Community - based rehabilitations
.health_
(Dr.fu Jrinivasamurthy to give details)
Mentally ill; xr valence; pattern
Mental health manpower; facilities; institutions
Jut patient, ambulatory, inpatient care
Innovations ~ Family in care
integration with general health care
.ioxes; s revalence
school mental health
Mental health
Mentally reta-.ded: education/training; care
Voluntary agencies in mental haalth care in Karnataka
i-sychosocial stresses
boxes (prevalence; institutions/hospitals, innovations)
addictions
rromotion of menial health; prevention of mental disorders
RationM programme and Karnataka
Future Fractions
17. .Tp... .1 1 jiAJ AND, IM ACT
X..5. printed_pagep)
Grot. j.K.Chandrashekar and Jr.Makapur to give details)
1 d«
AOLE. . JF._VOi.ui.TAii/ .,....i.G'.HiISAii-L-Ki IK HEALTH CARE IN KAaKALiKA .
(10 printed pages)
Ms.Ileer&jakshi & Or.H.dudarshan
a. Introduction
b, Definition
c. Brief back ground history
evolution of voluntary movement in Karnataka
d. Various cor^aittees formed by the government
o. Voluntary work in health care as a People’s mev-jsen'i. number
type .3..
of work of Voluntary organisations complete list
witl address including notary, -ions, Jaycees etc.,
f. Frogramme and Jtratergies
Health & wealth related Institutions - Integrated approach
coa..u nity « evelopment
- 11 g.
Area - Need assessment, planning, complimenting & sup- limenting
Government programmes, Liaison with government and other
organisations, population and family welfare, monitoring, Health
education (awareness (consumer action) information dissemination
training programmes, Service camps, Campaigns). Evaluation
curative services, Research,Rehabilitation, Referral counselling,
Intersectoral co-ordination, crisis management, Geriatic problems
legislation.
h. Strengthens
i. .-eaknoss - finance, personnel, skills, political interference
non co-operacion (State, district, 1'aluk & Fanchayat)
j. Conclusion
0 •
(10, printed pages),
Dr.C..V..Francis
History; geography - Maps, regions, districts
Karnataka at a glance
educational facilities - centres of learning; universities
<4usauras, libraries, cultural centres; recreational centres;
Sports complexes
Vehicles; transport
traffic accidents
Crime - murder rate - Kidnapping - abduction
Alcohol; tobacco
GUIDELINES
Actual state of affairs in Karnataka. Focus on Karnataka;
comparison with All India and neighbouring states.
Historical; Minimal
what 1:. :
innovative; special features
Future
ejections
Grit' ,ue, Recommendations
Visuals - graphics, tables, pie diagrams, bar charts, pictures
photographs, cartoons
boxes
References (minimal) ; bibliography
‘•rite-ups: A—4 size, typed, 1 1/2 spaskin spacing
i'he total number of pages has come to 305 (minimum) to 345 (minimum)
printed pages with about 15 pages required for introduction, editorial,
etc,, the total would come up to 320-360 pages, ihere is little
scope for increase (estimates 300-350 printed pages) Ihere can be
some
re-adjustments.
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T^CK
_
_
fM PU&.WT OF
VOLUNTARY, HEALTH ASSOCIATION. OF KARNATAKA
VHAK/C-22/E0-1993
Office at: Rajini Nilaya, No.60
Ramakrishna Mutt Road
Cross, Ulsoor
Bangalore ~ 560 003
.26 TH NOVEMBER 1.99.3.
Dear Sir/Madam,
We are confident, you all must have read through the papers,
heard from Radio and seen in T V the traumatic experience,
the people of both Karnataka 8. n.aharasntra experienced on the
early morning of 30th September 1993. It is a ghastly
experience for the people but it is a news to us. We are
sure we do not have the total picture of the damage that
occured to the properties, lives and other belongings, except
what Government and the media have projected in the official
circles. You must be eagerly awaiting to have a vivid account
of the total collourness.
We are glad that Mr.Ramappa C.Radii, Programme Co-ordinator,
as a VHAK representative visited the affected places, met
people from different walks of life and background and
collected the information personally and the same is complied.
The' copy of this report is enclosed for your first hand
experience.
*e< are also pleased to inform that a four member tea:.
comprising representatives from both VHAI and State VHAs
(MPVHA & UFVHA) undertook an on the spot assessment during
the first week of the onset of the disaster and suggested
the following that VHAI can take up:
1. Identification'of specific needs of two selected clusters
of affected villages receiving inadequate assistance.
2. On going monitoring of interventions and strategies being
undertaken by State agencies in order to identify specific
grievances and channelise resource distribution at local
levels.
3. Identification of specific long term health interventions
eg. physical/mental rehabilitation in selected areas to
be based on the lacunae in the present modus operand!.
4. Mobilisation of required resources among member institu
tions and other/professionals to facilitate targeted
field operations.
5. On going dissemination of primary and secondary informa
tion to State V.lAs, member institutions and others.
LOGISTICS.
In order to operationalise the above recommendations
suggestions for the development of a targeted strategy
for disaster management at three levels are as follows:
A. Resource/lnformation Centre: .Location: Sholapur
Maj or _.po.s s i bl e functions
-- Identification of interventions, plans and strategies
undertaken by NGOs and International agencies.
2
- 2 - Collection, analysis and dissemination of primary
and secondary information.
- Liaison with govt, and other agencies to follow-up
local grievances
- Co-ordination of activities based on selected
a ’
field level health interventions eg physical/
mental rehabilitation.
B. Fi.eld_Cen_tres_
1 . T_aluk__leye 1 „(O.neJ_
Location: Omarga, Osmanabad District
Majo_r „pps s ib ln__ Func ti qns_
- Orientation and training activities for community
volunteers.
- Physical arrangements for personnel (volunteers,
professionals etc)
- Liaison with district collectorate, volags and
others
- Co-ordination of community volunteer activities
- Compilation, assessment and feed back of primary data
- Development of resource materials for communit''
education (housing, causes and effects of earth quakes, mental health, local traditions & practices
etc) .
2. Village level (Two_)_
Location: in two selected clusters of villages needing
immediate attention
Major possible functions:
- Identification of beneficiaries in neglected villages
- Selection and supervision of community volunteers
- Liaison with Gram Sabhas and other agencies
- Referrals and identification of health services
(Physical + mental rehabilitation) and other immediate
assistance like agricultural requirements etc.
- Identification and registration of grievances and
channelising distribution «f relief supplies
- Provision of need based assistance e.g. writing
applications, identification and resettlement of
relatives, injured cases, registering grivances etc.
Hence, in view cf the above massive tas^ that VHAI proposes
to emrarkj VHAK wishes to join hands with VHAI. Through
this letter it is our earnest request 'TO ACT NOW' by
donations,contributions, help etc. which is feasible to you.
We solicit your kind co-operation.
Thanking you,
Yours Sincerely,
(t.neerajAkshi)
Promotional Secretary
VOLUNTARY. HEALTH .ASSOCIATION. OF KARNATAKA.
REPORT OF THE_EARTH. QUAKE
Man in the desire of conquering Earth, Sky, Air and Water has
denuded nature beyond limits, without thinking of the
consequences of such a venture which is the root cause for
many untold miseries and ills. People are of the opinion
that nature has punished her own children through natural
calamities. It appears true, though it may be considered as,
blind belief as human greed has resulted in many Disasters.
The above statements were expressed by Co-travellers when I
was travelling in the bus from Bangalore to Bijapur.
*
Discus
sion about earth quake has become the talk of the hour.
It was a grieving experience to personally witness the earth
quake disaster who had till then just read in News Papers
etc., heard in Radio and seen on the T.V.Screen about vehicle
and train accidents and plane crash.
It is difficult to
express in words the calamity.
The September 30 earth quake which drew the attention of not
only India but the whole world is the worst ever catastrophe
to hit the country in recent times, as the earth quake ripped
through Central Maharashtra region early on Thursday morning
and turned cluster of villages into graveyards.
It has not
only struct 73 villages of Lathur and Osmanabad districts
(Marathawada region) of Maharashtra State but also the 25
villages of Bijapur, Bidar and Gulbarga, border districts of
Karnataka State.
His.tory of.
ar th Quake:
The above Earth Ouake is the fourth in this decade - above
30,000 lives have been lost.
During the earth quake of 20 October 1991 at Uttara Kashi
nearly 1,500 were killed and thousands of them wounded.
The
intensity of the quake was 6.1 on Richter -dale.
- In the Bihar earth quake of 20 August 1988 more than 1,000
people died.
The intensity of the quake was 6.5 on Richter
Scale.
- The earth quake during the year 1967 in Maharashtra and 1905,
1975 & 1987 in Himachal Pradesh-resulted' in loss of many
cattle and human lives.
OPINION.:
Reasons for earth quake expressed by the Mass are
varied.
Due to the advancemen+ in science, computer horsoope,
- 2 information pertaining to share business, likewise cyclone,
fleods 8. famine can be predicted.
But we cannot forecast
earth quake or be aware of callousness. Hence, such disasters
strike suddenly.
Many may say that they were aware but none
ould perdict this.
Though not exactly, the people were
expecting this disaster cannot be ruled out.
The reason is
that frum the last two years people were experiencing slight
tremors now 8. then, within a span cf three months i.e.
between August - October 1991, 300 times in a day is a
common news.
Expecting the.earth quake the local people
approached the Government to provide them alternate place
(shelter) several times but in vain.
On the other hand after the devastation both Government and
Voluntary Organisations speakabout relief, rescue, compensa
tion, rehabilitation etc., but everything is in a state of
confusion as none of them have defined policies & programmes.
It is obvious that the compensation is not given to the
victims though it is announced in News papers.
In this
regard Karnataka Government has atleast disbursed meagre
interim relief fund.
But the declared amount of compensation
by the Maharashtra Government is not given
but adequate
water, milk and food are supplied.
The Government with its
stringent policies is aggravating the sufferings of the
victims.
CHALLENGE:
Rehabilitation of the victims of the Disaster is
a challenge to the Government and the society.
Many problems
such as supply of enough food, safe drinking water, providing
medical aid, education etc., are the immediate needs.
It also
encompasses the basic necessities of the people. Such a
’■''situation demands Rehabilitation of the victims, patients and
future of remaining adults and children.
Efforts should be
made to provide all the basic facilities and mobilise
resources for the same which is a great challenging task of
the future.
ASSUMPTWNS & ..FACTS: It is a common phenomenon that Why and
How the earth quake struck is being discussed.
Earth quakes
are caused by a variety of factors including the structure
of subsoil, presence of faults and rock formation.
But many
of them attribute that lack of scientific planning while
constructing reserviors around Koyna dam had been a major
cause of the earth quake which clainjed thousands of lives.
People also believe that this may be the result of large
number of borewells dug within a distance cf 20-30 metres.
3
30TH SEPTEMBER.DISASTER: Ganesha festival in Maharashtra is
celebrated with great .pomp and rejoice.
People had returned
home late night after the immersion (ceremony) of the Ganesha
idol and had gone to their bed.
Before they could go to
sound sleep, many, of them went to"deep sleep never to awake
again due to Eqrth Quake on 30th September early morning at'
3.56 a.m. the first tremui wi ch a loud noise was experienced.
The intensity was 6.29 ’n Richter scale that lasted for 45
seconds.
■..rc-iicrs i.c, second at 4.41 a.m.
The subsequer
(54 seconds) third at t ,
m.
a.
. a.m.
(12 seconds) fourth at 6.34
(22 seconds) and f" 'th at 7-,45 a.m. (2 seconds) were
experienced and at sev-: .1 places thrice again at 9.30 a.m.
9.40 a.m. and 2.24 p.m.
ias been reported.
It is ghastly
scene to witness the devastation in nearly 73 villages of
Lathur and Osmanabad districts.
AFTER DISASTER:
Aid was provided two days after the disaster
which took place on 30th September 1993.
The people of.
Pethsanghvi feel sorry and are of opinion that many more
lives could have been saved if the relief (AID) was rendered
immediately. Vivekananda Medical Foundation and Research
Centre - Lathur was the first organisation to arrive and
extend immediate help to the injured. After two days, Army,
Railway employees, Voluntary Organisations etc., from
Maharashtra and other parts of the country arrived and took
active role in the relief work.
It is gratifying to note
that the Maharashtra Police, Army and Railway employees were
actively involved in clearing the debris and extricating
the bodies.
Though the relief work : s hastened tc a great extent by
resources pouring in from various parts of the country and
abroad in the form of cssh.,. food, clothing, medicines etc.,
there was no proper disbursement of the same.
The tents
from America were not seen except in two or three villages
where it was used as school shelter, likewise, it was
astonishing to learn from the school master .of Pethsanghvi
that thousands of w«llen blankets arrived from Germany had
not reached needy people.
However, the first stage of the
relief work was continuing smoothly.
UNTOLD STORIES:
Though the relief work is carried out on a
war footing the major portion is done by Maharashtra Govern
ment. Initially few Quasi Govt, and voluntary organisations
were engaged in the relief work and later when large number
of organisations joined, Govt, had to impose restrictions to
entry around 30 kms radpus .without prior permission.
In
4
spite of the massive presence of the army and the police;
looting of valuables from the debris was rampant, after the
sun set both villagers and army personnel leave the place
and miscreants gain entrance under all guises, including
that of relief workers.,
Mr.Vishnu churilal Naroji is clawing
through the debris to retrive whatever possible.
He perso
nally shared that his brother's 25 sovereigns of gold and
cash of Rs.22,000/- were missing.
Many more such instances
have occured since Police also indulged in such crimes.
Hence, the local Marathi daily newspaper SANCHAR (7.10.1993)
had published that 75 police were suspended by Maharashtra
Government.
There was a rumour that nearly 150 police have
been suspended till now besides a Talishadar and his
assistant.
In the two districts of Maharashtra 46 and 21 villages;
(limarga taluk 28, Osmanabad taluk 18 villages of which 15
villages have been flattened and in the reamining 31 villages
the intensity of damage is less.)
In villages where the
damage is less the houses are unsafe for living and the
extent of damage is yet to be assessed.
Resides damage to the property the, number of- lives lost in
this disaster, Killari village contributes the major toll
(90/o of both life and property) •.-, Hence it has drawn the
attention of most of the organisations both from the govern
ment and voluntary organisations thus depriving othervillages of their services, which resulted in further loss
of lives.
The neighbouring villages of Killari, Pethsanghvi
Kavata, Narangavadi and
Sastur have been neglected.
This
fact was expressed by the villagers personally when we met
them. Dr.Mukunda Rao uindhe of Petesanghvi who had lost
4 children out of 6 in the cetastrophe, though engaged in
offering services to others feels extremely sorry that many
more lives could have been saved if timely services were
rendered.
But it is disappointing to note that some of the
leaders were engaged in Groupism.
CaSTl PpuiTICSj
Petsanghvi was a small neat village of
4000 population and there were 800 houses, one fourth of
the population were Muslims,
Though some of the victims are
provided with temporary sheds on the main road, few of the
Muslim community victims have been given temporary sheds on
the other end of the village where water supply and street
lights hardly exist.
Hence Muslims feel they have been
separated and neglected.
Curing the interaction with
5
Sri Dilip Rao Moule it was learnt that the Muslims are
disappointed and have been questioning this attitude, though
appears to be simple but may further lead to communal
disharmony. It was surprising to see that the only house to
have survived the quake is that of Sarpanch Dilip Rao Moule.
Government and the Voluntary organisations have undertaken
massive relief services to the victims. One of the important
area is disbursing monetry compensation.
It could be observed
that castism was important as the leaders of a particular
caste were interested to get the same for their people.
There was
no unity and trust among the villagers and each
one is suspicious of the other and this is being exploited by
politicians and caste leaders. This may grow strong further
and be an obstacle in providing the relief in future.
.IMMEDIATE.WORK TO BE UNDERTAKEN:
We may need another 3
months to arrive at a total picture of gravity of loss
occured. Immediate relief is temporary relief. Hence, an
intensive survey of the area has to be undertaken to disburse
monetry help to victims immediately. Otherwise, people will
lose faith and trust in Government and its officers, the
whole issue will become political and solution to the problems
may not be forthcoming in the near future.
Compensation announced by the Government is still remaining in
the form of declaration.
People approaching the concerned
officers along with their caste leaders for compensation is a
common sight, which has given room to dis-satisfaction among
all sections of the society.
Hence the government should
take immediate steps to resolve all the issues.
RELIEF ..WORK:
Indian army and soma of the organisations have
returned after helping in extricating the dead, clearing the
collapsed houses and saving the belongings for the claimants
to the extent possible. Many of the injured victims under
going treatment at private Nursing Homes, Vivekananda Medical
Foundation and Research Centre and Government Hospital at
Sholapur are recovering.
The helping hand extended to
Government and the services rendered by the Voluntary Orga
nisations from all over the country and globe is appauled
by everyone.
However, counselling and remedying the trauma
is challenging task to both Government and Voluntary Organi
sations.
It is important to make people realise that tarth
quake is' a Natural calamity besides providing relief,
relocating, helping in resettlement and counselling to start
new lease of fresh life.
AID:
Several countries have joined the United Nations and
International Voluntary Organisations in offering assistance
for rescue and relief operations to the victims of the
devastating earth quake, besides from the various parts of
the country.
1. ..orld dank has sanctioned $300 million, to be returned on
easy instalments.
Survey of the area was carried out by
the •••orld Bank.
2. European Financial Community has committed to extend their
help after getting complete report of the devastation.
3. U.hlCEF has. provided Rigs and Pumps to dig new bore wells
in the resettlement colonies.
4. Kerala Government has decided to adopt one quake hit
village for total development.
Also,International Lions
Club has adopted Kavara village.
5. Indian Red Cross has sent cotton
blankets and rations
"with other materials needed for the victims.
6. All the State Governments of our Country have extended
help in terms of Cash, Medicine, Food grains etc., besides
free Medical aid and Volunteers provided by Voluntary
Organis ations.
7. U.S.A, has supplied 950 tents and 2.6 million sq.ft, of
shelter material and medicines, similarly German Govern
ment has given wollen blankets.
Inspite of help extended from abroad and within the country it
is disappointing to note that some of the villagers have not
received any help till now.
Other villages are neglected as
everybody’s attention is centred round Killari.
Nearly 75%
have not got aid despite announcement in the media.
To cite ■
an example the immediate neighbouring villages of Killari,
Fetsangvi and Sastur have not got temporary sheds, yet the
reasons expressed are:
a. Lack gf^_Cp_~ord_iriatiqn:
Though Army, Police, large number
of Voluntary Organisations and different Government depart
ments worked with the same objectives, lack of Co-ordination
led to utter confusion and chaos.
The visit of. police,
politicians and political leaders hindered the relief work
hampering operations by their very presence.
This was
- 7 admitted by the Government officials who -expressed their help
lessness.
There was no method
the relief agencies.
to the madness brought in by
Many relief agencies, loaded with
perishable food items were halted outside the villages for
lack of permission by the officials.
No proper system of
disbursement of relief supplies was followed. As a result,
many a survivor received items for which he had no need.
b. Current situation:
Rumours about earth quake to take
place in the near future and slight tremors experienced now
and then has created
anic among the already numbed survivors.
People whose houses are intact are not courageous enough to
stay inside the houses. Hence, we can see people of Lathur
'Jmarga towns sleeping in the temporary tents erected in open
air outside.
Victims of the earth quake are yet to overcome
the mental shock.
liven the volunteers of some Voluntary Organisations are
assailed by the prospect of another earth quake hitting the
area.
in petnsangvi some rescue and relief workers are show
ing disinclination to stay on at the relief camp during night.
DEAD dOpluS AWAITING GREA^.ATluN: It is horrifying to see heaps
of burnt bodies, here and there relatives searching the corpse
of near and dear ones is a pathetic condition in 25 villages in
and around Killari.
Macabre- scenes of bodies being cremated on road sides, in the
fields on top of debris or just about any place dot the land
scape. Gome collected the Wooden supports - Windows, doors,
frames of their dwellings and used them for the pyre.
Though Army men dug through heaps of rubble to spot the dead
and removed thousands of dead bodies, the villagers are of the
opinion that many more are yet to be extricated. Dr.Tad salagi
Sarpanch of -illari affirms that many more dead bodies are
still left in the debris.
None are aware of the exact death toll
due to quake.
Govern
ment's estimation has not crossed 30,000 but the local people
are of the opinion that it is more than one lakh. This
figure is endorsed by Voluntary Organisations also.
According to Dr.i-adasalagi Garpanch of Killari nearly 50 - 60
thousand bodies are under the rubble.
The details of the
figures published in the Maharashtra times (Marathi daily) on
13.10.1993 is as follows.
In reality, besides the details of
66,400 dead the unearthed bodies when counted (not to be
found) would cross more than a lakh.
Name of the
Village
Percentage
Victims
Population
of village
according to
1991 census
No. of
persons
alive
No.»f dead
(Not to be
f o u nd )
. 20,000
5,000
8,000
2,000
5,000
19,000
4,500
6,000
T, 800
4 >900
1 ,000
500
2,000
200
' 100
15,000
12,000
800
2,000
5,000
4,000
3,000
1,500
6,000
5,000
6,000
1,500
4,000
2,000
5,000
1 ,500
10,000
5,000
2,000
2,000
1,500
6,000
2,000
14,000
10,000
200
500
1 ,000
1,500
1,000
300
5,500
3,600
2,000
500
3,500
1,500
4,500
500
8,000
1,000
1,500
1,800
1 ,000
5,000
1,500
1,000
2,000
600
1 ,500
4,000
2,500
2,000
1,200
500
1 ,400
4,000
1,000
500
500
500
1,000
2,000
4,000
500
200
500
1 ,000
500
1,42,800
1,06,100
36,700
18,000
1 ,000
5,000
1 ,500
3,000
1,500
5,000
2,000
3,000
1 ,500
2,000
5,000
2,000
1 ,000
1,500
5,000
2,000
1 ,500
1 ,000
200
500
500
2,000
1 ,000
4,000
1,500
2,500
1,200
1,800
4,500
1 ,500
800
1,200
4,500
1,900
1 ,200
17,000
800
4,500
1 ,000
1 ,000
500
1,000
500
500
300
200
500
500
200
300
500
100
300
61,500
31,800
29,700
UMARGA TALUK
1. Lohara
50%
2. Kanegaum
75%
3. Jevalli
60%
4. Kasti
50%
5. Sayed
35%
6. Hippuraga
6. anigoor
. 25%
7. Sasthur
60/o
8. S.3.Chincho li 75%
9. Rajegauva
95%
10. letsanghvi
80%
11. J.Holi
75%
12. Tavasigad
80%
13. Udatpur
75%
14. Makani
25/o
15. Kavatha
50%
16. Yekkundi
60/o
17. Kondavigad
55%
18. Salegaum
35%
19. Toramba
50%
20. K.Limbala
50%
21. Samudal
60%
22. Naijakur
75%
23. Narangavadi
60%
24. Kaladora
55%
25. Hvanthal
40%
26. Sori
50%
27. ft.atola
60%
28. Murshidapur
50%
-
•
QUSA TALUK
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
Killari
Killariwadi
Talani
Gubal
Nimbal
Panegam
ftiangarool
Nandurga
Naregaon
T.Chincholi
Javalaga
Lamjana
Gajarakhc-da
Sankhala
Sarani
Ujani
Malavana
Ashiva
90%
80/6
100%
70%
70%
60%
50%
60zJ
40%
55%
60%
50%
60%
45%
60%
50%
40%
50/6
.
---- ...
■
r* y
EARTH QUAKE IN KAR^TAKA
The most disastrous
earth quake of the century that devastated
many villages of Lathur and Osmanabad districts of Maharashtra
left a trail of destruction in Northern Karnataka claiming 13
lives. Also in Northern Karnataka the border, districts Bijapur, Gulbarga, Bidar and Raichur were affected severly.
The difference is that, in Maharashtra thousands of lives were
lost, but in Karnataka more than 40 villages in the above
mentioned districts nave shattered hundreds of houses into
rubbles.
Though people all over the state felt the early
morning quake, -it was only in some parts of Northern Karnataka
that it brought extensive damage to life and property.
The
death toll is 13, atleast six qf them in Bijapur alone two
persons each were killed in Bidar and Raichur districts
respectively.
Though many villages have been severly affected
it is unlucky that it has not drawn the attention of neither
Government not Voluntary Agencies.
The September 30th catastrophic earth quake which struck
around 4.00 a.m. has created havoc in the taluks of Indi.
mudhol, Jamakhandi
and Muddebihal in Bijapur district, Aurad,
Basavakalyan and ahalki taluks of Bidar district and Alanda
taluk of Gulbarga district, 29 villages pf Bijapur have been
damaged with a maximum death toll of 6 over 60 persons were
injured, several of them critically injured are under-going
Many of the
treatment at Government Hospital- Sholapur.
■villages in Karnataka are awaiting relief services.
BIJAPUR DISTRICT:,
Severly affected district in Karnataka.
Dhoolked, Umarani, ;Padekenur etc are totally flattened, out
of the total death toll of 13 in Karnataka 6 were in Bijapur
(Umarani - 2, Chadachan - 1, Bakeloni - 1, Padekanur -2).
More than 1000 houses have been badly damaged and nearly
4000 houses are partially damaged.
Likewise in Bikeloni,
Chadachan, Jamkhandi, Taddevadi etc villagers were shelterless,
In Dhoolked village over 150 houses collapsed and several
persons were injured, two of them seriously.
While 40 houses
were damaged in Pandanur village of the taluk, 20 others were
flattened in Chadachan village, 4 houses collapsed in Janawada
and four more in Jagadele near Banahatti.
Several persons
were injured in the house collapses in Jagadale.
Though the death toll is negligible when compared to
Maharashtra, damage to property is beyond estimation.
have left villages and are living in open air.
scared to go back to their houses.
People
They are
Some are of the opinion
that they would build their own houses if somebody provides
10
them land free of cost.
Government is silent by just provid
ing 6 zinc sheets for re-settlement.
What is the future,
is
a big question hanging on their head.
GULBARGA DISTRICT: In many villages which are just 25 - 30 kms
from Killari that drew attention world wide, such as Khajure,
Gaddegoan and Alanga villagers are living on road side as
nothing is left.
Nobody is bothered though many days have
lapsed after the disaster.
The maximum1, damage to the
property was in Jewargi taluk where 88 houses were shattered.
The number of houses collapsed in other taluks of the district
were 15 - Aland, 5 - Gulbarga, 16 - Sedam, 3 - Sholapur and
5 - Chincholi, 250 houses were collapsed or were damaged in
total.
Bhorga village is totally wiped out,, though of late
rescue and resettlement has been taken up. As some of the
villages are totally neglected, earth quake has made them
mentally depressed and lose hopes
of life and security.
The story of Rudrawadi village of the same district is
different.
The continuous emission of smoke from earth has
made people panic.
Besides, Gulbarga district has experienced
tremors 10 times. Hence, people sleep in tents in open air.
People whose houses are partially damaged and cracked are
scared that those houses may collapse any moment.
This has
made people come out of the houses in the late evening is a
common scene.
trauma.
People feel it is continous, agonising .mental
3IDAR DISTRICT:
The reminiscence of earth quake damage can
be seen in the villages of Ujallam and Illyala of Bidar
District. A young man was killed when a portion of his house
in Morkhandi village in Basavakalyan taluk collapsed.
The
tremors experienced now
and then and the smoke eminating
from the Earth in .certain places has made people perturbed. The
exact extent cf damage is not known. At least 50 houses in
Basavakalyana and I-lumnabad taluks have collapsed and 550
buildings are partially damaged according to Government
estimation.
Besides the houses which are completely damaged
hundreds of houses are unsafe for dwelling.
In the major four districts of North Karnataka the cracked
houses in many villages have deprived people of their right
to live.
They are under the fear of death. Added to this,
economically weaker section of the people are living on the
sheets.
For eg:- Though the 150 houses of Gaddegoan village
in Gulbarga district which is just 25 kms from Killari is
flattened, but people are still hopefully awaiting relief,
-< 11 r
compensation and resettlement.
Even after 7-8 days after
the disaster no relief until Minister Gopinath Sandra visited.
It is unfortunate that Government has not realised that there
are many Killaris in Karnataka also. When thousands of
volunteers and voluntary organisations offered to extend
their services at Killari, Government turned down their offer
under the pretext that they would be informed later, had to
return disappointed.
But th.: appeal by people to the Govern
ment has not y'eilded any result in Karnataka.
SOLUTION
Nearly five to six thousand houses are damaged in
four districts of Karnataka.
The figures for the partially
damaged houses are not available.
The figures of Government
registration and personal registration do not tally.
The
exact number is yet to be arrived at.
»<ith regard to relief,
Karnataka is better.
In Maharashtra people are running from
pillar to post, but in Karnataka though the amount is less
e.
i.
Rs.20,000 to each families who have lost lives,
Rs. 10,000 to each families whose houses have completely
collapsed and Rs.500 for partially damaged houses.
Ministers
have visited the place and have expressed their grief, but
what is the future?
Though 6 zinc sheets are distributed to each families whose
houses were totally damaged the shelter is not enough and
are scared that the sheets may fly off when a strong wind
blows.
People are totally confused.
RELOCATION/RESETTLEMENT :
Though the Government has come
forward to provide alternate land to build houses- it has not
confirmed the exact place. Hence in Dhoolked and Umarani
villages the farmers are prepared to build their own houses
provided free land measuring the dimension of their sital
area is given.
This is the demand from the youth to the
Government.
Government has agreed to build houses for the
economically weaker sections but no one is aware when the
process
would be initiated by the Government.
Sri Maruthi
Patil of Dhoolked is of the opinion that there is lack of
leadership to initiate the process among the villagers. This
statement was also supported by Mr.Ashok Chinchili of Umrani
village.
BAD ROAD’S: The condition of the Road is very bad with pot
holes and also untarred which makes reaching the village very
difficult.
But with the visit of the Ministers to these
places, scene has improved a bit.
It is surprising to note
that neitner Government nor voluntary organisations have
provided food, medical services, besides moral support.
Government has not taken up any followup action after giving
compensation amount.
People have welcomed the Government's
proposal of providing alternative land, but Government is
delaying its implementation.
The immediate action to be
takenup by Government is to provide proportionately alternate
free land, economic help to build houses and total development
of the weaker section are the needs of the hour and hasten the
process, otherwise the sufferings of the victims will be
further aggrevated.
CONSECyENCES AND SOLUTIONS:
1. Many children besides being the victims of earth quake
disaster have lost parents, relatives, property etc and have
become orphans. A thorough survey has to be undertaken and
priority has to be given to their Health, Education and total
development is very much essential.
In such a situation
everybody should share this responsibility.
2. The mental shock has created many problems.
On one hand,
there are cases of acute depression. Most survivors staring
vacantly into space, powerless to speak, unable to cry,
emotionally maimed. On the other some survivors have come to
terms with.the harsh reality, forced with the insecurity
of tomorrow, with their houses destroyed, their belongings
buried and their loved ones no more.
To solve such problems
psychotherapy and counselling are necessary.
Hence psychia
trists are needed.
3. Nearly 10 to 15% of the patients in Umarga, Lathur and
Sholapur hospitals are mentally depressed and shocked.
it is important to treat such patients immediately.
Hence,
4. Families who have undergone family planning operations and
have lost all the children they had are desparate.
A survey
of such families has to be done and establish family counse
lling centres to overcome
mental trauma, help and
encourage them to adapt to the prevailing situation. Govern
ment and Voluntary Organisations have to come forward to
conduct recanalisation operations free of cost to help such
families have'children so that new lease of life is started.
5. As many old people have survived the disaster, old age
homes have to be established.
Voluntary Organisation can
play an important role in this regard.
6. Since, many of the above problems are related to mental
health, it demands for the establishment of Mental Health
R. 1» -
'
counselling centres in the earth quake affected areas to
counsoll them,
7, Above all it is very much essential to relocate and
rehabilitate the victims who have lost property, houses and
are helpless .to lead a fruitful life in future.
Government, Voluntary Organisations, Medical personnel, Social
workers, Service organisations and Volunteers have to strive
and work collectively to bring a ray of hope into the lives
of the victims.
FLOODS IN KARNATAK^
The people of Jijapur and other districts were regaining
slowly their material, physical and mental trauma that were
suffered due to earth quake disaster.
In the meanwhile the
rains, which were expected during July - August, got delayed
and people thought they would suffer from another natural
drought' without the seasonal rains.
calamity
But to their
surprise the rains lashed out very heavily between' October
8-10 resulting in heavy floods.
To the dismay and shock the
people instead of thanking the ''Varuna Deva
'
*
'’Rai-n God:1 they
had to curse the God as His boon turned out to be a bane to.
the society. The heavy floods have wiped out many a houses
from the ground not even giving a trace of its original
existence.
The property, cattle, grains and all the belongings
the people had accumulated with their meagre savings were
completely wiped out.
This has made people to suffer in
silence. Nearly 23 people were left dead in floods, compared
to 8 lives in the quake. The floods have disrupted the road,
rail and telecommunication and people were isolated.
Immediate
and urgent relief was most essential to the marooned' people.
The Helicopters and Airplanes•have to be pressed into service
to air drop the food packets to nearly 20,000 people sorrunded
by water.
These floods took away 11 lives in Bijapur 9 lives from
Raichur, 1 in Bellary and 2 in Mangalore districts respectively
in total 23 precious human lives were rendered dead due. to
floods.
When we look at the district wise marroned villages
which were surrounded by floods is 18 villages in Raichur
taluk, 12 in Mianvi taluk, 6 in Sindanur taluk and one Deodurg
taluk, totalling to 42 villages were converted as islands.
In Raichur district alone, it is estimated more than 5000
houses and countless number of huts were washed away.
Similarly
in Siruguppa Taluk in Bellary district 5500 houses collapsed,
800 huts were washed away, 50 irrigation pumpsets were submerged
14 ~
in water.
Similarly the damage-in Bijapur district is^no^less
compared to other districts.
due to rains.
Here 2000 houses have collapsed,
-..hen we look -t the total loss/damage of housing
property in these districts one can estimate that nearly 15,000
houses collapsed, 200 to 3000 huts submerged in:water, and added
to this lot of cattle and human lives were lost with their
property.
This shows that the damage due to floods were more
than the earth quake in Karnataka.
All the lakes and ponds in the flood affected areas are full and
are nearing danger mark, Devanpalli, Tuntapura, Mangalore,
hagalapura, Manslapur, Kereburbur, Deodurg, Nagoli, Khanapura,
Honnatagi, Govindapalli lakes have breached and resulted in
destroying the crops. The sunflower (commercial crop) cultivated
in more than thousands of acres of land in Raichur district is
completely damaged.
In Gulbarga district 300 houses have collapsed and thousands of
houses are partially damaged.
Since there was a maximum rainfull
of 115 m.m and minimum of 25 m.m the sunflower and paddy crops
in thousands of acres have been destroyed.
Continous 3 days rainfall in Bellary district has resulted in
steep raise in eater level of Tungabhadra•dam crossing the danger
mark and the villagers living near the dam were cautioned.
Total
estimation of loss due to floods is around Rs.50 crores of
personal property, Rs.20 crores of public property besides Rs.2l
crores of crops (cultivation of 59700 hectares) 2000 housed
ruined completely and 1.50 lakhs houses are partially damaged.
It is estimated that loss due to house collapse alone is estima
ted around Rs. 30 crore.
Last year i.e..1992 during the
Floods is not new to Karnataka.
same season many of villagers were .homeless due to floods in
Raichur district. Till date no permanent steps/ta^en to control
floods in these flood prone areas except for doling out little
money as an interim relief, Government has failed to take precau
tionary . measures to prevent such calamitiqs/disasters.
THINGS ..TO BE DONE ON WAR FOOTING:.
1, Immediate adequate compensation to the victims and
bereaved families.
2. Guidance, financial help and materials at subsidised
cost to those who want to build houses.
3. Technical know how to build strong & high roofed houses
to people.
4. Above all compensation to persons who have lost houses,
property, human and animal lives etc immediately.
5. N^alth services, Medical relief, Preventive programmes
to control ensuing epidemics etc.,
X-
7.-
This Report is originally
*
-X
-X-
-Jr
-X-
prepared in Kannada by Mr.Ramappa
C.Hadli, Programme Co-ordinator & translated to English by
Ms.T.Neerajakshi, Promotional Secretary - VHAK.
2
1 992-93 is Rs. 14,800/- and the amount sanctioned by the Trust
is Rs.1,39,435.00.
ORATION :
Dr.K.S.Shadaksharappa oration was delivered by Dr.M.J.Gandhi
during Internal Medicine course held at Bangalore Oct.1992.
DONATION :
During the year we were able to collect Rs.73,104.00.
We have purchased an Electrical Typewriter for Rs.9,500/-.
As you can see, our field of activities as increased and we
are receiving applications for grant for research project as well
as CME programmes from Dist. & Taluk, Head Quarteres.
To fulfil
these obligations we have to generate more in financial resources
I request the members to use their good offices to get more and
more donation for the Trust.
I thank the various office bearers of Sister Associations and
convenors of the various course for their help in conducting the
CME programmes.
I specially thank all the Trustees who helped
and encouraged me in many ways.
My special thanks are due to
Dr.K.S.Shadaksharappa, the Chairman and Dr.K.Krishnamurthy
Vice Chairman who are a source of inspiration to me.
(Dr .M.MAIYA)
Hon.Secretary
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eiramt eoieges
** BANGALORE —, The
Supreme Court has-been in
formed of the Manipal and
Ramaiah groups’ refusal to
admit students selected in the
Joint Entrance Test (JET), it
is leamt.
However, the Court has not
issued any direction in this
regard so far. The students
allotted to these colleges have
been admitted at the Directo
rate of Medical Education and
will be considered as having
got admitted to the respective
colleges. ®ENS
Mw®
s@aic§ h r
$®rotatasjll e©l®g®§
From Our Special Correspondent
against the Supreme Court judgment. There have
been no reports of the private colleges refusing
BANGALORE, Oct. 12.
The Chief Minister, Mr. M. Veerappa Moily, admissions and they had apparently accepted
has announced a quantum jump in the number of the Supreme Court judgment, he said.
Last date for admission: The Supreme Court,
free seats available in medical, engineering, den
tal and other courses in both government and Mr. Veerappa Moily said, had directed the State
to take immediate and effective
private professional colleges in the State and Government
steps to ensure admission of students against all.
said the State Government was making every ef
free seats and payment seats in all professional
fort to abide by the Supreme Court Judgment.
Speaking to presspersons here on Tuesday, colleges on or before October 31 and confirm
the
same to the court. ' Now that the legal posi
the Chief Minister said the number of seats under
the reserved and merit category had vastly in tion is absolutely clear, virtually all the colleges
creased during the current year following the have started admission of the first free seat list
drastic reduction in the number of seats under students. The last date of admission for such stu
the capitation-fee quota. The Supreme Court in dents is October 12."
He said the first modified list and second list,
its latest order dated October 7 has permitted
the private professional colleges' managements would be announced on October 18 and the last
date
for admission was fixed for October 20. The
to admit 15 per cent students under the NonResident Indian quota while the admission under second modified and third list would be an-;
the remaining 35 per cent of the payment seats nounced on October 26 and the last date for ad
quota and the 50 per cent merit seats quota re mission fixed for October 28. The third modified
list and fourth list would be announced on No
mains vested with the Government.
Mr. Veerappa Moily said the number of medi vember 1 and the last date for admission fixed.
for
November 4.
cal seats available under the payment and merit
Under the payment seats quota to be an-';
quota falling under the purview of the Govern
ment this year had increased to 1862 compared nounced by the Government, the first selection
to 859 seats last year. In the Scheduled Caste list would be announced on October 15 and the
category, the number of medical seats had in last date for admission fixed for October 21 The
creased to 280 from 129 and in the Scheduled second selection list would be announced on
Tribe category the seats had increased to 56 October 26 and the admissions as per the list
from 26. In the field of engineering education, the would have to be completed by October 29.
number of seats had increased to 10,823 from
Mr. Veerappa Moily said the Governor in his
6461 last year and the 15 per cent Scheduled address to both Houses of the Legislature at the
Caste seats had increased to 1.623 from 969 and beginning of the budget session had announced
the three per cent reserved seats for the Sched the intention of the State Government to imple
uled Tribe category had jumped to 324 from 194 ment the Supreme Court judgment dated Febru
ary 4, 1993, in the Unmkrishnan case. The State
seats
The Chief Minister said effective steps had Cabinet In March 1993 approved the admission
been taken to ensure that the private profes rules in compliance with the judgment.
sional colleges went ahead with the admissions
The State Government thereafter conducted
as per the list prepared by the Government. the Common Entrance Test and published the
Apart from sticking to the Supreme Court ver rank list on August 7 last. The free seat list was
dict the State Government had simultaneously published on September 19 last excluding only.
implemented the reservation of seats for students those seats in minority institutions that had been
hailing from a particular university jurisdiction in specially ordered to be excluded by the court. "It
the colleges falling close to their hometown and is expected that the admission process will now.
the special quota for rural students. Steps had continue smoothly and we shall be able to start
Deen taken to ensure that these reservations the academic session by early November." the,
nade out by the State Government did not work Chief Minister said.
n
B
/I
O
(< :
pairffiil « te@§ ■>”’■
a ©ir@ifesg(i®roaU s©ll'©y=
c
K
From Our Special Correspondent
NEW DELHI. Oct 11
A Cabinet subcommittee has been set up by
he Prime Minister to study the norms governing
admission and fees at private professional institu
tions.
Giving this information to members of the Par
liamentary consultative committee attached to
his Ministry, the Human Resource Development
Minister. Mr. Arjun Singh, pointed out that the
Supreme Court had laid down a scheme for
'egulating private professional colleges.
Mr. Arjun Singh told the MPs that the need for
Central guidelines was underlined by the recent
Supreme Court judgment. The Prime Minister
had directed that the guidelines be formulated
well before the next academic session.
Mr. Singh ruled out the possibility of
privatising education. The Government was.
however, encouraging institutions to raise their
own funds in view of the resource crunch faced
by the Government.
The focus of discussion at today’s meeting
was on the financing of higher education — the
State's role and self-financing. Denouncing the
capitation fee system, members held it respon
sible for the falling standards of education.
The meeting favoured merit-based admission.
with an education cess On those who could af
ford to pay. It was essential to have two types of
seats — free for the poor and deserving and
paid for those who could pay.
The MPs also wanted a bigger role for the
°
III
University Grants Commission in monitoring
higher education in view of the vast expansion of
the sector.
Stressing the need for reviewing the scheme
of autonomous colleges, they favoured an in
crease in the intake capacity of the higher edu
cation sector.
The HRD Minister announced that another
round of discussion would be held at the next
meeting of the consultative committee.
them in connection with the hearing of the State
SLP and other connected matter before the court
in this regard These three lAs pleaded in sup
port of the continued reservation of 69 per cent
in Tamil Nadu having regard to social and other
relevant facts and circumstances obtaining in the
State for the last few years
A Special Leave Petition (SLP) from 'Voice
(Consumer) Care Council' through its trustee. Mr.
K. N. Vijayan (advocate) against the High Court's
judgment and orders upholding the State Gov
m
ernment's reservation in excess of 50 per cent
for admission of students in professional col
leges for 1993-94 was also adjourned till October
25.
From Our Legal Correspondent
On this SLP from 'Voice (Consumer) Care
NEW DELHI. Oct. 11.
Council', the apex court on August 24, by its in
The Supreme Court today adjourned until Oc terim orders, restrained Tamil Nadu from making
tober 25 a Special Leave Petition (SLP) from reservations in excess of 50 per cent for students
Tamil Nadu against that portion of the judgment of Backward Classes and other specified cat
of the Madras High Court delivered on July 27 egories m respect of admissions into profes
directing the State Government to bring down sional colleges (medicine and engineering) for
the quantum of reservation to 50 per cent in ad the year 1993-94.
mission of students into professional educational
An important question among others, that has
institutions before the academic year 1994-95.
arisen in these cases relate to the implementation
The Bench consisting of the Chief Justice. Mr. or otherwise of the Apex Court ruling in the
M. N. Venkatachaliah, Mr. Justice S. C. Agrawal Mandal Commission case' (in which the Apex
and Dr. Justice A. S. Anand also will take up on Court had held that reservation should not ex
the same date for consideration, connected ceed 50 per cent) by the Tamil Nadu Govern
interlocutory applications (IAs) from Mr. M. Karu- ment in regard to admission of students into pro
nanidhi, DMK leader, Mr K. Ramamurthy. presi fessional colleges for the year 1993-94 and also
dent. TNCC(I) and Mr. Vadivelu, president, Jana the interpretation by the High Court of the Apex
ta Dal. Tamil Nadu seeking the court to implead Court ruling in the Mandal case in this regard.
Hearing < T.N.
SLIP adjourned
End to capitation impasse imminent
Aided cdfeges hegm admwsiom
EXPRESS NEWS SERVICE
BANGALORE
HE Supreme Court judgment on the
capitation fee issue on Thursday has
come both as a joy and a jolt to the
thousands of students aspiring to get into
professional colleges in the State. While on
the one hand, an end seems to be imminent to
the impasse, on the other, the fee structure
has been increased exorbitantly, making it
almost equal to capitation fee.
For medical courses, the State Government
had fixed a three-slab fee structure of
Rs 65,000. Rs 75,000 and Rs 85,000 annually
while the Supreme Court has increased it to
Rs 1.4 lakh for colleges partly using Govern
ment facilities. Rs 1 lakh for those with own
hospital and Rs 90,000 for colleges availing of
Government hospital facilities, per year.
While the State Government had fixed a
higher fee structure for colleges which did not
have hospital facilities of their own, the Court
has reversed this by granting a higher fee
structure to colleges which have their own
hospital. The Government thinking was that
the underdeveloped colleges required more
finance, while developed ones could raise
sufficient funds through the hospital.
For dental courses, the State Government
had fixed an annual fee of Rs 40.000 and
Rs 50,000 depending on the facilities offered.
The Court has fixed Rs 1 lakh for colleges
with hospital facilities and Rs 90,000 for
colleges availing of Government facilities.
There has been no change in engineering
and free seat categories.
ADMISSION LIKELY: Though private col
lege managements maintained a silence over
the verdict, the indication is that they might
admit students. Federation of Private Medical
and Engineering Colleges Shamnur Shivshankarappa and Taralabalu Jagadguru Shivamurthy Shivacharya Mahaswamiji said they
would comment only after they received an
official copy of the judgment. While the
private college management representatives
are holding a meeting on Friday at 3 p.m. the
mathadipathis of five major mutts in the State
will meet at 11 a.m. to discuss the future
course of action.
However, nine private aided engineering
colleges and one unaided college have begun
admitting students allotted to them by the
Government.
Some management representatives said on
the condition of anonymity that they were not
averse to admitting students as the Court had
permitted them to fill 15 per cent of the seats
from among NRIs and foreigners. If these
seats are not filled, local candidates can be
admitted. “In effect, it means that the Court
has conceded to our demand for a quota as
generally these seats are not fully utilised by
NRIs," a representative noted.
Even if this quota is filled by NRIs, the
colleges stand to gain as NRIs are required to
pay US $ 50.000 (roughly Rs 15 lakh) for the
entire course in medical colleges and US S
5,000 (Rs 1.5 lakh) in engineering. This is
higher than the capitation fee collected ear
lier.
PAYMENT SEATS: The list of students
selected under the payment seat category
would be announced with in a week, a senior
officer in the Directorate of Technical Educa
tion said. The list was ready and the Govern
ment was waiting for the Supreme Court
verdict, he added.
There was no immediate proposal to extend
the last date of admission for students selected
under the free seat category beyond Oct. 11.
To avoid heavy rush on the last day, colleges
would be directed to remain open on Satur
days too.
The State Government has been directed to
send the list of defiant colleges to Supreme
Court Judge S.R. Pandian for further action.
SC gives 15 pc qwta
C t® private coleges
pointed out that only two medical colleges in
Karnataka attracted the maximum number of fore
ign students and that too Malaysians. The rest did
NEW DELHI
not. Hence the 15 per cent quota granted by
HE Supreme Court on Thursday gave the
Thursday's order for foreigners will effectively be
managements of private professional colleges filled up by Indian students at the discretion of the
throughout the country the bounty of a 15 per managements. Thus the key principle enunciated by
cent quota for admitting students at their own the Supreme Court in its earlier judgment in the
discretion in the academic year 1993-94.
Unniknshnan case that merit and merit alone sh'.ll
This order in effect gives the managements the be the criteria gets a knocking - at least this year - by
right to fill up 15 per cent of their intake capacity today’s judgment.
with Indian students, who are not allotted to their
Former Attorney-General K. Parasaran had
colleges by State Governments on the basis of argued before the five judges that "some quota" be
entrance examinations, in case of non-availability of given to the private managments as even an honest
Non-Resident Indians or foreign students to fill up honey extractor likes to lick his fingers and thereby
the seats.
have some taste of the honey. Parasaran was
This “special provision made only for this year, arguing for a private college in Tamil Nadu. The
being a year of transition" - since the Union court in its order today has noted that the Kerala
Government is examining its own policy of a 50 per scheme which had. not been brought to their
cent quota for foreign students for the next attention earlier allowed managements to admit
academic year - marks a major inroad into the students of their own choice to the extent of 15 per
five-judge bench judgment in the Unnikrishnan cent.
anti-capitation fee case. In that case the apex court,
The judges held that the demand of the private
: to put a stop to all malpractices by private manage
ments, had refused to give any quota at all to the colleges that they shouid be permitted to admit 50
per
cent of the students of their own choice "cannot
managements.
Justices S.R. Pandian, S.C. Agarwal, S. Mohan, be and shall not be conceded.” They also made it
B.P. Jeevan Reddy and S.P. Bharucha passed the clear that whatever might have been the circumst-'
order while rejecting Solicitor-General Dipankar ances and reasons for which the Government of
Gupta's plea for a “status quo” this year permiting a India had permitted the private medical colleges to
50 per cent quota for foreign students in the private admit foreign students to the extent of 50 per cent,
colleges in terms of the Union Government’s policy “it is clear that the said permission or arrangement
which is being examined de novo for the next is not enforceable and cannot be enforced with
effect from the academic year 1993-94, in view of
academic year.
However, none during the arguments by the the judgment in Unnikrishnan case.” They con
Union Government or the private managements cluded: “Admittedly there is a crying need for these
had argued that the foreign student quota, if not seats within the country itself and it is they who
filed up, be made available as a discretionary quota must have the priority in the matter of admission to
to th? private managements. It had been clearly these colleges.”
ENS LEGAL BUREAU
T
—=Fee structure fixed
ENS LEGAL BUREAU
NEW DELHI - A five-judge
bench of the Supreme Court on
‘Thursday fixed provisionally the
fee to be paid by students for
admission to payment seats of
private professional colleges in
the country.
For medical colleges having
their own hospital the fee would.
be Rs 1.40 lakh per student per
annum. It would be Rs 1.20 lakh1
for colleges partly using their
own and partly a Government
hospital while Rs 1 lakh has to
be paid for colleges using entire
ly Government hospitals.
For dental colleges the fee
would be Rs 1 lakh per annum
for those having their own hos
pital and Rs 90,000 per annum
for colleges availing of the Gov
ernment hospital facility.
For nursing and engineering
colleges the fee fixed by each
State Government would oper-
ate. All thes fees would be
subject to final adjustment
against the sums determined by
the Union Government or the;
professional bodies (like thej
Medical Council and the Alt
India Council of Technical,
Education) before the beginning
of the next academic year.
> Aided colleges begin admis
sions - Page 3
► SC rejects plea to admits
Malaysians; State rapped for
trying to explain away inaction;
Admissions open to engg colleges
- Page 11
mined ad hoc for this year since
the admission of students has
already been delayed extensive
ly and the Union Government as
well as the professional bodies
will finish their exercises in this
regard only around the next
academic year. Though the sums
fixed for this year may seem to
be high, the judges pointed out
that the payment seats are only
half and it is these seats that
have to .bear the entire burden
of the expenditure incurred by
the colleges, as ‘free’ students
admitted on merit pay only a
nominal fee.
The judges held that the Kar
nataka Advocate-General’s plea
that the NRI fees be taken into
account while laying down thej
fee structure is a relevant facton
but not significant for the tenta
tive fees to be determined for
this year.
The fees have to be deter
Now that the fee structure has
been fixed and the manage
ments of private colleges have
been given even a 15 per cent
quota for this year, the judges
Save directed that all students
be admitted to the free and
payments seats on or before
October 31, 1993.
DECCAN
FRIDAY, OCTOBER 1, 1993 III
HERALD
USA / The one fear that consumes the middle class is that of getting ill or becoming unemployed
Bfew BeaHtfe
HE last socialist revolution may
yet come from the biggest capi
talist country of all, when health
care is made available to all in the Unit
ed States.
T
And yet the irony is that this revol
ution has been fuelled not so much by
concern for the poor and the uninsured
as by the fear of the middle class thatit would lose medical insurance, for
whatever reason.
The one fear that consumes the
middle class is that of getting ill or be
coming unemployed. Faced with hard
times dominated by layoffs and unem
ployment, developing a health “condi
tion" like heart disease or cancer, or
even getting a divorce, would be ruin
ous.
As many as 25 per cent of all Ameri
cans are either uninsured or under-in
sured. Millions more live in dread of
losing their insurance as they go
through a personal crisis.
Last week President Bill Clinton set
the ball rolling to reform the health
care system so that everybody can get
basic medical care. That the health care
system was in need of drastic surgery
has been evident for a long time. At
least three Presidents, Harry Truman,
Richard Nixon and Jimmy Carter, tried
to reform it but were prevented by
deeply entrenched interests and
lobbyists who cried out that any change
would endanger free market principles,
encroach on the right of choice of the
people, and would make way for more
governmental interference in their
lives.
Naturally, with market forces hijack
ing medical care, it went beyond the
The costs of medical treatment in the world’s
richest country are enormous: a fracture: $10,000;
a heart surgery $100,000; organ transplant $300,000
reach of the poor, and less of it was
available to the middle class progress
ively. Ironically, even as medical re
search and technology achieved break
throughs, finding ways of lessening the
pain, new treatments, making more ac
curate diagnosis, etc., ordinary care be
came prohibitively expensive.
US suffers the ignominy of being the
only industrialised country not to have
universal medical coverage.
Consider the costs of medical treat
ment, regarded the best in the world,
in the richest country: a fracture:
510,000; a heart bypass surgery 5100,000
and an organ transplant 5300,000. And
yet the system ensured the insured per
son did not have to pay even a fraction
of a treatment (it was done by the in
surance company); and so overcharg
ing, paperwork, unnecessary and ex
pensive tests and surgical procedures,
malpractice suits and “defensive"
medicine, greedy drug companies and
doctors hiked the costs of medical care.
The profits of drug companies were
about 572 billion in 1992, and a doctor's
average annual income 5139,000 annual
ly; specialists earned two-three times
more.
As much as 14 per cent of the GDP is
spent on medical care and is projected
to increase to 20 per cent in the next
decade. In real terras, America spent.
5752 billion in 1991 on health; in 1994,
it is estimated to spend about $1 tril
lion.
On the other hand, Europe spends an
average of 7 per cent and Canada 10
per cent, all of which have universal
care. Monthly/quarterly premiums for
a family have increased four to five-fold
in the past five years and more and
more people fell through the holes in
the system to live with uncertainty and
constant insecurity of a medical emerg
ency hitting them and ruining thenlives for ever.
According to a survey, over 25 per
cent of the insured people fear losing
it .
The increasing national bill for
health care also drained resources from
schools. It decreased wages as employ
ers were forced to pay more toward in
surance premiums, and of course in
creased the federal budget deficit.
Today, spending on Medicare and
Medicaid programmes of the Govern
ment for the poor and senior citizens
takes up 16 per cent of federal outlays
and is expected to increase to 25 per
cent. In 1965, this expenditure was a
mere 2.6 per cent of the budget.
Mr Clinton decided to take the bull
by the horns prompted by a public out
cry for a cure which was first heard in
1991 when a Han is Wolford was elected
Governor of Pennsylvania on the basis
• t
las Httfew @©al
of a one-point agenda of health care for
all, defeating Republican heavyweight
Richard Thornburgh who had the back
ing of the then President George Bush.
Mr Clinton adopted this agenda in
his presidential campaign and on be
coming President allotted the tough
task to his wife, Hillary, to show both
his commitment to reforming health
care and his confidence in his wife’s
ability to tackle the problem.
The White House was deluged with
letters from people who had horror
stories to tell about their encounter
with the medical system. As many as
700,000 letters came to the health task
force. Seven months later, the broad
principles of a programme have been
announced with universal coverage as
its cornerstone.
Several fears have been voiced: that
those insured would have to pay more
and get less so that others get coverage;
that they would be burdened with more
taxes; that bureaucracy and role of
Government would increase. Worse,
health care would be rationed. Needed
care would be denied to control costs.
"Choice", one of the cherished
American values, would be limited: cer
tain procedures and facilities would be
curtailed and patients may have not
have the access to a doctor of their
choice.
Mr Clinton and his team have
launched a campaign, a little less than
the magnitude of a presidential cam
paign, to sell the plan to the people, ac
quaint them with the details, remove
their apprehensions and clarify their
doubts. Or else, the lobbyists of drug
companies, insurance companies and
others who benefit from the status quo
Clinton makes big promises on being sworn In as President
might run away with the programme.
And yet, they might as well be trying
to convince the converted Several
opinion polls show that about 50 per
cent of Americans want a total over
haul of tire system; with another onethird seeking fundamental changes.
Less than 15 per cent want minor
changes in the system.
Mr Clinton has been hailed as a vi
sionary; Hillary has been reinstated in
public and media favour for her obvi
ous dedication to people’s welfare, es
pecially the underdog. Both hope to
carve out a niche in history but there
is a long way to go before their vision
takes a concrete shape.
of the programme and finally vote the
programme into law. Mr Clinton hopes
to put the basic plan in place by 1995
and phase in the entire package by
1997. But, as a cynic would say, there
is many a slip between the cup and the
lip-____________________________
R. Akhileshwari
The various committees of the Con
gress will debate and finalise the shane
in Washington
DH News Service
X
Indian Express
BANGALORE
MCSs ensure eotedion
P. K. Ranade
Electricity today is the most
accepted and common form of
energy and our government has
laid great emphasis on its genera
tion and distribution in all its
plans. It is well appreciated that
for the economic growth of our
country the enhanced generation
is a necessity.
Whereas on one side the efforts
will be made to improve the gen
eration on the other side still great
efforts have to be put into de
velopment and manufacture of
equipment which would help in
distribution of power to the users.
Hence the large scale application
of power has necessitated the
development of superior protec
tion equipment like Miniature
Circuit Breaker's which have over
the years proved to be ideal solu
tions to meet with this important
requirement.
With the extensive use of power
in domestic, commercial and rural
sectors the size of transformers
used for the distribution have also
increased. Whereas earlier one
could use Rewirable Kit Kats for
distribution of power, today be
cause of the proximity of the big
transformers these devices are un
able to provide safety because of
high fault currents.
Miniature Circuit Breaker's
which are suitable for above ap
plication are based on the current
limiting principle, these Circuit
Breaker’s clear the fault even in
nf vew high currents in 4 to S
A dream from Parryware
All the current-carrying compo
nents of the circuit breaker are
totally enclosed in insulated hous
ing, which prevents accidents dur
ing normal operation. Even the
user is safeguarded against dirct
touch.
Mounting of the circuit break
ers is now easily done on standard
din channels where the circuit
generated which give a total pro
tection against immediate high
rust currents and sustained over
load conditions.
Since the fault energy can be
curtailed to pre-determined levels
these MCBs are fully selective
against HRC Fuselinks which can
act as perfect back up protection
which means circuit can break
ceeding 7 times the rated current;
and these are also designed to
withstand the starting currents of
the motors.
The circuits allotted to groups
of filament lamps that are to be
switched on simultaneously, re
sulting in peak current at the time
of switching on can operate
magnetic tripping system of the
and switching capacity in coor
dination with the size of the trans
formers. The short circuit release
has to be between 3 to 6 times the
rated curent when switching
transformers and the making-cur
rent of the transformer at no-load
must be taken into consideration.
Here again, the short circuits
levels of the entire system have to
be clearly defined in order to
avoid damage to the breaker by
installing a suitable HRC fuse
links as back-up protection.
Some breakers are extensively
used for low voltage generators
used in Marine spplications and
also in captive generators in va
rious industries. The expected
fault current, which is of an
asymetric nature, normally seen
in practice, is above 6 times the
rated current of the generator;
and in majority of cases, even
above 7 times the rated current,
the generator is adequately pro-’
tected.
Cables are reliably protected
against overloads or short circuits
by a circuit breaker equipped with
magnetic and thermal systems
compared to fuses. MCBs have
the advantage of being ready to
close again even on single pole
overload and disconnect the lines
on all poles; thus the lines on all
the poles get protected against
single phasing. The bimetallic sys
tem is duly calibrated to allow the
rated thermal current and cut any
I
^dlan Express
MONDAY OCTOBER 18 1993
BANGALORE
IX
Vertin r&e zzzzzzz zz.lzzr«zzW City
By Ali Khwaja
ANGALORE, ironically for a
Garden City, enjoys an FSI
which ranges upto 1.5 to 1.75 for
residential buildings. This means
that in a plot of 1,000 square
metres, a total of 1,500 to 1,750
square metres of livable area can
be built, on all floors put
together. The permissible FSI
does not include parking spaces,
staircases and balconies.
B
Contrast this with the concrete
jungle of Bombay. In that megapolis, the permissible FSI ranges
from a low 0.75 to 1.0, and 1.33
only in exceptional areas. So is
the case in many other metropoli
tan cities.
Despite this anomaly, Banga
lore still appears to be greener
and less congested than most
other cities of comparable size.
Those who ceaselessly complain
of the monstrous constructions in
Bangalore, and the destruction of
the city’s skyline and salubrious
climate, have obviously not lived
in other cities of the country.
While it is an undeniable fact
that the Bangalore df yore offered
vast open and shady spaces, that
high tiled-roof bungalows did not
need ceiling fans, and.that green
ery greeted the eye in every local
Ii-
ity. Today, the position is far
removed from what our grand
fathers had reveled in. But then
life itself has changed in all re
spects. Population explosion due
to migratory influx has made ev
ery city stretch at its seams. Civic
amenities are everywhere strain
ing to cope with the parabolically
increasing demands..
Thankfully the migration into
Bangalore has been more of white
from Bangalore, and slums ate
few and far between. This has
resulted in a comparatively plan
ned and esthetic expansion.
It has also resulted in a fast
increasing rate of demand for
upper and middle class housing.
Those moving into Bangalore, or
moving out of their ancestral
homes need comfortable houses
in decent localities, but they cer
tainly cannot afford even a frac
.. .It is an undeniable fact that the Bangalore
ofyore offered vast open and shady spaces,
that high tiled-roof bungalows did not need
ceiling fans and greenery greeted the eye in
every locality. Today the position is far
removedfrom what our grandfathers had
revelled in. But then life itself has changed in
all aspects......
collar workers and executives,
rather than the mail workers and
pavement hawkers who have in
vaded Bombay and Calcutta in
the past few decades. Polluting
industries have been kept away
tion of the old colonial bungalow
with its trellised windows and
open verandas, laid out sedately
in half an acre of lawn.
The need for providing housing
could not be met by governmental
authorities. The BDA, which
started off well by providing
thousands of residential plots in
new extensions during the eight
ies, found itself buckling under
the lengthening queues on the one
side, and reducing land availabil
ity on the other. Predictably, it
has been deluged under red tape
and scandals. People applying tor
plots to BDA now do not stand a
chance of getting an allotment
within the next decade or two.
The Karnataka Housing Board
also made valiant attempts at de
veloping satellite towns around
the city. Though it did meet with
limited success, the satellite towns
have not been entirely successful,
as the housing layouts have not
been|upplemented with transport
services, civic amenities, hospitals
or schools.
The only source which has
made some successful efforts at
alleviating the dire shortage of
housing in the city, has been the
private sector construction indus
try. Dozens of local and migratory
builders have been providing
apartments at various locations to
suit Afferent budgets.
I Although the rules of Banga
lore City Corporation allow a
higher FSI as stated earlier, the
mulfi-storeyed buildings have
Construction in the city never ends. Every year new structures come up, spoiling the sky line, robbing the city of its beauty. Trees are cut down to
house these massive buildings.
______________________
_________
been coming up with aesthetically
designed and functional layouts.
There have been stray cases of
misdemeanours of fly-by-night
operators, but they constitute a
small percentage.
Most professional builders have
taken pains to maintain colonial,
Gothic,
or
traditional
architecture. Greenery has been
developed in open areas around
the buildings, often by profession
al landscapists, and many plans
have been altered to retain ex
isting trees. This is the reason why
Bangalore’s multi-storeyed build
ings, the only affordable housing
in the heart of the city, are far
better to look at, and to live in,
than those in other cities.
The vertical rise of habitation is
inevitable in all respects. More so
in India where the traffic conges
tion and strain on civic services
prevents people from living too
far from their workplaces and
schools. As long as the high-rise
structures adhere to governmental •
regulations, and maintain a beau
ty and elegance, they should be
encouraged rather than looked
down upon.
. V Indian Express
MONDAY OCTOBER 18 1993
B’lore turning concrete jungle
. The City with a concrete skyl>ne. This is the new name, Banga
lore has acquired with concrete
monstrosities dotting the once
'beautiful landscape. Old Victo™n mansions are giving way to
huge, faceless buildings.
Karnataka was always known as
•he bungalow country. Slow
paced gentle towns like Mysore,
Mangalore, Dharwad and Banga
lore were famous for their sprawl
ing bungalows with tiled roofs.
The old bungalow culture is one
of the casualties of progress. The
highrise culture that is taking over
was given a premature start by the
Government itself when it put up
in the Capital some of the ugliest
buildings.
Some of them are not only
aesthetically offensive monstrosi
ties but also pose a danger to
occupants because Bangalore
does not have adequate high alti
tude fire fighting equipment and
has frequent power failures which
make lifts potential death traps.
However, this trend has been
arrested after the collapse of Gangaram Building which killed ab
out 100 people. Now builders
have been forced to confine them
selves to five storey buildings.
But it must be admitted that
Bangalore’s high rise apartments
have at least some sort of aesthe
tic appeal compared to Bombay’s
match box structures. Even the
Bombay builders have been
forced to adopt higher standards
in Bangalore. They have realised
that this is the only way they can
compete with established South,
Indian builders..
With a host of players operating
in the City, there is little reason to
doubt that both quality and aes
thetics are key criteria for the
success of any project.
Given the rising premium on
land, the spread of apartment
building is but natural. But what
poses a major threat is the impun
ity with which laws are broken
with official connivance. Consum
er awareness is the best weapon to
fight this. If flat buyers become
more demanding in terms of qual
ity and adherence to law, the
standards of building industry
may be maintained at an accept
able level.
For many occupants of high rise
building it is the question of secur
ity, the absence of beggars and
pestering salesmen. There are
Highrise monstrosities choking the City
...The old bungalow culture is one of the casualties ofprogress. The
highrise culture that is taking over was given a premature start by the
government itself when it put up some of the ugliest buildings in the
City. Some of them are not only aesthetically offensive monstrosities but
also pose a danger to the occupants.......
also no dacoities in such buildings
as they are well guarded. Inst
ances of robbery are also rare.
But people who are used to living
in independent houses definitely
jniss the open space and breezy
atmosphere.
Ground space for parking is
another ticklish issue with most
apartments charging Rs 25,000 to
Rs 40,000. But considering the
explosive price of house sites,
dismal public transport system
and tortorous procedures in
volved in securing a BDA site, itseems high rise apartments are
here to stay. Builders also feel the
flat-culture is fast catching on in
Bangalore.
With new builders coming up,
the business is getting increasingly
competitive. Their advertisements
are published in several foreign
newspapers.
But residents have often disco
vered that not all real estate de
velopers are reliable. One agency
promised three way entertain
ment channel, 24 hours water
supply, elevator, generator and
hygienic waste disposal, but resi
dents found when they moved in
that none of these facilities was
available. It was only later after
persistent demands that they were
provided.
The way Bangalore has grown
during the last two decades re
veals divergence between the plan
and ground reality. The Outline
Development Plan prepared for a
population of 1.9 million in 1976
remained in force up to 1984
when the population exceeded
three million. This has led to
un-planned growth of the City.
Thus planning has to be more
broad based with a clear vision of
the future role of Bangalore in the
national, and international con
text.
SOME COMMENTS AND SUGGESTIONS
(on draft outline of State of India's Health Report
drawn up on 21 Aug 1987)
(Since we missed the actual meeting
it is likely that some of the ideas
explored below may have featured in the
discussions and hence may be repetitive.
Also we are not adequately aware of the
follow up action since August 1987. It is
again likely that some of these issues
have already been considered as the process
of evolving the report continues. However,
in order to internalise ourselves into the
process activity, we raise these issues as
a starting point.)
*
It is a good idea to explore the conce^4coffiporrm-.i of health =—4
care as the
starting point of the report. How ver, we would
have to ensure that the 'social process' dimension
of health is given adepate emphasis and the
technical, technological and managerial do not
overshadow it as is usually done in the West with
their pre-occupation with the Drug-Doctor-Hospital
model. The emerging Indian experience has much to
contribute in establishing the much needed social
process dimension and the report would be a good
base for this.
*
There is need to situate the State of Health in
the context of the socio-economic political conditions
prevailing in the country’ and the nature of the
ongoing development process. Hence some underlying
framework of analysis and philosophy of approach
2
2
should be arrived at so that the chapters,
sub-sections and box items can be more than Just
bits and pieces of information. In the State of
Environment Report the ’Statement of Concern
*
and the
two papers by Anil and Dunu did this effectively. We
need some such effort for this report not necessarily
in the same way.
*
An exploration of the known indicators of health like
IMR, Life expectancy, MMR and Unoer-5 mortality etc.,
should feature in one of the first chapters and a
critical view of the broad trends since independence.
In spite of their limitations and the
inadequate
data bases, these do give some idea of the Stare of
health of our population and offer a possibility
of corperison with ether countries.With some creative
communications, these statistics and comparisons
could bring out the stark realities and Inadequacies of
our situation—even some of the inequalities for that
matter.
*
Section II A.
While obesity is a growing problem
it is limited to a small number in
a particular strata and should not
get over emphasised.
* Section II
A3 & A4
Of particular interest to us. Send
further details of the evolving format.
* Section II A5.
SCs, landless labourers and urban slum
residents are equally vulnerable groups
and their nutritional status could be
explored in item iii) other disadvantaged
groups.
3
3
* Section II A6.
Lathyrism is an unusual and unique case
study but the problems of anemias Vitamin A
deficiency and endemic goitre are of far
greater epidemiological significance.
NIN has done pioneering work on Vitamin A
resulting in the v/orld’s largest 6 monthly
distribution programme and this needs definite
comment.
* Section II A7.
The relevance of nutrition
rehabilitation centres
are in question. Therefore, is it a worthwhile
case study? The focus on the other hand could
be a wide range of projects using locally
prepared nutritional supplements not
nec®ss~rjly in the NRC.^et up but more
*
A
community oriented.
* Section II A8.
Food toxins particularly mycotoxins are
a major problem and could be featured in a
box item.
* Section III
Could the changing agricultural environment
be introduced as a separate chapter or subsection?
The range of health problems attributed
to agricultural maldevelopment are more than
nutritional problems and pesticides; spread
of malaria, Japanese encephalitis, problems
related to larg'-' dams, marginalisation of
rural poor and consequent changes in their
health and nutrition, changing work patterns
o£- women agricultural workers and its effects
and so on. Would you want a draft outline with
further details?
4
4
While talking of environment and pollution
there is a tendency to concentrate on urban
and factory environment because of the
diversity of the problem but the changing
agricultural environment, in sheer magnitude
of the people at risk is a far greater problem.
* Section II A5.Mental Health could well feature as a separate
section rather than be clubbed with social
erviror.m-r.t. While adverse environment does
affect mental health, mental health is more
than just that.
* Section V A2. Medical Education is an important area no
doubt, anc we need to refer to the curriculum
changes, Kottayam experiment etc., but it
would be better to call this section something
broader to encompass nursing/pharroacy education
e.s well as the wide range of para medical
training including MPWs and CHWs.
There are lots of issues and inadequacies but
also lots of NGO alternative initiatives.
♦Section V A4.
This section needs to explore and document
the role of the large variety of issue raising
groups which include groups like mfc/SHR;
Co-ordinating agencies like VHAl/CHAl/CMAI and
the increasing range of smaller and sometimes
more localised health activist and action groups.
Here again NGO roles can be critically explored.
While focussing on NGO projects it is important
not to project role of NGOs as 'innovators of
model projects' but part of a wider NGO response
where project building is only one of a three
pronged response. The other two being 'innovative
training’ and 'issue raising’.
5
5
* Section V A5. The sub-sections of Primary Health Care
are questionable especially items iv)
and v) . These could feature in a separate
section on Secondary/Tertiary Health Care.
It is important to record end critically
com.ent on the secondary/ter-ciary health
care build up since Independence and the
pre-occupation with curative, institution
and high tech medical model approach to
health services in India and the increasing
privatization and corporate industry take
over of recent years.
Some additional projects/initiatives/issuus that could
feature as box items somewhere in the report:
(a)
LOCOST Baroda - Low cost rational therapeutics
(b)
ARCH, Mangrol - Under 5 care to rehabilitation of tribals
(c)
Traditional birth attendants - situation and training
evicted by Narmada Dam.
experience.
(d)
Deenabandhu - Herbal medicine dimension.
(e)
Lok Vidgyan Sanghatana, Maharashtra
(f)
(g)
Arogya Dakshat3 Mandal, Pune
Appropriate technology in health care.
Some resource persons
i. Nutrition/Agriculture: Dr SG Srikantiah, ex-HIN
Vandana Shiva - agricultural policy
Endemic
ii.
goitre
HI. Medical Research
: CS Pandav (AIIMS New Delhi)
: FRCH team Amar Jeseni etc/Padma Prakash
6
6
iv)
Drug Issues
: Anant Phadke, Mira Shiva, Dinesh Abrol etc.
v)
Traditional
systems
: Dhruv Mankad
vi)
Anernia/mal nutrition
in women
: Kamala Jayarao
There are many others but you probably have a much
larger updated list by now. We could add to it when we
get it or atleast suggest people for areas where
no resource persons have still been identified.
A good bibliography highlighting the large range of
meaningful publications, reports and project reviews
could be an a citional feature of the report so that
readers interested in further details could follow up.
We could support the sections on Health Status, Nutrition
and Agriculture, Health, & Agricultural Development,
Medical Education, Pesticides, Role of voluntary organizations,
nori-formal health education. Appropriate technologies in
health care and health research. You must heve already identified
resource persons for these sections. We could be in touch
with them .and or respond to initial drafts by them.
14
Indian Express
BANGALORE
FRIDAY OCTOBER 151993
GOVERNMENT OF KARNATAKA
DEPARTMENTS OF TECHNICALjDUCATION AND MEDICAL EDUCATION
.'COLLEGES IN KARNATAKA
tTHE ACADEMIC YEAR 1993-94.
PROVISIONAL ADMISSION TO
(ENGINEERING, MEDICAL, DEN
TION LIST
DTE/65/CET/93
-
Date :15th October 93
PAYMENTS!
SJC Engineering College
National Institute of Engineering
Dr. Ambedkar Inst, of Tech.
Mysore
Mysore
Bangalore
RV Engineering Collego
MSR Inst, of Technology
Dayanandasagar Engg. Collego
Bangalore Inst, of Tech.
Sir MV Inst, of Toch. Hunasamaranhally
KLE Engineering College
KLS Gcgto Inst, of Technology
Vijayanagar Engg. College
Rural Engineering Collego
BLDES Engineering College
SJC Institute of Technology
Adichunchangiri Inst, of Tech.
SJM Institute of Technology
Bapuji Inst, of Engg. & Toch.
RTE Engineoring Collogo
GV Trust Engineoring College
NMAM IT Engineering College
S.L N. Engineering College
STJ Engineering College
JNN Engineering College
KVG Engg. Collego
Kalpatharu Inst, of Tech.
Siddaganga Inst, of Toch.
Sri Sidhartha Inst, of Toch.
PES Institute of Technology
Malik Sandal Institute of Architecture
M.V.J. Colioga of Engineering
Ghousia College of Engineering
Islamiah Institute of Technology
S.D.M. Collego of Engineering & Technology
Guru Nanak Dev Engineering College
Khaja Banda Nawas College of Engineering
Manipal Institute of Technology
Bangalore
Bangalore
Bangalore
Bangalore
Bangalore
Belgaum
Belgaum
Bellary
Bhalki
Bijapur
Chickballapur
Chickamagalur
Chrtradurga
Davangere
Hulkoti
KGF
Nine
Raichur
Ranobennur
,Shimoga
Sullia
Tiptur
Tumkur
Tumkur
Bangalore
Bijapur
Bangalore
Ramnagar
Bangalore
Dharwad
Bidar
Gulbarga
Man pal
Bhatkal
be considered for allocation In subsequent lists.
CATEGORY / GROUP RESERVATIONS NOT AVAILABLE UNDER PAYMENT SEATS.!
CHANGE OF COLLEGE I COURSE - a) Candidates should get themselves admitted by paying the prescribed fees and if satisfied with
the allotment of college / course, should write as "SATISFIED" followed by his signature in the computer register at the Directorate of
Technical/Medical Education.
b) Candidates admitted, but desiring change of college / course should write as "DESIRE CHANGE" and sign in the computer register.
Their cases for changes will be considered as per merit in the subsequent list. No separate application for change of college I course will
be accepted.
c) Candidates who are "SATISFIED" with the allotment as well as candidates who "DESIRE CHANGE" should pay full fees as given below.
d) The candidates are advised to preserve the fee receipt issued at the Directorate at the time of admission as it will be insisted upon at
the time of joining another college, if change is given.
Cods
CHANGE FROM "PAYMENT SEAT” CATEGORY TO "FREE SEAT' CATEGORY AND VICE VERSA;
a) Candidate who joins under "Payment Seat" category and in subsequent lists gets a seat under "Free Seat" category, may cancel his
A
B
Architecture
"Payment Seat" and obtain the original documents from the Directorate by cancelling his seat under "Payment Seat" category and get
admitted under "Free Seat" category.
b) Similarly a candidate who has joined a college under "Free Seat" category and if he is allotted a seat under "Payment Seat" category in
this list or subequent lists, may cancel his seat under "Free Seat" category and obtain the original documents from the college and get
admitted under "Payment Seat" category.
c) Candidate cancelling seats either in "Payment Seat" or ."Free Seat" category is eligible to claim refund of fee for the cancelled seat.
C
Ceramic and Cement Tech
D
Chemical
P
Q
E
Civil
Computer Science
R
S
Electrical
T
Electronics
Industrial Production
Instrumentation T echnolgy
w
COLLEGES
(Rupees per Annum)
ENGINEERING
MEDICAL
Category
■
■
25,000
Candidates joining private Medical and Dental
Colleges have to pay Rs. 1000 and Private Pharmacy
and Nursing Colleges Rs. 500 as University Fees t°
the concerned Universities.
NRI / FOREIGN
STUDENTS
(For full course)
OTHER
FEES
TUTION & DEV. FEES
1590
$ 20,000
1350
H $ 50,000
-J
2
Candidates joining Medical, Dental, Pharmacy and
Nursing colleges have to deposit Rs. 1000 as Caution
Money, which is refundable.
■A'
■B1
■c
1,40,000
1,20,000
1,00,000
■A'
■B'
1,00,000
90,000
1350
$ 30,000
4. . Candidates should pay one year fees by Bank Draft
PHARMACY
20,000
1350
$ 10,000
NURSING
15,000
1350
$5,000
(Nationalised Bank) payable at Bangalore in favour of
Director of Technical Education / Director of Medical
Education.
■>$
DENTAL
Category
j
3.
NO NEED TO FURNISH BANK GUARANTEE
FOLLOWING ARE CUT-OFF RANKS UPTO WHICH SEATS HAVE BEEN ALLOTTED
CATEGORY
KARNATAKA
OTHER STATES
(Including Karnataka)
ENGINEERING
MEDICAL
DENTAL
PHARMACY
NURSING
7939
1958
2263
4192
1840
5148
1121
1290
2399
1120
LIST OF PRIVATE PROFESSIONAL COLLEGES IN KARNATAKA WITH THEIR COMPUTER CODES
CODE
NAME OF COLLEGE
PLACE
CODE
NAME OF COLLEGE
24
Mair,ad Engineering College
S VS Engineering College d Engg. A Tech.
PES Engineering College
PRIVATE AIDED ENGINEERING COLLEGES
BMS Engineering College
Basaveswara Engg.'Coliege
PDA Engineering College
Bangalore
Bagalkot
Gulbarga
F
G
H
PLACE
PRIVATE AIDED ENGINEERING COLLEGES
25
26
Hassan
HubS
Mandya
K
L
M
SUBJECT
Cods
Au (mobile
N
O
V
Mechanical
X
Y
B. PHARMACY DEGREE COLLEGES
Medical Electronics
z
Silk Technology
Metallurgy
Civil Environmental Engg.
Refuh-ul-Muslamoen Education Trust,
Farooquia Institute ol Pharmacy
College of Pharmacy
NCSM College of Pharmacy
V.L. Coltego of Pharmacy
S.C.S. College of Pharmacy
T.V.M. College of Pharmacy
H.K.E. Society's College of Pharmacy
Luqman College of Pharmacy
K.P. College of Pharmacy
M.M.H. Goal Institute of Pharmacy
Bangalore
Bangalore
Bangalore
Bangalore
Ramnagaram
Kengal
Bangalore
Bangalore
Tumkur
Bangalore
Bangalore
Bangalore
Bangalore
Bangalore
Bangalore
Bangalore
Devanahalli
!
Dr. Ramabai Ambedkar Dental College
PM Nadagowda Mem. Dental College
SJM Dental College
SDM Dental College
HKE Dental College
Somanath Dental College
KMC Dental Wing
KMC Dental Wing
AB Shetty Mem. Dental College
KVG Dental College
Bapuji Dental College
College of Dental Sciences
JSS Dental College
KLE Dental College
Hasanamba Dental Coltego
MGVP Dental Colloge
Gokul Edn. Trust Dental College (M.S.Ramaiah)
SGR Edn. Trust Dental College
P.C. Dental Collego
Sarribaram Charitable Trust Dental College
Vignam Inst, of Dental Sciences
Vokkaligara Sangha Dental College
Academy of Liberal Edn. Dental College
AF Ameen Dental College
Yenopoya Dental College
Rural Gubarga Dental Cot logo
HKS Trust Dental College
SKDE Trust Dental College (H"nasemaranahalli)
Babu Jagajeavan Ram Dental Coltego
R.V. Dental Coltego
Oxford Dental Coltego
Sri Sidhartha Dental College
Sharavathi Dental College
KLE Dental College
Rajareshwari Dental College
Amruth Edn. Cut Society
Rifah-uFMusL Edn. Dental Cd.
Maratha Mandate Dental College
Sovalal Dental Collogo
NSVK Dental Coltego
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
Bangalore
Bagalkot
Chrtradurga
Dharwad
Gulbarga
Bidar
Mangalore
Man pal
Mangalore
Sullia
Davangere
Davangere
Mysore
Belgaum
Hassan
Bangalore
Bangalore
Bangalore
Bangalore
KGF
Bangalore1
Bangalore
Raichur
Bijapur
Mangalore
Gulbarga
Gulbarga :
feongolore
?anga!ore
Ba-^alore
Bangalore
Tumkur
Shimoga
Bangalore
Bangalore
Bangalore
Mysore
Belgaum
Bangalore
Bangalore'
NURSING COLLEGES
College of Nursing, Father Muller's Hospital
College of Nursing, M.V. Shetty Memorial Hospital
College of Nursing, K.L.E. Society Hospital
College of Nursing. Bapuji Hospital
Co8®ga of Nursing, K.M.C. Hospital
M.S. Ramaiah College of Nursing
College of Nursing,
Hyderabad Karnataka Education Society
College of Nursing, Nittoe Education Trust
P.C. Dental and Nursing College Trust
Oxford Nursing College. J. P. Nag ar
K.G.F.
Chkkaballopur
Mysore
Chennarayapaina
Mysore
Manipal
Dheralakatte, M'Io re-3
Raichur
Harappanahalli
Bellary
Gulbarga
Gulbarga
Bidar
Bidar
Bangalore
Banga'ora
Be'gaum
BeRur
Bijapur
Davangere
Gulbarga
Kolar
Mangalore
Mysore
Turrkuf
Manipal
Bangalore
Bijapur
DENTAL COLLEGES
Mining
Telecomm Engg.
B. PHARMACY DEGREE COLLEGES
Visveswarapuram Institute of
Pharmaceutical Sciences
Al-Ameen College of Pharmacy
V.E.T. St. John's College of Pharmacy
P.E.S. College of Pharmacy^
M.M.U. Colloge of Pharmacy
Dr. H.L. Thimrrogowda Collego of Pharmacy
Dayanandasagar College of Pharmacy
C.N.K. Reddy Institute of Pharmacy
Sri Siddaganga College of Pharmacy
G.K.M. College of Pharmacy
Krupamdhi College of Pharmacy
K.L.E' Society’s Colloge of Pharmacy
Milind Institute of Pharmacy
Pawan Coilego of Pharmacy
Vivekananda Institute of Pharmacy
The Oxford College of Pharmacy
Rural Collogo d Pharmacy
Noorie College of Pharmacy
K.V. College of Pharmacy
JSS College of Pharmacy
SAC College of Pharmacy
Davangcra
KM Doddi. Maddur
BangaZre
PRIVATE MEDICAL COLLEGES
SUBJECT
Manufacturing Engg.
Printing Technology
Gulbarga
Humanabad
Rakhut
Belgaum
Hub!
Belgaum
HubS
Bagalkot
Bijapur
Oharwad
Shimoga
Chrtradurga
Dr. Ambedkar Medical College
Kempegowda InsL of Medical Sciences
JN Medical College
Adichunchangiri Inst, of Medical Sciences
Al Ameen Medical College
JJM Medical College
MR Medical College
Devaraj Uro Medical College
Kasturba Medical College
J.S.S. Medical College
Sidhartha Medical College
Kasturba Medical College
M.S. Ramaiah Medical College
BLDEA Medical College
Textiles
Bio-Medical Engg.
Transportation
Information Technology
Polymer Technology
PLACE
NAME OF COLLEGE
H.S.M.A.K. Charitable Trust.
Mohamadi College of Pharmacy
Sri Veerabhadreshwar Education Society
N.E.T. College of Pharmacy
K.L.E. Society’s School of Pharmacy
K.L.E. Society’s School of Pharmacy
Marata MandaJ’s College of Pharmacy
Al. Fatah College of Pharmacy
Basaveshwara School of Pharmacy
BLDE Association School of Pharmacy
Sbnia Education Trust
NES Institute of Pharmacy
SJMM College of Pharmacy
Bapuji Education Society’s
BEA School of Pharmacy
Bharathi Education College of Pharmacy
M. S. Ramaiah College d Pharmacy
COURSE CODE FOR ENGINEERING
J
FEES FOR PAYMENT SEATS - PRIVATE COLLEGES
CODE
PRIVATE AIDED ENGINEERING COLLEGES
|
Following is the list of provisionally selected candidates for admission to the FirstyearofB,E./B.Tech./B.Arch./MBBS/BDS/B.Pharma/Bachelor
of Nursing Degree courses based on ranks obtained and the choices given by the candidates. The candidates selected for Engineering, Medical,
Dental, Pharmacy and Nursing should report to the Director of Technical Education, Palace Road, Bangalore 560 001, for Engineering courses and
to the Director of Medical Education, Ananda Rao Circle. Banqalore 560 009 for Medical, Dental, Pharmacy and Nursing courses on or before
21.10.1993. The admissions will start from18.10.1993 (Monday).The candidates will be given admission letter for proceeding to the allotted college
for joining the college.
The candidates selected should produce the original certificates along with two xerox copies of the following documents:
(Common to all courses);
a) PUC-2 or equivalent.qualifying examination marks card.
b) Study certificates for having studied for at least 5 years in Karnataka between 1st Standard and PUC-2 or equivalent or certificates claiming
exemptions under any of the sub-paras 6(a) to (h) of General Instructions in the application form (If you are claiming under seats reserved for
Karnataka)
c) Physical fitness certificate by a Registered MBBS doctor in the prescribed form.
d) Three copies of latest passport size photographs of the candidates of size 35 mm x 45 mm.
e) Date of birth certificate or SSL C. Mark card or any document as proof of Date of birth.
Candidates selected for more than one course like Engineering, Medical. Dental, Pharmacy & Nursing have to decide and get themselves admitted
to any one course. Candidates admitted to a course will automatically lose their seat in other courses. If a candidate gets admitted to a course
and later (in subsequent list) gets a seat in other course, he can forfeit his earlier seat and get admitted to the course allotted in subsequent list.
For example: If a candidate gets an Engineering seat in the first list and gets admitted and subsequently he gets a medical seat, he can forfeit his
engineering seat and join Medical seat or any other course. Candidates will be admitted only on submission of original documents. If a
candidate wants to surrender a seat to join another professional course he must request the Principal in writing to cancel his admission and obtain
original documents and can claim refund of fees. Candidates who have been allotted seats, but have not reported to the Directorate will not
21
22
23
PLACE
NAME OF COLLEGE
CODE
U
(Dr. M. V. Ramanna)
'
Director
of...
Medical Education
Mangalore
Mangadore.
Bo’gaum
Davangero
Manpal
Bangalore?
Gulbarga
Mangalore
Bangalore
Bangalore
(Prof.P. V.Bhandaty)
nirfw
’Tnr of
nt Iechnical
Technical Education
Director
DIS”'RICTWI3E OBSERVATION ON "HE MMR 07 LCDS
S1.ro. vane of tee
Bis trict
1. sans-alore (y)
2. ganralore (r)
3. ghi tradur.o-a
?HC
KO
NO
report!nr positi on. Trained
_%___
_____
68.42
96.72
69.49
82.35
95.65
70.45
82.05
82.17
82.17
aS ON '.'ARCH 93
Severe malnutrition
2.38
visits
by ho
_____ _
29.57
91.07
96.96
1.35
1.81
19.77
19.52
1.09
0.57
L-!VS
posi ti on
- ~ $ - 96.15
AN’S
posi tion
________ _
9 8.46
sit/phc
95.24
85.96
0-30
4. polar
5. Shimon-a
6. ^umkur
90.74
90.32
66.07
84.51
91.71
1.36
1 5.65
0.66
94.44
100.00
79.21
83.21
75.00
89.47
88.
88.06
91.57
93.33
1.44
1.74
30.26
84.59
0.^4
0^2
1. Bangalore DVN
88.73
85.94
76.95
88.71
93.83
1.61
21 ,_56
7, gelraum
8. yijapur
81 .08
88.24
88.57
84.62
73.33
66.13
88.6 4
77.78
87.06
1.33
1.41
0.14
91.23
92.31
87.21
96.97
1.55
1.26
19.24
23.19
23.26
28.39
92.77
1.41
22.78
1 J1
0.56
9. pharwar
85.71
86.49
90.77
97.41
________ _________
0.97
0.52
2. gelpauni dvr
71.43
82.48
86.82
54.55
82.50
66.52
11. gellary
12. pidar
95.24
72.41
87.50
90.00
71.43
75.56
93.33
59.26
79.01
90.75
1.60
1.23
20.83
19.81
2. X)
0.42
1 3. culbarira
14. paichur
74.55
51.72
82.67
86.21
41.94
71.43
62.50
78.69
1.51
1.52
3. cuIbarra DVN
15. Chi clcaar-alere
72.39
1 8. pod avu
94.44
19. Haniya
85.71
91.38
52.17
83.02
83.33
82.20
88.42
90.43
81.25
79 .05
1.33
1.44
80.00
81.43
76.47
75.00
86.19
74.32
78.49
76.09
82.14
14.24
11.15
16.08
-20- Mysore_________
_4. Mysore DVN
70.77
94.07
54.95
93.65
77.73
83.15
59.22
93.44
10. U. p0- nnad a
16.
17.
D.j^-nnada
^assail
86.96
64.00
61.33
54.55
53.42
60.00
72.95
91.18
96.20
86.21
94.44
90.05
86.32
~ ~87~.0~1
1.25
1.22
1 .1 5
1 .58
16.02
17.29
21.66
1.37
1.32
~ "l.-29~ "
21 .73
16.22
15.74
" 17 .~82
1 .£8
1.4-0
0.77
0.63
1.36
0.43
0.32
0.35
'O ."56" "
Surveys/stuc'ios conducted by IppS consultants.
1. infant and early childhood mortality I988-I99I at
channarayapatna, [josadur^a, sullia, phadravathi and
1
ponnampet projects.
2.
(i)^nnual survey at Hunsur project-1990-91
(ii)Status of adolscent rjirls at Hunsur project-1990-91.
3.
Study on impact of IqDS on phycholorical development of
children at Malavalli project-1991-92.
4.
annual survey at nanjan/iud project 1992-93.
■ 5. Amual survey at sira^uppa project 92-93.
6.
Ann,iat survey at pellary urban project 93-94.
7.
Baseline survey pilot project(Rural)T.ijarasipura I976.
8.
First repeat survey - 198QO
9.
Annual survey at Kollez?al(Rural) project~l985.
10.
Annual survey at Mys©re(U) project - 1986.
11.
Annual survey at M»lur (Rural) project-1983-94.
12.
study of jnfant and Early childhood mortality in 3 Rural
I CDS projects-^, jyarasipura, ROllegal, yarakapura-89-to 91.
13.
coverage Evaluation survey of immunisation Nelamanjala-1980.
14.
Armi.ia.! survey at Ban"alore(u) project-1991 .
15.
vit • *'A
16.
Annual survey at pevanahalli(Rural)project-1993.
17.
impact of ICDS on fertility regulations- study.
18.
I CDS - an attqjnpt at primary Health care through Multisectoral
prophylaxis survey at Bangalore(u) project-1992.
ap proncli.
19.
A study of A-W.W - rer-ardin-i their role in icDS.
20.
a study
of diarrhoeal disorder.'’ irnon,.’ 374 children in 7
Lilian.nwrvll nrciu'i.
21 . Acceptunce of oral Rohiidrn.tlon -therapy - a follow up study.
...2
STATE LEVEL CONVENTION OF ICDS
19th JUNE 1993
AGENDA
10.00
A.M.
REGISTRATION
10 . 30
A.M'.
Inaugural Session
Adviser ICDS.J
Welcome
Status of ICDS in Karnataka
Introductory Remarks Z14.
D
sQfif.i,-c, Data Analysis, ICDS.-J"
Pl
1 f
Co-ordinator,
ICDS.
Inaugural Address
Secretary to /Health & F.W.
Services, Govt.of Karnataka.
Address by Director of
Women & Child Development.
Director of .Women & Child
Development.
Q/V,/yl'Vvft.v
Address by Chairman
Central Technical Committee
Dr.B.N.Tandon.
Chairman, C.T.C. Delhi.
Presidential Address
Secretary to Social
Department,
{.’Cijvt.of -Kanrataka.
Welfare
Vote of Thanks
Senior
consultant
iK-arnataka.
(ICDS)
11.15
A.M.
1 1 .30
A.M.
ICDS and its impact
Dr.B.N.Tandon,
CTC., New Delhi.
12.30
P.M.
Inter Sectoral Co-ordination
in effective Implementation
of ICDS.
.Dr. Krishna Raju
Joint Director, ICDS.
1 .00
P.M.
Energy Food & Supplementary
Nutrition Programme.
Mr. Balasubramanvam,
Managing Director, Agrocorn
products, -Bangalore.
1.30
P.M.
2.15
P.M.
Promotion of Children's
Mental Health through ICDS
Need & Scope.
Dr.Channabasavanna, Director
NIMHANS, Bangalore.
2.45
P.M.
Implementation of ICDS
Achievements/Suggestions
Chief District Advisor
Asst. Director (W&C. D )
consultant, ICDS.
3.15
P.M.
Group Discussions.
Topics:-
TEA
Chairman,
LUNCH
i.
•
Providing Nutrition Services.
to - 0.3Years effectively
ii. Strengthening the referral
services.
iii. Training Monitoring and feed
back system.
4.30
P.M.
Concluding Session
Presentation of Reports
a) Concluding Remarks from
state Co-ordinator.
Vote of Thanks.
b) Director of Women & Child
Development.
47/1 St Mark's Road
COMMUNITY HEALTH CELL
Bangalore 560001
22 March 1988
THE STATE OF INDIA'S HEALTH REPORT
(an initiative facilitated by VHAI, New Delhi)
Sectiont
Team
A—A Statistical overview of the quantitative response in
the 50's; 60'sj 70's & 80'so (Pictorial presentation)
Trends and inadequacies
Manpower trends—comparisons
B—Medical Education
i.
150 years of Rhetoric/relevance
ii.
The PSM Departments--enablers or blocksJ
Community
iii.
oriented medical colleges—tinkering with reform
Report—a serious indictment
iv.
The *
'Shrivastava
v.
The Kottayam and Jamnagar experiments - lost initiatives
vi.
The 'ROME' programme - white elep hants let loose
Capitation
vii.
viii.
fee medical college - business in medical seats.
An alternative curriculum - a non-starter
(responses of MCI, IAAME, mfc)
C—Nursing Education
i.
Overview of 5 decades—inadequate investment and
confusing classifications.
11.
A 'status' problem and a gender bias
iii.
Community 'nursing' alternatives
D—Paramedical training
i.
The unipur'ose responses of the 50's & 60's.
11.
The multipurpose metamorphosis - Kartar Singh Committee & beyond.
2
2
iii. The Gandhigram explorations
iv.
Evolving the three tier system — workers, supervisors and
assistants.
E— pre Community Health Worker
i.
The NGO pioneers
ii.
The CHW scheme and evaluation——euphoria and disillusionment
iii.
The CHW - lanky
iv.
The anganwadi worker - ICDS alternative
v.
Alternative ped gogy - helping health workers learn s the
or liberator—thsNGO innovation continues
Indian experience.
£~Education in Publ^c Health
i.
OPH to MD - loss of the old guards
ii.
The story of three institutionsj AIIPHH/aiims/NIHFW
iii. The community health alternative - masters/diplomas/leaders
JNU/RUHSA/Deenabandhu
iv.
Courses and more courses - the mushrooming NGO sector
G—Training of_Dais
i.
Recognising the traditional ’obstetrician’
ii.
Training - from condescension to dialogue
Ucc!:S?ucation_in_Mental Health
i.
Reaching the unreached
Educational innovation to promote mental health skills in the
3-tier health system.
I“Trainin2_in_ the_^Traditional • sector
i.
The non-allopathic training base — recognising the step brother
ii. Where are we heading in Ayurveda, Homeopathy, Unani, Siddha,
Yoga and Naturopathy?
3
3
iii.
Separate streams or integration—a knotty problem in training.
J—Continuing Education of the Health Team
i.
A non-starter programme
ii. Leaving the field for pharmaceuticals and multinationals.
K—Educating the Health Team - A final comment
a.
Trends towards Health for All by 2000 ABi challenges/alternatives
b.
Building on failures/inadequacies and micro level experiences
c,
A plea for an alternative pedagogy & plan for manpower education.
Resource persons for section apart from Community Health Cell Team,
Bangalore
1.
Dhruv Mankad and contributors to mfc medical education anthology
2.
FRCH Bombay (Ravi Duggal)
3.
Prof Banerji, JNU, CSMCH
4.
Rani & Abhay Bang, Search, Gadchirol
5.
Ulhas Jaju, MGIMS Sevagram
6.
ARCH Team, Mangrol
7.
Mohan Isaac & Joseph Panackel, NIMHANS
8,
Abraham Joseph, CMC Vellore
9.
Daleep Mukerji, CMAI (ex-RUHSA)
10.
Prem and Harl John, ACHAN cc AnITRA
11.
Mira Shiva, Manjunath and VHAI Community Health team
12.
CS Pandav, AlIMS
13.
Dr CM Francis, Editor, Health Action
14.
Prof George JosephCSI Healing Ministry, Madras
15.
PK Karthiyaini (ex Rural Health Cell, GOI)
16.
Community Health Team, CHAI, Hyderabad
All these persons will be informed about the outline of the section
and requested to send their own papers on the subject or any other
papers/reports/comments that they feel are relevant to the different
sub-units of the section. Some of them will be requested to contribute
some of the box items.
Four resource centres will be particularly tapped for background
information—VHAI Documentation Centre, FRCH, JNU-CSMCH and mfc/CHC.
1'he section will be put together by Ravi Narayan and the rest of
the Community Health Cell team in Bangalore.
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I
STATE OF HEALTH
-
KARNATAKA
VOLUNTARY AGENCIES_IN HEALTH_CARE:
Voluntarism in Health Care has been an old tradition in Karnataka, with
many institutions over a century old.
These institutions have become
major hospitals, especially in the Missionary sector.
Movements in
social and economic development have also been quite active, with health
as one of the areas of focus.
Some efforts have developed into other
areas from their entry point in health, understanding the links between
Health and Development.
Voluntary efforts have arisen at each place in response to local needs.
Hence, they have focussed on a range of issues like tribal health,
physical handicap, training, school health, and so on.
Their size,
reach and approach to the problems they address, are as varied too.
This is the essential strength of these voluntary agencies, who have
been experimenting with innovative approaches, something the
Government cannot do.
The voluntary agencies in the areas of Health and Development have
joined hands in their work in federations like VHAK (Voluntary Health
Association - Karnataka), CHAK (Catholic Hospital Association - Karnataka),
CMAI (Christian Medical Association of India) and FEVORD-K (Federation
of Voluntary Organisations for Rural Development in Karnataka).
These
federations interact with the Government on their behalf as well as
help coordinate activities in the voluntary agency sector.
Other
agencies like the CHC (Community Health Cell) help in networking
efforts in various areas of voluntary action.
Apart from these, Karnataka has a number of National Institutes,
which play a national role, but are involved in local service and
research.
What follows is a sampling of the varied areas of voluntary agency
involvement, to given an idea of the needs of people and the varied
ways they are being tackled.
NATIONAL INSTITUTE OF MENTAL HEALTH AMD NEUROSCIEIMCES
The erstwhile 'Lunatic Asylum' later renamed as the 'Bangalore
Mental
Hospital'
was unique in its services even
before
Independence. Consequent to Shore Committee Recommendations, the
All
India Institute of Mental Health (AIIMH) was established in
1954,
and
based in the Mental Hospital
premises.
For
administrative purposes the AIIMH and the Mental Hospital were
amalgamated and thus in 1974, and the National
Institute of
Mental Health and Neurosciences (NIMHANS) was registered as a
society.
NIMHANS
is
a
simultaneously in:
multi-disciplinary
working
organisation
i caring for those with mental disorders;
$ training psychological,
nursing staff; and
neurological,
neurosurgical
and
t researching in several cognate fields.
Separate well-established departments in Clinical, F'arac1inical,
Diagnostic and Therapeutic areas undertake these functions.
Research is done in Ayurveda too, a separate Epidemiology
department is a unique feature, while the Library and Information
centre is the referral centre for Mental Health and Neurosciences
in India.
The team approach is towards promotive, preventive and
curative aspects of health.
The Institute has been the core
centre for developing a National Mental Health Programme and
propagate and monitor its implementation in the country.
SPECIAL FEATURES
# The CLINICAL SECTION of NIMHANS cater to the needs of patients
sufferring from psychiatric, neurological and neurosurgical
d isorders.
+ The out-patient department functions on all week days and
offers a combined neuropsychiatric out-patient service too.
+ The in-patient ward has a total
separate for children and adults.
bed-strenght
of
805,
+ A 24 hour neuro-psychiatric casualty and emergency service
is available too.
^FACULTY:
There
Low income
are
15ule
Questionnaire
Schedule
Questionnaire
Category
Category
Category
Cate
77.1
1
74.8
61.6
62
Middle income
25.7
20.7
35.4
Upper income
6.0
3.8
9.8
Rural
59.2
65.3
68.4
Ur ban
8.5
10.1
13.9
Tribal
23.5
23.5
12.6
Forward caste
11.8
12.7
24.1
Backward caste
■7;’ ET “"i
43. 1
33.5
Scheduled caste
45.4
43.2
34.8
INTERNATIONAL NURfINB MRVWgg A§g96IATI@N UN§A/iN0iftj
INSA / INDIA was started in 1992 aiming to train and enhance the
skills of those working in Community Health to improve the
quality of their programmes.
They are health care professionals
and others involved with social y and economically backward
sections
in
rural and urban
areas.
Various
voluntary
organisations and state government bodies, as well as governments
of Nepal, Bangaldesh and Mauritius have referred their staff for
training at INSA.
The ten week Rural Health and Development Trainers Training
Programme has six weeks of intensive class-room work and four
weeks of field work covering a wide range of topics.
The
participants are helped to understand the comprehensiveness of
health in its socio-cultural physical, spiritual, economic and
environmental
aspects. Women's health and empowering them are
focussed upon.
By the end of the 10th week, each participant draws up a one-year
project plan to be implemented on their return.
This is
monitored by the well INSA /
INDIA faculty through regular
reports and field visits. At the end of the year a follow-up
workshop in one of the developed projects helps in their learning
to evaluate programmes using a participatory approach.
At the
end of the workshop they develop a long-term plan for 3 to 5
years.
From 1991, INSA / INDIA has'also concentrated its efforts in the
field
of
AIDS
prevention
education
programmes
in
schools/col1eges, youth clubs, industries and other groups in the
city of Bangalore.
SOURCE ; INSA / INDIA Report
national
institute
of
public
cooperation
child
DEVELOPMENT
(NIPCCD)
NIPCCD
is an autonomous body working under the aegies of
Ministry of Welfare, Deparmtment of Women and Child Development,
Government of India, Bangalore, Guwahati and Lucknow are the
three regional centres wherein they conduct
research
and
training in the area of public cooperation and child development
and is engaged in giving consultancy services in these areas.
The main objects of NIPCCD are:
1.
To Develop and promote voluntary action in social development;
2.
To take a comprehensive view of child development and develop
and promote programmes in persurance of the national policy
for chiIdren;
3.
To develop measures for the co-ordination of governmental and
voluntary actions in social development;
4.
To evolve framework and perspective organizing children's
programme through governmental and voluntary efforts.
The activities of NIPCCD
a)
b)
c>
d)
e)
f)
g)
are divided into various functions;
Public Cooperation Division
Child Development Division
Women's Development Division
Training Division
Monitoring and -Evaluation
Common Serices Division
Resource Centre on Children
NIPCCD has come out with various publications and
useful
materials for workers/researchers/planners .in various aspects of
child development.
Regular evaluation studies of the ICDS
programmes are conducted by the regional centres.
NIPCCD has been awareded the Maurice Pate Memorial
UNICEF for its outstanding contribution in the field
deve1 opment.
SOURCE; NIPCCD Leaflet.
4
Award by
of child
VIVEK ANANDA GIRI JAN A IK ALY AN A KENDRA ( VGKK )
Biligiri Rangana Betta (B.R.Hills) is the home of the
'Soliga'
tribals who, with the changing times led a isolated existence for
a long time. Declaring these areas as reserved forests and the
introduction of new forest regulations in
1950's certainly
helped to save the forests from the modern man,
but made the
Soligas discontinue some of their practices like
shifting
hunting etc .
agriculture,
This made them vulnerable
and
e xp1 cited.
It is to serve these brethren, that Vivekananda Girijana Kalyana
Kendra was founded with the twin objectives of
a)
improving socio-economic conditions of the tribal
people
and,
b)
of helping them enrich their culture and values.
The
centre is a non-sectarian
humanitarian
organisation,
dedicated to the ideal of "service of God in Man".
Orginally
started in B..R.Hills, it has now spread to incorporated Yelandur,
Chamarajanagar, and Koi legal taluks (including Male Mahadeswara
Hills) and Satyamangala Taluk of Tamil Nadu.
The project covers
an area of about 60 kms radius and serves a tribal population of
The essential aspect of the work has been to actualise the dream
o.f a self-reliant, united and stable Soliga society by conducting
various programmes each one aiming at unfolding the human
potential,
creating an awareness towards self-help and also to
maintain the balance between modern day
progress and the
preservation of the Soliga's cultural identity.
HEALTH- Health care has been the main entry point of the Kendra
and has established a ten bed hospital with an out-patient
department, a laboratory, a dental unit and an X—ray unit.
It
also runs a Mobile Medical Unit catering to the needs of hamlets
in the interior forests.
An intensive Sickle Cell Anaemia
Research and Screening Work has been undertaken as the disease is
much prevalent among the tribals .
Immunization, training, health
education promotion of Traditional Medicine etc. are part of the
Community
Health
activities.
Karuna
Trust',
a
Leprosy
Eradication Programme has been launched at Yelandur taluk, as it
is hyperendemic
Leprosy.
The Mother and Child Health
Programme also runs a School Nutrition Programme.
Two Mini
Health Centres have been started to reach out to the larger
population.
VOCATIONAL TRAINING AND COTTAGE INDUSTRIES- The cottage industry
works on a co-operative principle wherein the actual working
people become the members and run the industry.
Vocational
training is given in twelve cottage industries like Agarbatti,
Cane and bamboo handicrafts, Bee-keeping, Coir-rope making etc.
COMMUNITY ORGANISATION—
With the help of the Kendra's social
workers,
the tribals have organised themselves into ’Soliga
Abhivriddhi Sanghas'
in each of their ’F'odu'
(hamlet).
These
have grouped as ‘Taluk Sanghas'
and which in turn has a apex
body coordinating called the "Soliga Abhivriddhi Mahasangha".
EDUCATIONVGKK runs a Non-formal school and Adult Education
and Sunday schools at remote F’odus, apart from the Primary and
High Schools at the main centre.
The schools aim at
t emphasizing an maintaining tribal identity,
# encouraging inherent skills to develop,
* inculcating spirit of community living and team work;
f vocational training to promote sei f-employment,
t emphasis on experimental learning,
& environmental education, and
* exposure to community organisation and social work.
The High School, first of its kind in Karnataka, caters to the
needs of other tribal communities. A tribal
hostel
provides
accommodation for nearly 200 boys and girls from interior
hamlets.
OTHER ACTIVITIES:
The Christians Children Fund, Bangalore
in
been helping foster—parents to sponsor tribal children,
'Family Helper Project' taken up by the Kendra.
has
the
With the assistance of ASTRA and KSCST (Karnataka State Council
for
Science
and Technology),
the Kendra
has
introduced
appropriate technology to the tribal people like
f ASTRA Vole (smokeless fuel efficient chulhas),
* Solar Energy Appliances,
* Wind Mill,
S Gobar Gas Plant,
* Wood Gassifier,
% Cement soil block maker, etc.
The Kendra is also working in the following areas:
% Rehabilitation of Displaced Tribal Families,
# Agriculture, Dairy, Fisheries and Poultry,
* Low Cost Housing,
Co-operative Societies, and
S Social Forestry.
SOURCE: New Frontiers of Tribal Development VGKK.
6
ST. JQHN's MEDICAL COLLE0E - DEPARTMENT OP COMMUNITY HEALTH
1 he Department of Community Health, St. John's Medical College as
a voluntary organisation with social committments has -focussed on
the following areas:
1» Development of Health Training Programs for auxiliary and lay
personnel.
2. Coordination of training efforts with the Health needs of
other voluntary organisations.
3. Enhanced collaborative research with private voluntary organi
zations and Governmental Health sector.
4. Development of Extension education capabilities by the Depart
men t.
5. Evolution of problem based learning methodologies for medical,
paramedical and lay training.
6. Staff developments by way of exposure of varied training and
research opportunities at all levels of trainee capabilities,
thus emphasizing the place of "Health Team" approach in train
ing .
7. Development of Urban training and research opportunities in
anticipation of future health needs.
8. Opening up of existing frontiers in medical science research
such as PRA techniques, qualitative research methodologies,
plantation medicine specifics.
Three urban and nine rural health centres are being utilised for
training service research activities. Training programmes are
conducted for under—graduate and post-graduate medical students.
Continuing Medical Education Programmes are held for Government
Medical Officers, Practitioners of Xndigeneous Systems of Medi
cine and Plantation Medical Officers in all areas of Community
Health.
Diploma as well as well Post—Diploma / B.Sc. students in
Nursing form part of -Community Health training.
Training of
Auxiliary workers like Auganwadi, Traditional Birth Attendants,
Community Health Workers, etc., is regularly undertaken.
Apart from these, health related training programs like Health
Management, Food Hygiene, Teahcers Training, training for Deacons
and Seminarians, Occupational Health, First Aid, etc., are being
carried out.
The Department also undertakes evaluatqry and
research projects.
Some of the other unique projects are:
- the establishment of a Rural Health Training Centre at
Mugulur village;
- Mahila Vikas Project; and
- Central Documentation and Monitoring.
7
MYRADA PLAN » H.D. KOTB PR04EBT
The primary aim of the H.D. Kote project was to establish a micro
level
primary health care development system,, managed and sus
tained by the community at the village level. The project has
been concentrating in the health sector since its inception in
early 1980's. Their activities can be broadly classified into:
1)
Preventive Health Care.
2)
Curative Health Care.
3)
Development of Individual and Community Health Infrastructure.
The Preventive Health Care Programme concentrates on:
~
—
—
-
training village birth attendants (dais),,
identifying village health promoters and anganwadi workers.,
initiating a health fund by starting self-help credit groups
immunization,
nutrition programs,
family planning, and
health education.
The
by
-
project is attending to the curative aspects in health
care
bearing the expenses of hospitalisation of the poor,
training for the blind,
rehabilitation services for the handicapped, and
conducting various health camps.
Some of the health infrastructure development programmes at
individual level are in the nature of:
-
providing housing for the homeless,
electrification of houses,
low cost latrines., and
astra ole and biogas programs.
Some of the Community Health infrastructure development
of the project are
-
the
programs
potable water system to ensure safe drinking water facility to
the community,
support to Government Primary Health Centres/Units, and
Drainage with Community participation.
SOURCE:
Report on Health Activities undertaken in H.D. Kote
Project (1992).
PRARAMBHA
Prarambha is a Trust founded in 1985 by a group of people activeinvolved in rural development as administrators,
trainers,
active field workers, etc.
The concept is intended to:
- sponsor individuals to work for rural development
- help individuals to set up action groups in villages
- create support base for individuals engaged in rural
development
- provide assistance to young groups already involved in
development work
- provide administrative, financial groups, and other infra
structure needed by individuals / groups willing to work
in rural areas
- serve as 'resource organisation' for persons / groups
associated with rural development.
Prarambha has initiated a study on rehabi1itation of irrigation
tanks in Karnataka with the objective of drawing up an action
plan and optimisation of available water resource utilisation.
Prarambha's main commitments for the future are - to initiate .1.00 small development groups in the village
of five drought prone districts of North Karnataka
- to create strong and committed team in each of the
sponsored village and an information and training base in
each district.
- to produce measurable and qualitative results in the
villages like education, health care, savings, etc.
SOURCE: PRARAMBHA
9
£988100
Ashika was started in 1987 to play the role of a catalytic agent
in bringing out people's awareness and people's action for rural
development through people's education. Ashika laid down specif
ic objectives for women, youth, children and the weaker sections
of the society.
For Nomen:
To promote Sanghatanas among rural women and
employment activities through paper training and education.
self
For Youth:
To foster among youth a spirit of geunine civic
interest,
social commitment and service to their community by
conducting leadership training camps.
On the whole, the main activities of Ashika are Literacy, Self
employment, Vocational guidance, Environment education and Health
with the help of low cost media like Street plays,
charts,
as
well as group discussions and symposiums.
238k LC)O
ASHRAYA
Ashraya is a shelter for the under-privileged children, which
began its Welfare activities in 1972.
Now it is a multi-faceted
child welfare organisation, caring for destitute children in the
age of 0-10 years.
For the children awaiting adaption, a pre
school informal training is given.
Ashraya encourages Indian as
well as international adoptions, especially of physically handi
capped and disabled children. The centre runs a Parent Support
Group and takes care of necessary legal aspects before giving in
a child to the new parents.
Inter-country adoptions are conduct
ed on the guidelines formulated by the UN, and on the basis of
Supremen Court judgements.
Adoption counselling by a professional adoption counsellor in
clude pre and post placement advice.
Causes and classes are
conducted for those who wish to adopt. Access is made available
on reading materials, audio-visual aids, etc.
Apart from adoption, Ashraya also has mobile reaches for children
of construction workers.
They also run a day-care for children
of working mothers.
Ashraya is helping to standardise adoption procedures in Karnataka,
thus acting as a Pressure Group to prevent malpractises in
any area of adoption.
SOURCE; ASHRAYA leaflet
11
MABHYAM 60MMUNI0ATI0N8
Madhyam is a non-profit media organisation setup in
primary objectives are:
1983.
Its
- to -fulfill the communication needs of the many groups and
non-governmental organisations engaged in social action.
- to create public awareness of problems and issues like
the oppression of women., tribals, caste and class injus
tice and consumer exploitation.
Madhyam's work comprises of training and support of cultural
action groups.
It is involved in production of communication
materials and interaction with / consieutisation of mainstream
media practitioners, journalists, film makers and other communi
cators.
In all its work, Madhyam aims at preservation of cultur—
al forms, encouraging tribal and folk art forms and their use for
cultural action.
Madhyam's productions include communication materials on varied
topics like tribal welfare, female child labour, trends in educa
tion, etc.
Also they conduct training programs on folk arts,
street theatre workshop, use and preparation of flash cards.
Madhyam has setup a audio-visual resource centre at E<angalore to
enable groups and grassroot organisations to have easy access to
relevant films and audio-visuals.
SOURCE: MADHYAM leaflet.
/
I
THE A8gQ(2IATI0N OF THE FHY0J6ALLY HANBX6AFFID (APH)
APH embarked on a mission in I960 to educate, train and rehabili
tate the orthopaedically handicapped. On an experiment basis,
industrial jobs were acquired for the handicapped and this later
became a hit as industries participated in the growth of APH.
Rehabilitation through placements consumed lot of energy of APH
and thus a Rehabilitation Centre was started in 1970 with foreign
funds for acquiring machinery and other necessary tools.
The
'Shradhanjali' Integrated School is a innovative project of
APH to provide medical and educational facilities for the chil
dren .
The Industrial Training Institute for Orthopaedically Handicapped
was reorganised in 1975 along the lives prescribed by National
Council of Training in Vocational Trades.
The trainees receive a
monthly stipend and need to appear for an examination before
getting their placements.
Home-bound programs have been started for the severely handi
capped who are either averaged or under—qualified to undergo
formal training.
Apart from these, an on—the—job training is
also given with the State Governments assistance.
Source: APH Souvenir.
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SEARCH
SEARCH is a secular, non-profit voluntary organisation which
started its intervention with NGOs in 1984.
Over the years there
has been a gradual transformation from a Training Institute to a
Strategic Organisation playing multiple roles today.
* It is committed to the promotion of marginalised groups such as
Dalits, Tribals, Landless Agricultural Labour, Women and Children.
*
It is a support institution working primarily with voluntary
agencies
with the two-fold objectives of
Human
Resource
Development and mobilising people around development issues.
*
It collaborates with NGOs in initiating,
strengthening issue-based networks.
*
It carries out policy reviews and plays advocacy roles.
*
It works with a variety of partners;
People's Organisations,
Network Associations, Donor Agencies and Government Departmernts,
besides Voluntary Agencies and Support Institutions.
*
It makes use of Participatory Methodology in Research, Training,
and Evaluation.
promoting
and
Their interventions are based on a geo-political perspective in
all the three states namely Andhra, Karnataka and Tamil Nadu.
Regional Trainers Training Course is conducted in regional
languagesfor middle level staff from NGOs to strenghthen their
potential in training and direct this towards organising and
promoting a large number of marginalised people's organisations.
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ACTIDN AND DISABILITY AND DEVELOPMENT (ADD)- India
Action on Disability and Development (ADD)— India was established
by a group of disabled people and their friends with the
following aims:
To relieve poverty and sickness amongst disabled and handicapped
persons throughout India,
To advance any other exclusively charitable purpose for the
benefit of disabled and handicapped persons,
To assist any other person, body or organisation engaged or
seeking to engage in similar activities,
To carry on any appropriate activity for raising funds for the
above mentioned objects.
ADD-I
helps disabled people to identify their own needs and the
best ways of fulfilling them under the 'meeting-trees in the
villages'. The most commonly identified needs are:
* better appropriate transport,
$ orthopaedic support,
* education and training, and
* the right to earn a living.
ADD-I is committed to work with disabled people in vi1lages,since
80 percent of the disabled population lives in villages, whereas
all
the facilities for education, training and employment for
disabled people are concentrated in cities and big towns.
The
strategy ADD adopts is to work through the voluntary agencies
working in villages to reach disabled people.
This is to avoid
duplication of infrastructure and adding on disability as a
development issue and not as a welfare issue to the agenda of
existing voluntary agencies. The second task is to enable the
voluntary agencies to give visibility to disability and to change
attitudes towards disabled people.
As a result 41 self-help groups of disabled people have been
established with a total membership of about 600. These disabled
people.come from 158 villages of seven taluks in four , districts..
Attempts are being made to provide schooling for handicapped
children,
to obtain, transport concessions,
to, get land for
collective farming and a forum to deal with women s issues.
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INTERNATIONAL NURSING SERVICES ASSOCIATION (INSA/INDIA)
INSA / INDIA was started in 1982 aiming to train and enhance the
skills of those working in Community Health to improve the
quality of their programmes.
They are health care professionals
and others involved with socially and economically backward,^1 in
rural and urban areas.
Various voluntary organisations and state
government bodies, as well as governments of Nepal,
Bangaldesh
and Mauritius have referred their people for training at INSA.
The ten week Rural Health and Development Trainers Training
Programme has six weeks of intensive class-room work and
four
weeks of field work covering a wide range of topics.
The
participants are helped to understand the comprehensiveness of
health in its socio-cultural, physical, spiritual, economic and
environmental aspects.
Women's health and empowering them are
focussed upon.
By the end of the 10th week, each participant draws up a one-year
project plan to be implemented on their return.
This is
monitored by the' well developed projects helps in their learning
to evaluate programmes using a participatory approach.
At the
end of the workshop they develop a long-term plan for 3 to 5
years.
From 1991, INSA / INDIA has also concentrated its efforts in the
field
of
AIDS
prevention
education
programmes
in
schools/colleges, youth clubs, industries and other groups in the
city of Bangalore.
SOURCE
INSA / INDIA Report
REFERENCES
1-
De Souza A.
and De Souza
(eds). 1984s
Psychiatry in
India,
Publishers, Shri Rajesh c?. Bhalani, Bhalani Book Depot, Bombay,
PP.l, 14. 15. 16.
2-
Goldman , Howard H. Review of general Psychiatry, 2nd ed/.,
1988,
Appleton Aanqe, Prentice Hall International Inc., pp.8, 9, 10,
17,
369, 699.
3.
Major,
Ralph H.s History of Medicine, 1954, Charles C.
Thomas
Publisher, Springfield, Illinois, U.S.A., Vol.i & li, pp.206, 218,
388, 487, 502,506, 652, 728, 729, 928, 929, 1038, 1042.
4.
Castig1ion^A.: A History of Medicine, translated by E.B.Krumbhaar,
1941, published by Alfred A.Knopf, New York, pp.451,452, 633.
7
NATIONAL
INSTITUTE
OF
PUBLIC COOPERATION
(NIPCCD)
CHILD
DEVELOPMENT
' NIPCCD
is an autonomous body working under the aegies of
Ministry of Welfare, Deparmtment of Women and Child Development,
Government of
India, Bangalore, Guwahati and Lucknow are the
three regional centres wherein they conduct
research
and
training in the area of public cooperation and child development
and is engaged in giving consultancy services in these areas.
The main objects of NIPCCD are:
1.
To Develop and promote voluntary action in social development
2.
To take a comprehensive view of child development.and develop
and promote programme.in persurance of the national
policy
for children;
3.
To develop measures for the co-ordination of governmental and
voluntary actions in social development;
4.
To evolve framework and perspective organizing children's
progrmme through governmental and voluntary efforts.
<—The
activities of NIPCCD
are
functions:
a) Public cooperation division
b)
Child Development Division
c) Women's Development Division
d)
Training Division
e) Monitoring and Evaluation
f)
Common Serices Division
g) Resource Centre on Children
divided
l^into
various
—NIPCCD has come out with various publications and useful
materials for workers/researchers/planners in various aspects of
child development.
Regular evaluation studies of the ICDS
programmes are conducted by the regional centres.
<=- NIPCCD has been awareded the Maurice Pate Memorial Award by
UNICEF for its outstanding contribution in the field of child
development.
With
deeper understanding,over the centuries, of
the
mental
in
involved
and
disturbances
their
the
processes
the
manifestations,
treatment of the mentally disturbed has undergone radical changes.
In
the modern climate of opinion, it is difficult to believe that in
/fc.
the
bAijMA wb
past lunatics were caged in isolated premises and exhibit^d^as strange
g!ga(-ins-t^^t-he~~:paym&Q-t —o-f-^-a—smal-l—foe>
animals^
point,
in
case
Phillippe Pinel not only recommended humane treatment for the mentally
illy but even lived with them in order to understand their habits
personalities;
concept
of
investigating such individuals as a
modern
originating
the
taking
into
whole,
their environmental and social influences.
To quote
trend
and
consideration
"The
for
he should be credited
such
as
and
is to combine biologic,
psychologic
social
in a tailored approach^ to a particular patient with
intervention
—
a
2
specific disorder.
In
medical
curriculum in the 1930's.
progress
in
the
contributions
treatment
Since then,
of the
mentally
considerable
ill,
significant
mode of treatment is
doubt
An
The
exception
development
in
some
psychiatric conditions, but further study is required.
i-HModern treatment is available in thejR^tropolises and in a few of
the
of
i p
few
to psychiatry in general have been made.
a
the
despite
is the development of the concept of family therapy.
ybga
into
psychiatry as a separate subject was introduced
India,
as
no
beneficial
yvi
larger cities, and for various reasons, benefits only a few
patients.
population (nearly 807.) is obliged to seek
treatment
The large rural
from
local temple priests, astrologers, soothsayers
healers,
treatment,
all
of
whom
provide
inexpensive
and
which however has the disadvantages of
and 5/ occasional ly harmful.
and
traditional
easily
available
being
ineffective
,
_
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BANGALORE ONIYAVARA SEVA COOTA-BOSCO
BOSCO began in June 1980 by a group of students from Kristu
Jyothi College Bangalore, which grew into a full fledged
project in 1984.
HdMEafcisniEfc
1)
W draws inspiration from- DON^BOSCQr-an-
It approaches the problem by-
supporting the child in his effort to grow and integrate
into society and
2)
building a meaningful social and political movement capable
of challenging those situations that leave children abandoned
on the streets.
By adopting a preventive and promotive a system of education,
it aims to create, an environment free from the dehumanising
factors prevalent ofi the streets.
BOSCO has a
tier
PRESENCE
STREET PRESENCE: The innovative BUDDIVANTHA follow up is a
comprehensive educational project kaxanJuHCB
and support to
children through activities like Counselling, Literacy classes.
Home Placement, Tracing missing children. Medical Help,
Advocacy and acting as guardians of children,and Orientation
programmes, picnics, drug x deaddictidn camps etc.
SHELTER PRESENCE; City centres, Day-Night Shelters become the
home of these children till they reach their homes or a place
of permanent settlement.
INSTITUTIONAL PRESENCE; BOSCO basically adopts a non-institutio—
nal approach in working with the children, but directs those
J noZcJ-ciskc uU
in need to different instkt-tt-l-ons- which are already in exis
tence.
BOSCO has evolved a YOUTH FOR YOUTH programme initiated to
enable the fortunate youth of the city to mask interact with
the less privileged youth pn the steet and to create an
awareness towards an effective social change.
The elderly
and the experienced form a PATRON'S GROUP to support and
encourage.
RAGPICKERS EDUCATION AND DEVELOPMENT SCHEME (REDS)
R.E.D.S. had evolved from the initiative of the Jesuit Priests
at Ashivard, Bangalore, along with an active collaboration
and direct involvement by the members of the Christian Workers
Movement, during 1979.
It took shape in the form of a full
fledged project providing shelter, care, education, recreation
c
and rehabilitation in August 1985.
by the Archdiocese of
The project is sponsored
Bangalore, under the auspicies
of the Bangalore Multipurpose Social Service Society.
The
financial assistance for the building and administration are
provided by the MISEREOR, Aachen, West Germany.
The project
cares for 70 children at both the centres and works with
1500 on the streets of Bangalore.
R.E.D.S. aimsxaljhas drawn out an action plan:
* Minimise economic exploitation
* Facilities for bathing and temporary shelter,
* Saving Schemes to promote the habit of thrift and self-
reliance,
* Life oriented Education,
* Cultural and recreational facilities,
* Rehabilitation,
* Co-operative Society
X-,
Mju
c
R.E.D.S. offers facilities in the areas of^helter, BBUCATION,
Vocational Training, Recreation, Counselling, Job Placement
and has a host of actaivites on its side. They maintain street
level contacts^ith children, conduct short term programmes,
weekend camps, research and documentation activities and
community educatiob and participation.
SOURCE: R.E.D.S. leaflet
NATIONAL TUBERCULOSIS INSTITUTE
The National Tuberculosis Institute located at Bangalore, in
Karnataka State was started in 1990 by the Government of India
through the active assistance and technical support of the World
Health Organisation(WHO) and UNICEF
le main purpose for which
this Institute was established are:
a)
To formulate and evolve a practicable, economically feasible
and widely acceptable tuberculosis programme for the entire
country
b)
To train medical and para-medical workers to efficiently
implement the programme in rural and urban areas, and
c)
To undertake necessary research to give substance and support
to the above two aims.
In addition, the Institute also monitors the District Tuberculosis
Programmes in the country.
The NTI developed a methodolgy for
organising TB control services in the community.
The district,
being an administrative unit of the country, is taken as the
basic unit of National Tuberculosis Control Programme.
The aim
is that there must be at least one Cente, the District TB Centre
(DTC) in each district.
Today, these centres form the core of
the National TB Control Programme.
The District Tuberculoses Officer os orn"
the tuberculosis programme in the district.
overall charge of
He is assisted by
a team consisting of a laboratory technician, an X-ray technician,
a treatment organizer and a statistical assistant.
All are trained
at National Tuberculosis Institute in the organization of District
Tuberculosis Programme.
The function of the District Tuberculosis
Centre is to organize and supervise the case-finding and treatment
activity in all the health institutions in both rural and urban
areas.
The staff of these health institutions are trained in
sputum microscopy and to treat the patients diagnosed by them.
STUDENT MOBILIZATION INITIATIVE FOR LEARNING THROUGH EXPOSURE
<.J.iACC. /7£?6_)<
SMILE,is an attempt to mobilise and motivate college students from
various academic backgrounds to:
* deepen their awareness of themselves and of the society in
which we live.
* experience the day to day struggle for survival of the rural and
urban poor through an exposure to their living realities.
* learn from the efforts of NGOs, which, while working for and
with the poor, are discovering new and alternate approache^s to
development.
SMILE also supports students who are willing to work with an NGO
as an outcome of their experiences.
If one is a student (s)he i-s=
becomes a SMILE participant and some of them are selected for an
exposure programme every year, on the basis of their interest,
sensitivity and awareness, and will be given a week londj orientation
before the exposure.
SMILE is' in touch with a number of NGOs and Action Groups
working in various aspects of development work.
a staff member
Along with their
of SMILE the student &tays with a "poor1 family for
a period of 4 to 6 weeks.
The emphasis during yrifir first exposure
is on learning from theS experiences of the people and the prevail"
ing situation.
The second exposure would enable -y&fa to vjsit two &
or three other organisations and with the third exposure the studeriT
is helped to discover her/his aptitude to become a development
worker/actlvist.
SMILE participants have initiated small programmes, conducted
surveys, case studies, awareness campaigns, etc.
SOURCE: SMILE leaflet
/
CAIM TREATMENT AND RECOVERY CENTRE
CAMl-n (Twx
,
.
.
/'A^rfn/X^
Ae'/uu'cz^t
. ,
,
/ d7 n
The CAIM Treatment and Recovery Centre offers an intensive,—extension—
6a 12 steps centered service for the treatment of the disease of
chemical dependency.
The treatment methods include an in-patient
programme of variable lenfth of stay as indicated as well as out
patient services individualised to the patient’s needs.
Counsellor
function with a team of Physicians, Psychiatrists, Clinical
Psychologists, Qualified Social Workers to meet the medical and
Psychosocial meeds of the patient.
The teeatment method has elements of both Western and
<2
Eastern philosophies in a therapeutic ambience.
Extensive use of
individual and group counselling, di^fdactic educational sessions,
exercises, yoga and meditation, games etc'form part of the rehab
ilitation process.
At CAIMS Family Threapy is an integral part
of the trearment plan keeping in mind the Co-tjependency factors.
The CAIM programme is specifically focused and designed to
restore the chemically dependent person and their family members
to optimal health and functioning of Body, Mind, Emotions, Spirit
(Values) and Relationships.
CAIM is also equipped with a dual-diagnosis wing to treat
addicts with other psychiatric disorders.
It maintains a open
door policy and conducts numerous self-help group meetings.
offers a full-scale Implementation of an.Employee Assistance
Programme at various business and industrial centres.
i
SOURCE: CAIM leaflet.
It
VIMOCHANA
Vimochana is a Women1s Organisation that has been
attempting to
protect and defend the rights of women wherever and whenever thgy have
been violated/^Working in and around the city of Bangalore for the
past 13 years, Vimochana has also been a space for women to come and
voice their views on any issue that affects them-ranging from ecology,
militarism, communalism, domestic violence to the basic violation of
any human right.
„
STREELEKHA
Streelekha is a project of the Society for Informal Education
And Development Studies, a registered non-governmental organization in
Karnataka.
Streelekha is in contact with several women’s groups in
India and grew out of the experiences of some of the women in the
women’s movement.
Having taken on the mainstream publishing world which had mar
ginalised women’s writings, in 1985, they have today managed to
lay specific focus on feminist works(be it in the form of fiction^
poetry or theoretical research), as well as offer books on various—
other tacirlty.
They also invite social meovements in India and the
Third World to place for displayand sale their publications, studies
and newletters in the bookshop.
Streelekha also has a wide collection
of books in iszaixianguagES Kannada and other local languages and
undertake translation work too.
.mochana, axwEmesiks
Streelekha has also been”a reference
’ Z|
i>
L n „ I „ Ai
/
> <
reached out to women in distress through informal counselli
and legal support, apart from initiating campaigns and discussions
on other related social, political and legal issues. /
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REPORT
POLICY
V.'A TER ANO S * NJ i ATiON I
Providing everyone with clean water
and basic sanitation
AND NUTRITION
Ensuring an adequate and affordable food supply
and a blanccd diet.
MOTHER AND CHILD
CARE
Restricting drugs to 200 essential ones
and making them available at a cost people can afford
CURATIVE CARt
Training village health workers to diagnose
and treat common diseases and injuries.
Educating people in understanding the causes
of ill health and promoting their own health needs.
T VHAI
Training birth attendants, promoting family planning
and monitoring child health.
Primary
Health Care
PROVIDES
OMPREHENSIVE SERVICES
TO THE ACTUAL
NEEDS AND PRIORITIES
OF THE COMMUNITIES
AT A COST WHICH
PEOPLE CAN AFFORD.
TRADITIONAL MEDICINE
Enlisting traditional healers, giving
additional training and using traditional medicines.
IMMUNIZATION
mmunizing all children
against childhood diseases.
KARNATAKA
VHA
The Need for Partnership
There is growing recognition that partnership between govern
ments and non-governmental organizations is an inescapable
necessity for the attainment of Health for All by the year 2000. It is
also felt that the time is opportune for intensifying such partnership,
based on mutual understanding identification of appropriate roles,
complementarity of actions, mutual learning by doing and full
fledged cooperation. The World Health Organization is promoting,
fostering and strengthening such partnership.
HFA Leadership/IM 11
We acknowledge with thanks the financial support given to us by WHO through
the Ministry of Health and Family Welfare.
Organized by :
KARNATAKA VHA
RAJ1N1 NILAYA, NO. 18 (NEW NO 60)
RAMAKRISHNA MUTT ROAD.
CAR STREET. 3RD CROSS.
ULSOOR.
BANGALORE-560 008
In Collaboration with
Voluntary Health Association of India
40, Institutional Area, South of I.I.T.,
New Delhi - 110016
Tel : 668071, 668072, 665018
Printed at:
Excellent Printing House,
New Delhi.
WOK K S H o p
ON
oi A T I O N A L
H
P
E A
O L
Dales
Venae
:
:
L
5
T
C
H
April 9 and 10, 1992
Institute for Social and Economic Change
Nagarbhavi P.O.
Bangalore - 560 072
ORGANISED DY:
VOLUNTARY HEAL'D! ASSOCIATION OE KARNATAKA,
VOLUNTARY HEALTH ASSOCIATION OF INDIA, AND
DIRECTORATE OF HEALTH AND FAMILY WELFARE SERVICES, KARNATAKA.
CONTENTS
PROLOGUE
PROGRAMME
INAUGURAL SESSION
INAUGURAL ADDRESS
Sri T.R.Satish Chandran
KEYNOTE ADDRESS
Sri V.S.Badari
NATIONAL HEALTH POLICY - AN OVERVIEW
Dr. (Mrs) M.K.Vasundhara
CURREN T HEALTH STATUS OF INDIA
Dr.J.P.Gupta
NATIONAL HEALTH POLICY - VIEW POINT OF GOVERNMENT
Dr.C.R.Krishnamurthy
VIEW POINT OF VOLUNTARY AGENCIES
Dr.Shirdi Prasad Tekur
VIEW OF PEOPLES’ REPRESENTATIVE
Dr.M.V.Kulkarni & Dr.G.N.Prabhakar
CLARIFICATIONS
GROUP DISCUSSIONS
Primary Health Care
Health Education
Intersectoral Co-ordination
Health Information Systems
PLENARY SESSION
CONCLUSIONS AND MAJOR RECOMMENDATIONS
APPENDIX
NATIONAL HEALTH POLICY - 19H2
Today we have a National Health Policy
Health and F.W.Services, District Health Officers.
(1982). ihis comprehensive document is relevant
People’s Representatives (Presidents ol
to all involved in Health Care including the non
governmental sector. Among other things, die
Parishalhs and Chairmen, standing committee on
Health of Zilla P.arishads), Voluntary Organisations
and Media persons along with experts in the field
will help in the study of the Health Policy and to
determine which way to go. This may ultimately
pave the way to the formulation of a Health Policy
suited to Karnataka with implementation at the
District level.
statement of policy highlights die role of Vol
untary agencies in Hcaldi and emphasises the
Government’s desire to involve, support and
enhance diis role.
The very fact that we have a National Health
Policy is an indication that there is political will
towards better care of the people. There is need for
careful slud)' of this policy to determine.
(l)in what direction we are going, and
(2)how to operationalise this policy,
into improved practice than what it is today. Such
a study will help people involved in planning
Health Care at the State and District levels to orient
their approach and decisions towards elements of
the policy.
It is pertinent to recall and remember with
gratitude initiatives by Voluntary Health Associa
tion of India (VHAI). When the. Voluntary Health
Association of India first printed the statement on
National Health Policy, there were requests from
individuals.and institutions from all over the coun
try for more copies of the policy. In some cases,
bulk supplies weie requested. This wide-spread
interest inspired VHAI to plan a systematic dissemi
nation and discussion on the policy. The first
National Seminar on National Health Policy was
held at New Delhi on April 23, 1983. State level
seminars were to follow this.
Voluntary Health Association of Karnataka
(VHAK) made a beginning towards this end, by
initiating discussion on National Health Policy at
St.Philomena’s Hopsital, Bangalore, during 1984.
Following the workshop at St.Philomena’s
Hospital, during 1984, and in recognition of the
crucial need to continue an active and constructive
dialogue among all groups for continuing identifi
cation of progress or lack of progress in this regard,
and to seek participatoiy measures to accelerate
process
*
this
towards progress, a group of experts in
the field of health both from Government and
Voluntary Sector met at St.John’s Medical College,
Bangalore on October 31,1991 under the auspices
of VHAK. After an elaborate discussion it was felt
that an intimate dialogue among the Directorate of
Zills
The group of experts (who formed the work
ing committee and the Resource) also felt that as an
initial step, there is a need for creating awareness
of the document itself among the participants. To
meet this aspect, it was planned to invite papers on
the document. The group, realising the impossibil
ity of discussing the National Health Policy in its
entirity within a span of2 days, decided to focus the
discussion on four specific issues:
(a)
PRIMARY
HEALTH CARE
HEALTH
(b)
EDUCATION
(c) INTER SEC TORAL CO-ORDINATION
HEALTH
(d)
INFORMATION SYSTEM.
In the pre-planning phase itself it was felt that
it is imperative to promote a relationship of partner
ship between the Government and Voluntary
Organisations. It was very strongly expressed that
such an exercise will help promote District level
planning.
PROGRAMME DETAILS:
9th ARPIL 1992
MORNING
INAUGURAL FUNCTION
1. Invocation
_ .
Mrs. Joyce Jayasheelan
2. Welcome
__
Dr.H.Sudarshan, Treasurer, VHAK
3. Lighting of the Lamp
and
Inaugural Address
—
Sri.T.R.Satish Chandran, Director
ISEC and Former Chief Secretary
Government of Karnataka
4. Key Note Address
—
Mr.V.S.Badari, Asstt. Director
Population Centre, Bangalore.
5. Representing Government
of Karanataka
■—
Dr.T.Ranganatha Achar, Director
Health & F.W. Services.
6. Representing VHAI
—-
Dr.Mira Shiva, VHAI
7. Representing VHAK
—
Dr.Upendra Shenoy
8. Vote of thanks
—
Dr.Sona Kalyanpur Rao
Hon.Secretary, VHAK
SCIENTIFIC SESSION
Moderator
9.4.1992 : 11 a.m.
Dr.C.M.Francis, Director
Sl.Martha’s Hospital, Bangalore-5Mi 009.
PAPERS PRESENTED
V(fJ‘Nalioiial Health Policy - an Overview’
Dr.(Mrs) M.K.Vasundhra
Prof. & HOD, Community Medicine
Bangalore Medical College, Bangalore.
((f'Current Health Status of India’
Dr. J.P.Gupta
Regional Director
Health & F.W.Services
Government of India
H^7“National Health Policy - View point of Government’
Dr.C.R. Krishna Murthy
Addl. Director
Health & F.W.Services
Government of Karnataka
P°7“National Health Policy - View point of Voluntary Agencies’
Dr.S.P.Tekur
Consultant Pediatrician
Community Health Cell
Bangalore.
1 if=T'View of People’s Representatives in National Health Policy’
Prof. M.V.Kulkarni and Dr.G.N.Prabhakar
Department of Preventive and Social Medicine
Mysore Medical College, Mysore.
(Paper circulat ed among the participants)
general, response to presentations
Clarifications
9.4.1992
•
2.00 p.m.
GROUP DISCUSSION
GROUP I
:
‘PRIMARY HEALTH CARE’
GROUP II
:
‘HEALTH EDUCATION’
GROUP III
:
‘INTER SECTORAL CO-ORDINATION’ Facilitators
GROUP IV
:
‘HEALTH INFORMATION SYSTEM’
Facilitators
DrJ.P.Gupta
'Dr.I I.Sudarshan
Dr.Mira Shiva
Dr.S.Pruthvish
Dr.Upendra Shenoy
Facilitator
Dr.C.M.Francis
Sri. S.M.Subramanya Setty
Dr.C.R.Krishna Murthy
Mr.Mohammed Snfruddin
Facilitators
Dr.'l,'.Annappa Rao
Dr.S.P.Tckur
10.4.1992
9.00 a.m.
Group Discussion (Continued)
Preparation and presentation of report within the group.
10.4.1992
2.00 p.m,
Plenary Session
Moderator
Dr.C.M.Francis
Presentation of reports of Groups I, II, III & IV
Presentation of conclusions and
Recommendations
Dr.S.Rruthvish
Valedictory Address
Sri G.Puttaswamy Gowda
Hon’ble Minister lor Health & Family Weilar
Government of Karnataka
Remarks by
Dr.T.Ranganalha Achar
Dr.C.R.Krishna Murthy
Dr.C.M.Francis
Participants
Vote of thanks
Formation of Committee to draft the proceedings.
Dr. (Mrs) Sona Kalyanpur Rap
Hon. Secretary, VHAK.
7Z?e Workshop started with invocation by Mrs. JoyceJayasheelan. Dr.H.Sudarsban, Treasurer,
VHAK welcomed the guests.
Sri. T.R.Satisb Chandra, Director, InstituteforSocial and Economic Change and Former Chief
Secretary, Government of Karnataka, lighted the lamp and gave the inaugural address (given
separately).
Sri. V.S.Badari, Assistant Director, Population Centre, Bangalore, delivered the Keynote
address (given separately).
Dr. T.Ranganatba Acbar, Director of Health and F.W.Services, Karnataka, spoke about the
context of the workshop and its importance. Tbepresence ofall the senior officers ofthe Department
of Health Services reflected the importance attached by the department to this workshop. It is
necessaryfor Government and Voluntary Agencies to work together to achieve better health status
of the people. The Government bad considerable resources. Karnataka has made good progress in
the health sector. But there were constraints. He promised all the help in improving the health ofthe
people.
Dr. Mira Shiva, Public Policy Division, Voluntary Health Association oj' India, conveyed
greetingsfrom Sri Alok Mukhopadhyay, Executive Director, who could not be present. She pointed
out specifically to the problem of irrational use of drugs. Unfortunately, Drug Policy is not part of
the National Health Policy. Drug Policy is made by the Petroleum and Chemicals Ministry and not
the Ministry ofHealth. Dr.Mira Sbiva also referred to thepossible impact ofthe NewEconomic Policy
and privatisation of health care sector. ’
Dr.UpendraShenoy, Member, Executive Committee of VHAK, appraised theparticipants, ofthe
activities of Voluntary Health Association of Karnataka and the expectations of VHAKfrom this
workshop.
Dr.Sona Kalyanpur Rao, Honorary Secretary of VHAKproposed the vote of thanks.
Sri. TJZ. Satisb Cbandran
I am indebted to the Voluntary Health Asso
ciation of Karnataka, together with the Voluntary
Health Association of India and the Directorate of
Health and Family Welfare, Government of
Karnataka, for the unexpected privilege conferred
upon me of being the Chief Guest at this function.
it is ten years since the National Health Policy was
enunciated and it is lime that a review is made of
the developments during the last ten years in order
that future lines of advance can be identified. I
compliment the Voluntary Health Association of
Karnataka for organising this workshop which has
brought together representatives of voluntary
organisations and Government officials and other
professionals interested in the area of public health.
2.
If one were to ask whether the enunciation of
the National Health Policy brought about any
significant change in the strategy or content of
health programmes in the country, I am afraid that
one does not have much to report. In our country,
we are good at framing policies; we have policy
documents in diverse areas such as education,
science, technology, etc. But, when it comes to
translating the laudable sentiments and eminently
reasonable recommendations contained in the
documents into concrete action, we do not have a
good record of performance. It is as though we arc
satisfied with the ritual of framing a policy and
forget the substantive objectives immediately there
after.
In the area of health also, whether at the
National level or at the state level we do not see any
innovative changes in the health strategy in the last
ten years.
3.
Undoubtedly, India has made good progress
in the area of health since independence, progress
being measured in terms of well-recognised param
eters such as life expectancy al birth, infant mortal
ity, etc. Clearly, the foundation had been laid long
before the National Health Policy was enunciated.
Substantial as the progress has been, we cannot
claim that the health care situation in the country is
satisfactory. There is still a vast difference between
•Director, Institute for Social and Economic Change,
Bangalore-72 and Former Chief Secretary, Government of Karnatak
6
urban and rural,.rich and poor in regard to access
to health care. In the recent years, there is increas
ing recognition that it is not enough to achieve .1
reasonable rale of economic growth measured in
terms of GDP or per capita income. It is fell more
and more that 'development’ is far more important
than ‘growth’, since the former has many more
dimensions than the latter. It is realised that for
sustained long term advancement of the country,
investment on human resources - mainly in el
ementary education and Primary Health Care - is
vitally important. In the last two years, the United
Nations Development Programme has brought out
an annual Human Development Report. Taking
into account various parameters such as per capita
income, enrolment in Primary Schools, number of
years of schooling, life expectancy al birth, infant
mortality etc. a human development index has also
been evolved. Unfortunately, India still figures
pretty low among the list of countries because of its
low human development index. It is clear that we
have a long way to go before we can feel satisifed
regarding the health status in the country.
4.
Among the Stales in India, Karnataka has
performed better than many other states in the area
of health. The 1991 Census shows that the annual
compound growth rate of population during the
decade 1981-91 came down to 1.9 percent. This is
certainly a matter of some satisfaction and it reflects
the good work done by the health seivices in the
State. Nevertheless, we should Lake note of the fact
that the gap between Karnataka and other stales is
steadily narrowing down. Karnataka had a head
start because of the good network of health ser
vices developed in the old Mysore Stale, but in the
recent yeats the proportion of Government expen
diture on medical and health services has been
lower than in many other Stales. One would not
attempt any comparison with Kerala, but it is
interesting that the share of health expenditure in
Karnataka is lower than in Tamil Nadu for instance.
The situation is aggravated by the distortion in the
allocation of expenditure for preventive rural health
care on one hand and for medical education and
urban curative services on the other. The propor
tion of expenditure on the latter is disproportion
ately high. No doubt this tendency is visible in a few
oilier Slates also, but ibis should not console us.
Thus, viewed overall, Karnataka’s performance
in the health sector shows weaknesses and
deficiencies which need to he corrected ur
gently.
5.
The world over, it lias been realised that a
development programme oriented towards a com
munity is more effectively implemented if (here is
participation of the community or of the beneficia
ries. The concept of participatory development
implies people’s involvement al all stages - plan
ning, implementation and evaluation. The paiiicipation can be through formal or informal compo
nents. Voluntary groups represent the informal
components. In Karnataka, a major step was taken
to set up formal structure at the district level and
below entrusted with the responsibility for the
planning and development of their respective ar
eas. The Zilla Pcirisbacls and Mandal l'.in> hnyats
were designed lobe instruments of decent! T a ion
which would also secure greater accountability in
the implementation of development activities.
Unfortunately, one sees in the recent months a
tendency to weaken the structure if not to wholly
dismantle it. Il is sad that after having taken one step
forward the Stale is taking two steps backward.
6.
In the context of the difficult economic situ
ation facing the country, major economic policy
changeshave been introduced in the recent months.
This may have an indirect impact on the health
sector. Given the general approach of curl.tiling
governmental activity and relying more and more
on market forces, there is a strong possibility of
expenditure on social services being reduced.
’Ibis would be most undesirable as it won!'.!
further reduce access of the poor to health
services.
7.
One of the aspects of the new economic
policy is abolition of subsidies. Subsidies are of two
kinds - direct or open subsidies and coven or
concealed subsidies. A recent study by the Halioi. li
Institute of Public finance and Policy estimated the
total amount of direct and indirect subsidies given
by the Central and Stale Governments (<>>? th- ■ it
l?s.42,OOO crores a year. The major pint ol it is
accounted for by the Slate Governments. These
comprise mainly indirect subsidies in the provision
ofsocia I services, of which health is one. It is argued
thalgovcrnmcntshould recovers fairproponion of
the cost it incurs in delivering its services. While one
would not suggest charging the poor for the
educational or health facilities provided to them,
there is no reason why those who could afford io
pay should not be required to meet reasonable
charges. Today, we have a peculiar siitiaiicti of
highcredticalion receivinga level ofsubsidy greater
than primary education. There is a similar distoi tic,;:
in the area of health also. The approach should be
to charge those who can afford, and use the
additional revenue to improve the quality of service
to the poorer sections of the community.
8.
it is encouraging that a large ntimbe; of
voluntary agencies are working, in lite health men
and manyofthem are represented here. I hope that
during (he discussions in (he next two days, erm
struclive ideas and suggestions will be gener. ivd
which will kelp to shape the health policy in I'm v -
FACTORS PROMOTING HEALTH Sil AII US
*
V.S.BADAHI, POPULATION CENTRE, BANGALORE.
Since Independence, India made consider
able progress in the field of health. Smallpox has
been eradicated. Cholera, Malaria, Tuberculosis
and other communicable diseases have been con
trolled. A number of medical institutions have been
established all over the country lor providing
curative services. A comprehensive health policy'
was formulated a decade ago. As a result of these
measures, the death rale could be brought down to
reasonably low level of 10 pci 1 <>00 population.
The expectation of life at birth has increased to
nearly 60 years. Yet, there is lot more to be
achieved, especially with regard to women and
children. For instance, the infant mortality rate per
1000 live births is around 90, which is live times the
rate in the developed countries. The maternal
mortality rate isaboul 5 per 1000 live births in India,
compared to 0.3 in the developed countries.
C
N'
P
N
P
The reduction in mortality achieved so far has
been mainly due to public health measures (such
as immunization of children and control of epidem
ics) a nd improvement in curative services, thanks to
the ad vances in medical technology. Further reduc
tions would depend mainly upon the socio-eco
nomic development of the country. This is because
a wide variety of factors like education, food,
nutrition, shelter, clothing, water, environmental
sanitation and personal hygiene in fluence the health
status of people. In other words, provision of health
services is necessary but not sufficient to bring
about substantial reduction in mortality. An inte
gration of the plans for health with those of the
health related sectors such as education, agricul
ture, social welfare, I1'"- Ing, rural development,
ersupply and sani'■ n is, therefore, desirable.
Studies have shown that neither per capita
expenditure on health nor per capita income is the
most important determinant of health status of
people. Literacy, especially female literacy, is the
most Important determinant of health status. There
fore, literacy campaigns should receive lop priority.
Promoting literacy is also desirable from the point
of view of fertility reduction.
There has been undue emphasis on doctors.
dispensaries and drugs, that too of the Western
•Keynote address delivered during inaugural function.
8________________________________________ ___
50 ----
model, for provision of health care. The Allopathic
system, which is considered to be the ‘modern'
system, has been given the position of prime
importance in recent decades, while olhersystems
such as Ayurveda, though popular In the mra|
areas, have been neglected. The lime has conic
when we should move away from the expensive
Western model and encourage and promote the
indigenous and other systems of medicine, viz.,
Ayurveda, Unani, Siddha, Homoeopathy,
Naturopathy etc., especially in the rural areas. This
is because the people in the rural areas have been
using the indigenous systems of medicine and they
find them not very expensive. There is need to
identify the private practitioners (of the Indigenous
and other systems) who are popular In the rural
areas and provide them training, so that they are
better equipped to serve the community. There
should be more colleges for teaching Ayurveda,
Homoeopathy, etc.
Prevention is always better than cure, ’lite
emphasis should be on preventive rather than
curative aspects of health care, Therefore, health
education Is very important. The block Health
Educator of every Primary Health Centre (.1’1 IC)
should be provided with a vehicle, so that he can
easily cany the health education materials front
place to place and impart appropriate health edu
cation to people in the rural areas.
Studies have shown that cooking demonstra
tions of nutritious food prepared out ol locally
available raw materials have been useful In chang
ing the food habits of people. Thvrefmv. such
monstrations should be arranged, especially "
the rural areas There is nls< ■ need to edue.t1
mothers, especially' in the rural areas, about propel
infant feeding practices, so that infant mortality rate
can be brought down further.
Supplementary' feeding programmes arranged
fot children having protein - calorie malnuirituioit
ate useful in improving the nutritional statusol ll>C
children. Such programmes should be organised in
every' Primary 1 lealth Centre for carefully identified
target groups at risk. This would help in the
reduction of infant and child mortality
The National Health Policy enunciated in
J982 lays stress on provision of “universal, compre
hensiveprimaiy health cate services, relevant to the
actual needs and priorities of the community at a
cost which the people can afford ensuring that the
planning and implementation ofthe various health
programmesarelhrortghlheorgartised involvement
and participation of the community, adequately
utilising the services being rendered by private,
voluntary organisations active in the Health Sec
tor". However, it does not spell out how to bring
about community participation. Nor does it specify
how to involve the Voluntary organisations. 1
suggest a modification ofthe Health Guides'Scheme
(earlier known as Community Health Workers’
Scheme orCommunily Health Volunteers’ Scheme)
in order to achieve both these objectives.
According to the Health Guides Scheme, a
Worker/Volunteer is chosen from the community
(i.e., village or a population of 1000) by the
community to provide certain basic health services
to the community. He (or she) is paid an hono
rarium of Rs.50/- per month and is provided medi
cines worth Rs.50/- per month through the PHC. A
Village Health Committee consisting of five mem
bers supeivises his/her work. The health guide is
given training fora period of three months at the
PHC in first aid procedures, treatment of simple
ailments, health education, environmental sanita
tion, etc. I le/she receives professional and techni
cal guidance and service support from the PHC
staff. He/she is expected to refer patients (whom
he/she cannot treat) to the Multipurpose Health
Worker or to the PHC or to the district hospital. The
Health Guide has to create health consciousness
within the community. He/she has to mobilise and
organise voluntary effort for environmental sanita
tion and other health activities in the village; but he/
she is generally ill-equiped to cany out this particu
lar task. The preventive and promotive aspects of
primary health care are usually neglected. It is here
that a voluntary organisation hasa key role toplay;
it can help the health guide irt mobilising the com
munityfor active participation in health tasks.
One private voluntary organisation active in
the health field may be chosen from each taluk and
encouraged to work in the rural areas by providing
suitable grants. It may be asked to provide the
necessary guidance and support to the health
guides in the taluk who are also volunteers, strictly
speaking. In order to ensure community participa
tion for health programmes, the voluntary
organisation and the health guide should adopt the
strategy of organising developmental activities in
the community and winning the confidence ol the
people. The various activities that could be taken
up are kitchen-gardening, adult education, voca
tional training (sewing, etc.) and income - generat
ing schemes like daily farming, poultry farming,
coffee powder, etcM rearing silkworms, bee-keep
ing, etc. The voluntary organisation may also en
courage development of community organisations
such as Mahila Maridals and Youth Clubs, so that
they could be involved irt the developmental activi
ties. Thus, the voluntary organisation can act as a
catalyst stimulating community participation.
The honorarium paid to the health guide may
be enhanced to Rs.lOO/- per month, as the presen
*
amount of Rs.50/-appears to Ire small. The amount
maybe paid through the voluntary organisation, so
that it can exercise some control over the health
guide. The payment can be made on receipt ofthe
certificate from the Village Health Committee, say
ing that the work ofthe health guide is satisfactory.
It is desirable that the cost of essential medicines to
be supplied to the health guide is borne by the
community itself. /\ sum of Rs.50/- per month may
be earmarked for this purpose by the Panchayat.
This would give the community a sense of partici
pation in lite provision of health care, further, as
per the modifications suggested here in the Health
Guides’ Scheme, life health guide need not depend
upon the PHC for, the honorarium amount or the
medicines; this would give him/her a sense of
independence, and he/she would be in a better
position to demand health services for the commu
nity from the Pl IC staff.
The members of the Village Health Committee
may be provided orientation training at PHC, so
that they can effectively supervise the work of the
health guide and also appreciate the need for
community participation in health care.
NATIONAL HEALTH POIJICY - AN OVERVIEW
’ Dr.(Mrs) M.K.Vnsumlhara
Introduction
Since independence the nation has taken
forward strides to improve tlte hea 1 th of its citizens.
There lias been a substantial success in lowering
die dcatli rates and raising the life expectancy.
Small-pox has been eradicated. Plague Is almost
eliminated; the incidence of malaria is reduced.
However, health problems still pose a challenge.
Our current infant mortality rate (IMR) is 94 which
does not compare favourably with that of Japan
which is 4. It is estimated that 3 deaths occur every
minim- from dehyratlon due to diarrhoea while
tuberculosis claims one life. At any one time, 1215% ol the population is sick, mostly due to
communicable diseases. The major brunt of these
illnesses is borne by women and children. It is all
the more tragic b<-<-tuse most of this morbidity and
mortality is preventable. 7.5% of the Illnesses are
related to poor hygiene and lack of sanitation. The
resurgence of the repressed diseases like kala-azaar
or malaria and emergence of new diseases like
AIDS pose a further challenge. To top it all, the
rapidly expanding population takes its own toll. It
is estimated that on the economic front, for every'
5 points gained, 2 points are lost due to minimum
demands of the growing population. It is “tight
rope walk exercise" to check tire slide down and
balance the development because for the overall
development, health is a critical factor.
1. Equity in distribution of health care
2. Appropriate Health Technology
3. Multisectoral Approach
4. Community Participation
Equity had to be considered because the health
care services were concentrated in urban areas
catering only to a small section of the population.
The \rulnerable population were often neglected.
Inadequate referral services led to consumer in
convenience, congestion, duplication and frag
mentation of the services leading to increased
cost.
Appropriate Health Technology: 'Hie curative
bias led to wastage of resources In treating over
again the diseases which were preventable. A
comprehensive health care consisting of preven
tive, curative, promotive and rehabilitative services
was envisaged. The specialisation and hospital
based services engulfed the major chunk of the
budget favouring the few while denying the essen
tial care to the majority of the community.
Tlte shift is now from specialisation to services
which are appropriate,; effective, simple and fea
sible. Such technology promotes self reliance, eg.
Oral rehydration therapy' to combat dehydration.
Muiti.scctorahippronch: 1 lealth cannot be viewed
Need for National Health Policy
The Government's concern regarding current
situation and Its commitment to achieve ‘Health for
All by 2000 A.D.” led to evolvement of the National
Health Policy In 1983. The enunciation of policy
highlights the Government's efforts at removing
inequity in the health care delivery by reaching out
to the “voiceless" vulnerable population with a
.health care technology which is appropriate,
affordable and acceptable to the community. Por
the first time, time as an important resource was
realised and targets to be achieved by 2000 A.D.
have been clearly spell out.
Strategy
The Stratcgv suggested for Implementation of
this policy is the ■■■line as that evolved for Primary
Health Care. i.e.
'
in isolation as both health and development are
intcidcpendcnt. Therefore, a multisectoral approach
with intersectoral co-Ordinatlon between health
and allied sectors like food and agriculture, educa
tion, water supply and sanitation, social welfare
etc., Is required for balanced development. This
calls for horizontal Integration of services at all
levels.
Community participation: Sir Joseph Bhorc in
1946 indicated the need for community participa
tion. Tills critical need is not yet realised. There
have been some sporadic unorganised ventures
which have been short jived. The dialogue between
the plannerand the consumer is lacking. Therefore,
the envisaged community participation in plan
ning, implementation and evaluation of health care
services is minimal.
Profession & Heart of the De/mitmenl of Community Medicine Dangalmv Medical College, lipngolmv - 560 M2.
fO________________________________________ _____ _____________________ _________________________
Broad Guidelines
Certain broad guidelines have been identified
in tlie National Health Policy. They arc:
1. Strengthen the health care services
2. Develop referral linkages
3. Restructure medical education
4. Exploit the potential of Traditional Sys
tems of Medicine
5. Promote action oriented health service
research
6. Develop Health Information System
7. Attempt Population stabilisation
8. Provide for environmental sanitation
9. Involve Non-Governmental
Organisations in health care delivery
10. Highlight the role of health education
11. Reform health legislation
Health Services: In older to make health care
services appropriate, the stress is on shifting the bias
from “somewhere to everywhere” by establishing a
network of services to reach the remotest of the
areas. This takes into consideration the population
density, topography, transport and priority criteria
like tribal, hilly and endemicareas. The curative bias
is shifted to comprehensive health care.
The lack of referral services leads to consumer
inconvenience, congestion at the specialist centres,
duplication and fragmentation of services which
add to the cost of the already constrained re
sources. Therefore, “Back-up support" is provided
for by establishing Community Health Centres
(CHC) with specialist services. Each CHC will be
catering to the needs of 4 to 5 Primary Health
Centres.
Critical analysis reveals that the above objec
tives are not yet realised though there has been
considerable expansion of health infrastructure.
Essential drugs are not yet available within one
kilometer walking distance. The ding policy is
topsy tuivy with a bias on the price line than tile
health needs. Control is still vested with Ministry of
Petroleum and Industries though drugs are critical
for health care needs. It shall rightfully be under the
Ministry of Health and Family Welfare.
Medical Education: Due to acculturation, the
Medical Education had been “Western oriented"
creating a "Culture gap” between the training and
health demands. The policy indicates a need for
restructuring the syllabi and revision of the training
programmes.
Health Service Research: In older to seek optimal
solutions to the existing problems, greater stress
has to be placed towards operations research.
Health Information System: Hard factual data
are needed for planning, evaluation and under
standing of epidemiological trends of diseases.
Monitoring and evaluation process would permit
“Midterm corrections” in the programmes and also
ring a timely warning bell in the event of emergence
of a new problem. This is how AIDS was delected
in U.S.A. Our reporting system needs revamping as
the data available are often incomplete and irrel
evant. The person who gathers the data and the one
who transmits i^are not oriented in the process and
the relevance of data generation. Further, there is
lack of “feed back” of data to the grass root level
though communication is one of the fundamental
principles of management.
Involvement of Traditional Systems of Medi
cine: A vast potential ofa vailable health manpow 11
already practising traditional system of medicine as
well as general practitioners of allopathic medicine
remain unexploited in the implementation of Na
tional Health Programmes. Their contribution is
neither recorded nor recognised. It is higli time this
manpower availability is exploited to draw them
into national health stream in order to achieve the
Goal of Health for All by 2000 A.D.
Voluntary Non-Govcrnmcnt Organisations
have contributed a lot towards community health
by extending their services to outreach areas.
educating the community; facilitating research;
sensitising Government about health needs of
community, e.g. Family Planning Programme was
first activited by the voluntary organisations. It is
indeed a welcome change that the Government is
now inviting Voluntary Organisations to extend
their role in National Health Programmes.
Health legislation needs to be reviewed and
revised to be relevant in context of the cunent
knowledge. It needs to be implemented uni
formly throughout the country because diseases
or health problems recognise no geographical
boundaries.
Health Ecluation: The unfortunate loss of limbs
and life is avoidable if the community is educated
about ways and means to prevent the same. People
have a right to information. The messages have to
be meaningful to promote self reliance. People
have to realise their rights, role and responsibilities
for their health care. Health education therefore
should be the foundation stone on which health
care services should be built.
The “Count Down 2000 A.D.” has already begun. It
is high time, therefore, that we critically review our
progress, remove the impediments and reinforce
our activities on war-fooling basis to convert the
cherished “dream” of National Health Policy into a
reality.
CURRENT HEALTH STATUS OF INDIA
♦ Dr. J.P.GUPTA
According to WHO, "the process of continu
ous progressive improvement of the health status
of a population reflects the health development of
the nation”. It is a product of raising of the level of
human well-being marked by containment of dis
eases and attainment of positive physical and
mental health related to satisfactory economic
functioning and social integration. It is based on the
fundamental principle that Governments have re
sponsibility of their people and simultaneously
people should have the tight as well as the duty,
individually or collectively, to participate in the
development of their own health.
REFORMULATED GLOBAL INDICATORS
The health status depends upon the overall
social and economic development of the country.
•
*
•
•
•
*
*
There are a number of indicators to gauge
health status of the community to the extent to
which the objectives and targets of a programme
are being attained.
Characteristics of indicators
The ideal indicators scientifically should be
Valid, Reliable, Sensitive, Specific and Quantifi
able. There is presently no available definition
(including WHO definition) coma ining all the ideal
indicators as criteria for measuring the health. Only
the measurement of health have been dubbed in
the frame work of illness, the consequences of ill
health (morbidity or disability) and economic,
occupational and domestic factors that promote ill
health.
*
Health is multidimensional and each dimen
sion is influenced by numerous factors (known or
unknown); thus the health status may cover the
following indicators:-
Mortality indicators, Morbidity indicators.
Nutritional status indicators, Health care delivery
indicators, Utilisation rates, Indicators of social and
mental health, Environmental indicators, Socio
economic indicators, Health Policy indicators, indi
catory of quality of life and other indicators.
■
•
•
•
Health for all is continuing to receive
endorsment as policy at the highest level.
Involving people in the implementation of
strategies with mechanisms fully functioning
or being further developed.
The percentage of gross national product
allotted for health.
Ute percentage of National Health Expendi
ture devoted to local health services.
Resources for Primary Health Care becoming
more equitably distributed.
The amount of International Aid received or
given for health.
The percentage of the population covered by
Primary Health Care, with alleast the follow
ing (a) Safe water in the home or with reasonable
access and adequate excreta disposal fa
cilities available.
(b) Immunization against Diphtheria, Teta
nus, Whooping-cough, Measles, Polio
myelitis and Tuberculosis.
(c) Local Health Services, including availabil
ity of essential drugs, within one hour’s
walk or travel.
(d) Attendance by itained personnel for preg
nancy and child birth and caring for
children upto alleast one year of age.
(e) The percentage of each element given for
all identifiable subgroups.
(f) The percentage of women of child-bear
ing age using Family Planning.
The percentage of newborns weighing at least
2500 grains at birth and the percentage of
children whose weight-for-age and/or weighlfor-height are acceptable.
The IMR, MMR and probability of dying be
fore the age of 5 years (U5MR), in all identifi
able subgroups.
Life expectancy at birth, by sex, in all identi
fiable subgroups.
The adult literacy rate, by sex, in all identifi
able subgroups.
The per capita Gross National Product.
Regional Director, Health & Family Welfare, Government of India, Bangalore.
fl
National Gioals of Health
(Source: National Health Policy Document)
GOAI.S
ACHIVEMENT
60
80 (1990 - prov.)
UNDER - 5 MORTALITY
(per 1000 live births)
70
146 (1990)
MATERNAL MORTALITY
(per lakh birth)
200
400 (1990)
PERINATAL MORTALITY
30-35
50.1 (1987)
•
CRUDE DEATH RATE (combined)
9/1.000
9.6 (1990-prov.)
'
CRUDE BIRTH RATE (combined)
21/1000
29.9 (1990-prov.)
••
EFFECTIVE CPR
60%
44.1 (1991-prov.)
©
N.R.R.
1.0
1.6 (1981)
2.3
4.1
1.2
2.11 (1991)
(source Census
Report 1991)
@% NEWBORN WITH 2500 Gms
Birth Weight
10%
30% (1990)
@% OF ANTENATAL CARE
100%
40-50%
@% DELIVERIES BY TBA
100%
40.5% (1987)
•
INFANT MORTALITY RATE
(combined)
(per 1000 live births)
©0 FAMILY SIZE (Rural &
Urban combined)
©
EXPONENTAL ANN GR.RATE
•
(1987)
••
IMMUNIZATION - TT (PW)
IT School Children
DPT
POLIO
BCG
DT
100%
100%
100%
100%
100%
85%
79% (1991)
55.6% (1989)
82% (1990)
82% (1990)
89% (1990)
80% (1990)
••
MEASLES
100%
90.1% (1991)
Other Indicators
(Source: National Health Policy Document)
GOALS
ACHIEVEMENT
UFE EXPECTANCY AT BIRTH
(persons)
64.0-
59-0 (1990)
©0 LEPROSY (% of Disease
arrested out of those
detected)
100%
55% (1989)
0© T.B. (% of Disease
arrested out of those
detected)
75%
65% (1989)
0.3
0.7 (1990)
@0 INCIDENCE OF BLINDNESS (%)
Female Literacy (1991) ” 39-4
0% of children suffering from
underweight (0-4 yrs.)
(By Comez - 8 States)
Moderate & severe
severe
©
0
Average index of food production
per capita (1979-81 - 100)
= 61 (1980-91)
= 9 (1980-91)
- 118 (1990)
Daily per capita calorie
supply as % of requirements
(1988)
= 95
O% of household income (1980-85)
Spent on - All foods
Cereals
= 52
= 18
0% of population with access to
safe water (1989-90)
Total
Urban
Rural
- 75
= 79
= 73
©
O.R.T. use rate 91987-89)
- 13
0
GNP per capita (in US$) (1989)
- 340
SOURCES *
- SRS Report 1990
©
- The State of the World’s Children 1992 - UNICEF
**
- MCH&FW Quarterly report
00 - 2nd Evaluation - Countiy report on strategies for Health for all by the year 2000-1991-
Level of achievement of some norms
All India position as on 30.09.1991
SI.
No.
1
I’aramctcrs/indicators
National
Norms ,
Norms achieved/
established
(Approximate)
3
4
3000-5000 Pop.
4576
2
1.
Population covered by a Sub-centre
2.
Population covered by a PHC
20,000-30,000 Pop.
27168
3.
Population covered by a
Community Health Centre
About 1 lakh Pop.
3.10 lakhs
4.
No. of Sub-centres for each PHC
6 sub-centres
6.0 sub-centres
5.
No. of Primary Health Centres
for each Community Health Centre
4 PHCs
11.4 PHCs
6.
Trained Village Health Guide
One for each
Village/1000
Population
1.42 Village/VHG
1442 Population/VHG
7.
Trained Dai
Atleast one for
each village
1.00 Villages
1002 population
8.
Population served by
Health Workers (Male and Female)
M:3OOO-5OOO
F:3000-5000
7632
4953
9.
Ratio of HA(M):HW(M)
1:6
1:3.4
10.
Ratio of HA(F):HW(F)
1:6
1:5.4
11.
Average area covered by Sub-centre
-
24.00 Sq.km.
12.
Average Area covered by a PHC
-
142.45 Sq.km.
13.
Average area covered by a CHC
-
1626.93 Sq.km.
14.
Max.radia distance covered
by a PHC (in km.)
-
6.73 km.
Max.radial distance covered
by a Sub-centre (in km.)
-
2.76 km.
Max.radial distance covered
by a CHC (in km.)
-
22.81 km.
Average number of villages
covered by a Sub-Centre
-
4-5
Average number of villages
covered.by a PHC
-
26-27
15.
16.
17.
17.
19.
Average number of villages
(Covered by a CHC
304
Source: Quarterly Bulletin on Hural Health Statistics - Sept. 199115
Hcakk Infrastruciurc
- As on
A.
Total
functioning
Sub-Centres
130983
PHCs
22065
CHCs
1932
B.
In Govt
Building
51985
(39.7%)
12500
(56.6%)
1179
(61.0%)
71093
(54.3%)
8176
(37.0%)
469
(24.3%)
7905
1389
284
No. of PHCs & Sub-centres required and in position in Tribal Area -
- 776.84 lakhs
- 403.02 lakhs
= 3507
- 3198 (91.2%)
» Total Population in TSP Area
- Total Population in Tribal pocket
« Total PHCs required for Tribal Area
- Total PHCs in position in Tribal Area
- Total Sub-Centres required in Tribal Area
= Total Sub-Centres in position in Tribal Area
C.
Building
to be constructed.
Building
under construction
- 23586
» 18996 (.80.5'Ji.)
Primary Health Centres with or without Doctors -
(Information available for 10787 PHCs (18.9% only)
= PHCs with 4 or more Doctors
- PHCs with 3 Doctors
- PHCs with 2 Doctors
- PHCs with 1 Doctor
« PHCs without Doctors
- 427
- 450
= 3875
= 5048
= 987
D.
= PHCs without Lab. Technician
- PHCs without Pharmacist
" 3787
-311
E.
Total No. of ANM Schools
= ANM admission capacity
= Total No. of LHV promotional schools
- ANM admission capacity
= 476
= 20337
® 46
" 3863
F.
- Total Dais trained since inception
- (as on 30-9-91)
- Village Health Guide Scheme
- PHCs covered under VHG Scheme
- Villages covered under VHG Scheme
(including 948 AHGs)
- No. of working VHGs
G.
" 597761
= 4220
= 531009
= 335590
- Medical Care Statistics - As on 1-1-1990
(Source - Health Information India - 1990)
*- No. of Hospitals
- No. of beds
- No. of Dispensaries
- No. of Beds
Total
Rural
Urban
3167
95722
12747
13642
7005
10172
5(X>768
602490
15557
9286
28304
2’928
II.
I.
" Disabled Population (as per 1981 Census report)
- Disabled persons in Rural Area
- Disabled person In Urban Area
- Total Disabled person
- 969401
- 149547
- 1 1 IHU-iH
- Percentage of Population I>el<nv poverty line (1987-88 Prov.)
(Source - Health Information India - J99O)
- Rural
" 32.66%
- Combined
= 29.23%
HEALTH MAN POWER IN RURAL AREAS -
J.
Category
No.Sanctlonetl
1.
Surgeons
914
2.
Obs. & Gyn.
3.
Physicians
4.
5.
No. in
Position
Vacant
('•/..)
676
26.1
627
362
42.4
535
406
24.2
Paediatricians
512
274
16 i
Doctors al PI ICs
25062
21278
15.1
6.
Block Extn. Educators
6154
57<>3
6.4
7.
Health Asstts. (Male)
24891
23273
65
8.
Health Worker (Male)/MPW
86713
78538
9.4
9.
Health Asstts. (Fein)/LHVs
25044
22282
1 l.l
10.
Health Workers (Fem)ZANMs
132449
121016
8.7
11.
Pharmacists
19172
17578
8.1
12.
Lab. Technicians
10189
8629
15.4
13.
Nurses Mid-wives
13790
119<>9
133
14.
Radiographer
658
509
22.7
Total category 1 to 4
2588
1718
33.6
Total of category (5 to 14)
344122
310835
9.7
Grand total of all (1-14)
346710
312553
9.9
PERCENTAGE OF GROSS NATIONAL PRODUCT SPENT ON HEAl TIT Estimation of total expenditure on Health and Family Welfare have been taken into consideration on the
following basis
(1)
Expenditure of Ministry oil lealth and Family Welfare (Centre and State - both plan and Non-plan)
(2)
Expenditure on I lealth and Family Welfare by other Government Departments (except Defence.
Paramilitary Forces, Local bodies and P & '1' etc - since data are not available).
(3)
For estimating private expenditure on 1 lealth and Family Wei la re. the basic assumption is that the
private expenditure is double the amount of Public Sector Expenditure (on the hums ol National
Sample Survey findings).
The findings arc -
(A)
During Sixth and Seventh Plan the total expenditure on Health and Family Welfare (from
Departments of Health and Family Welfare of Stales, UTs. and Centre only) as percentage o:\iNP
is between the rate of 0.98% (1986-87) to 1.32% (1984-85)
For year 1984-85
x 100
GNP
Rs.3018,36 Crores
Rs.228,118 Crores
x 100
- 1.32%
(5b/mce - Planning Commission)
(B)
As percentage of HNP, the total public sector expenditure (as per above information) has rem...
within the tango of 1.32% (1984-85) and 1.07% (1986-87).
(C)
The total expenditure on Health and Family Welfare including the Private Sectoi is within tin i mt,.
of 4.08% (1984-85) to 3-2% (in 1986-87).
PERCENTAGE OF NATIONAL HEALTH EXPENDITURE ON LOCAL HEALTH SERVR ES
Only outlays of Minimum Need Programmes (below district level) has been considered. I lieu
following figures are not showing realistic picture - rather it is an under estimate -
ti.
For 1985 - 1990
National Health Expenditure elevated
=
iQ.local services
x 100
National Health Expenditure
(including F.W.)
Rs. 1063 Crores
x 100 - 42.6%
Rs. 2495 Crores
(.Source - Planning Commission)
(It excludes Central Health outlay ofRs. 897 crores, Family Welfare on Ha j> of Rs. .1256 cron
outlaysfor National Ilea!th Program nies - because expenditure below district lerel isiiot anailable).
NATIONAL HEALTH POLICY
—VIEW POINT OF GOVERNMENT OF KARNATAKA
* Dr. C.R.Krishnamurthy
HEALTH CARE SERVICES - KARNATAKA GOVERNMENT
The health status of Karnataka (by almost all health
indices) is better than the national average. How
ever much more needs to be done to improve the
health of the people. The infant mortality rate is
unacceptably high, by itself and compared to the
neighbouring skates of Kerala and Goa. The mater
nal mortality rate, percentage of newborn with low
birth weight, percentage of malnourished children
and women with anaemia are all indices which
need marked improvement. The disease profiles
show large numbers of the people affected by
controllable infectious diseases, including pulmo
nary tuberculosis, acute respiratory diseases, gastro
intestinal diseases, malaria and others. There are
districts with high prevalence of leprosy. Kyasonur
Forest Disease is seen in Shimoga and neighbouring
districts.
The Department of Health and Family Welfare
Services provide the following Health care services
through:
1. Rural Health component of minimum needs
programme
2. Medical Development programme
3. Family Welfare programmes
- FP, MCH, Immunization, ORT, ARI, CSSM
Programmes
4. N.M.E.P. and N.F.F.C.P. (Malaria/Filaria)
5. National Leprosy Eradiantion programme
6. National Tuberculosis control programme
7. National programme for control of Blindness
8. Prevention and control of other communi
cable diseases like :
Diarrhoeal diseases, KFD, IE, AIDS, Etc..
9. School Health Programme
10. Nutrition programme - Nutrition education
and demonstration
11. Laboratory services and vaccine production
units
12. Education on Environmental Sanitation
13. Curative Services.
Health and Medical Institutions
(Govt. only) in Karnataka
AS ON 31.3.1991
1.
2.
3.
4.
5.
6.
No. of Hospitals
No. of Community Health Centres Including upgraded PHC’s
Taluk level
.•
Below Taluk level
No. of PHC’s upgraded
Taluk level
Below Taluk level
No. of Primary Health Centres
No. of Primary Health Units
Total No. of Institutions
Total No. of Beds
-
176
160
129
31
48
36
12
1,198
626
2000
31,434
-
134
276
578
210
217
Number of Sub-centres (District wise) as on 31.3.1991
Bangalore Urban
Bangalore Rural
Belgaum
Be/llary
Bidar
.
Additional Director (Family Welfare & MCH),
Government ofKarnataka, Bangalore.
of Health £ Family Welfare Se/rices.
<9
Bijapur
Chickmagalur
ChiLradurga
Dakshina Kannada
Dharwad
Gulbarga
Hassan
Kodagu
Kolar
Mandya
Mysore
Raichur
Shimoga
Tumkur
Ultara Kannada
Total (Karnataka)
420
328
44 1
692
571
467
450
158
r
359
364
672
348
365
404
302
=7,793 Sub-centres
Bed strength in District Hospitals as on 31.3.1991
District Hospital
Bed
Strength
Bidar
Bijapur
Chitradurga
SC Hospital
Hassan
Dharwad
Chickmagalur
Karwar
Mandya
SNR Hospital
Kolar
Raichur
Tumkur
MC Gann Hospital
Shimoga
Madikeri
283
316
405
344
170
279
170
250
260
183
325
429
410
3,824
Total
Bed strength in Major Hospitals, specialised services Hospital and E D Hospitals in
Karnataka as on 31.3.1991
1.
2.
3.
4.
5.
6.
7.
Major Hospital Strength
Bed
General Hospital, Jayanagar, Bangalore
HSIS Women & Children Hospital, Bangalore
K.C.General Hospital, Bangalore
Women & Children Hospital, Chickmagalur
Women & Children Hospital, Madikeri
General Hospital, KGF
Women & Children Hospital, K G F
200
120
433
88
210
110
65
Specialised Services Hospitals
1. t Leprosy Hospital, Bangalore
2.
T B Hospital, Old Madras Road, Bangalore
3T B Hospital, Bijapur
4.
T B Hospital, Madshedde (DK)
5Mental Hospital, Dharwad
20
260
234
no
100
375
6.
7.
8.
MGM TB Hospital, Malla samudra (Gadag)
Dharwad District
KNTB Hospital, Kolar
TB Hospital, Mandya
^4
62/|
.
ED Hospitals
1.
2.
3.
Epidemic Disease Hospital, Bangalore
Epidemic Disease Hospital, KG F
Epidemic Disease Hospital, Mysore
128
24
40
Specialised Hospitals and Institutions
A.
Specialised Hospitals as on 31.3-1991
1.
2.
34.
5.
6.
7.
8.
Minto Opthalmic Hospital
T B Hospitals
Leprosy Hospitals
Mental Hospitals
Cancer Hospitals
Sri Jayadeva Institute of Cardiology
Sanjay Gandhi Institute of Accident,
Rehabilitation and Physical medicine
Epidemic Disease Hospitals
B.
Specialised Institutions like Clinics, Centres, Units etc as on 31-1-1991
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
Central Malaria laboratory
Drug distribution centres (DDC’s)
Fever Treatment Depats
Urban malaria centres
Filaria Survey Cell
Filaria clinics
Filaria control units
Virus Diagnostic laboratory, Shlmoga
KFD Trial vaccine unit, Shhnoga
,
Cholera combat Teams
Mobile Ophthalmic - cum - Dental units
Divisional Mobile Ophthalmic Units
District Mobile Ophthalmic units
Eye banks - 4
15. Lady Willington State TB demonstration centre
16. District TB Centres
17. District Leprosy offices
18. Urban Leprosy centres
19. Leprosy control centres
20. Modified leprosy control units
21. Survey, Education & Treatment (SET) Centres
22. Epidemiological surveillance team
23. Sample survey - cum - assessment units
24. Temporary Hospitalisation wards (20 Bedded) Leprosy
25Reconstructive Surgery units-Leprosy
■26.
Model Leprosy control centres
27.
Leprosy Rehabilitation promotion units
28.
Voluntary Organisations
29- * Mobile Nutrition Education and Demonstration units
30. Public Health Institute, Bangalore
31. Divisional Food Laboratories
32. District Laboratores
33. Regional Assistant chemical exazminers laboratories
"13
'2
'2
•3
■ 1
- 2282
-4180
*8
■1
"
'6
■ 1
- 1
■ 5
-4
-4
■6
"3 (.Govt)
- 1 (Private)
- 1
' -" 20
*
" 30
' 1-677
- 22
"6
■3
' “2
-5
' 1
'4
'
-9
34.
35.
36.
37.
Vaccine Institute, Belgaum
Hospital Pharmacies
Sexually Transmitted Disease Clinics
Psychaitric clinics
38.
39-
Bums Wards
Blood Banks - 60
- 1
- 17
- 26
- 127 +
(4 mobile Ophtholmic-cumDcntal Clinics)
-6
- 34 (Govt)
- 2 (Autonomous)
- 19 (Private)
- 5 (Voluntary)
HEALTH FACILITIES INDICES - KARNATAKA
(Government 199'1 Census Population)
1.
2.
3.
4.
5.
- 1:22409
- 1:1426
Institution: Population Patio
Bed: Population Ratio
Doctor: Population Ratio
excluding Teaching Staff
including Teaching Staff
Auxilary Nurse Midwife/
Midwife Population Ratio
NURSE: BED RATIO
- 1:10256
- 1:8335
- 1:4905
- 1:8
All Hcaldi and Medical Institutions in the State:
1. Institution: Population Ratio
2.
- 1:19276
- 1:957
Bed: Population Ratio
TRAINING FACILITIES IN KARNATAKA
Name of Course
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
1314.
15.
16.
17.
18.
No. of Institutions
Health & F.W. Training Centre
- orientation training for Fresh Medical graduate of Health
- Supervisory training for Health Assts. (M/F)
Basic M.P.W. training course for Male
- Training of BHE’s in communication
Leprosy Training Centres for Para Medical Staff
Health Inspectors Training Coutse
Promotional L.H.V. Training for Sr.H.A.(F)
A.N.M. Training (M.P.W.) Training for Female
Condensed general Nursing Course
I/tb. Technician training Course
Lab. Technician Training Course Jr.
X-ray Technician Training Course
Dental Mechanic and Dental Hygienist training course
General staff Nurses training
Basic B.Sc., Nursing
Basic Nursing Post-certificate Coutse
Ophthalmic Asst./Refractionist Training Course
Orthoptists/Refractionists and opticians training
Food Inspectors Training Coutse
tontinued education for
Medical Officers
Sr. H.A. (M/F)
Jr. H.A. (M/F)
5
5
Duration
1
2 weeks
12 days
12 months
2 weeks
4 months
12 months
6 months
18 months
12 months
12 months
12 months
12 months
12 months
42 months
48 months
24 months
24 months
24 months
24 months
4
5
5
2 weeks
2 weeks
2 weeks
5
5
4
4
7
4
19
2
1
4
6
1
9
1
1
4
1
FAMILY WELFARE FACILITIES KARNATAKA
Nos.
1
20
I. .Sene Family Welfare Bureau
2. District P.WS. Bureau
'3.
City I'.W. Bureau
2
4. City I'.W. Bureau
a. Government - 46
b. Local bodies - 27
c. Voluntary organisations - 26
d. Public sector undertakings - 3
5. Rural I'.W. Centres
6. Post partum Centres
a. - Type’A’ -12
b. - Type ‘B’ - 10
c. - Type 'C’ - 6
<1. -Sub District level PPC - 75
7. Medical Termination of pregnancy
< iovernmcnl - 325
Private - 145
8. SUB CENTRES 7,793
102
Hospitals attached to these Medical Colleges pro
vide clinical facilities for students.
INDIAN SYSTEMS OF MEDICINE NIIOMEOPATHY
lite Department of Indian Systems of Medicine and
I lomeopathy is headed by the Director of Indian
systems of Medicine and I lomeopathy.
269
103
470
At the District level, District Health &• I'.W. Officer
of the Department of I lealih & I'.W. Services is the
Administrative controlled for the dispensaries of
Indian Systems of Medicine and I lomeopathy
There are 6 Govt. Colleges and 14 Private colleges
and 23 Govt Hospitals with total bed strength ol
750. There are 411 Dispensaries functioning in the
state.
There are 12 Ayurvedic Hospitals in the state-
DEPARTMENT OF MEDICAL
EDUCATION
l ite Director of Medical Education is incharge of
Medical Education and Nursing education includ
ing Teaching Hospitals attached to Medical col
leges in the state.
There are 19 Medical Colleges in the state
I. Govt. Medianl College
- 4
ii. Private Medical Colleges - 15
There are 13 Dental Colleges
i. Govt. Dental College
ii. Private Dental College
- 1
- 12
- College of Nursing - one (Govt); two (Private)
- Schools of Nursing - 23
i. Govt.
9
ii. Private - 14
7 Ayurvedic Hospitals at District level (3 I lospitals
are teaching Hospitals)
5 Hospitals render service, in rural areas.
Ayurvedic Dispensaries :
364
Unani Hospitals : 4; Unani dispensaries :
32
Homeopathic Hospitals :
2
Bangalore
1
Somwarpet (Coorg)
1
1 lomcopathic dispensaries ;
it)
Nature Cure Hospital
1
Nature Cure Hospital :
5
Yoga wings have been established to provide voga
therapy in Hospitals at Bangalore. Mysore and
Bell ary
A Sidha wing has been provided in Institute ol
Indian systems of Medicine, Bangalore
INSTI TUTIONS IN TOE STATE AS ON 31.3.1991
Systems
No. of Hospitals
No. of Beds
No. of Dispensaries
1.
2.
Ayurveda
12
573
UNANI
4
111
3.
1 lomeopathy
2
4.
5.
6.
Sidha
Yoga
1
35
10
364
32
10
3
15
Naturopathy
1
(>
Total
23
750
41 1
No. or Ayurvedic colleges :
Govt.
-3
Private - 6
No. ol Nature Cure Colleges
Govt.
- 1
Private - 1
No. of Homeopathic colleges
Govt.
- 1
Private - 7
Training programme for Nurses
1
Training programme for Pharmacist •
Ayurveda - 1
Unani
- I
No. of UNANI Colleges
Govt.
- 1
Govt. Central Pharmacy - 1
NATIONAL HEALTH POLICY STATEMENT
-VIEW POINT OF VOLUNTARY AGENCIES
• Dr. Shirdi Prasad Tckur
The Government of India’s National Health Policy
Statement 1982 recognises the importance of com
munity participation and its role and relationship
with voluntary agencies in the following areas a)
b)
c)
d)
e)
for identification of health needs and
priorities, as well as in the implementa
tion and management of various health
and related programmes. (P-4)
for providing universal comprehensive
primary health care services relevant to
the actual needs and priorities at a cost
which the people can afford, ensuring
that the planning and implementation of
the various health programme is through
the organised involvementand participa
tion of the community, adequately
utilising the seivices being rendered by
private voluntary organisations active in
the health sector. (P-4)
at the community level, to devise ar
rangements for health and all other de
velopmental activities to be co-ordinated
under an integrated programme of rural
development. (P-17)
for offering organised logistica 1, financial
and technical support to voluntary agen
cies, while adequately utilising and en
larging the seivices rendered by them,
and intermeshing it with governmental
efforts in an integrated manner, espe
cially for those which seek to seivc the
needs of rural areas and urban slums (P6, 9, 10)
for initiating organised measures to en
able development of various indigenous
and other systems of medicine and a
phased integration in the overall health
care delivery system, specially in regards
to preventive, promotive and public health
objectives. (P-10, 11)
The policy clearly enunciates what is desirable. It
also calls for
decentralisation of services like MCI I s_.
vices to the maximum possible extent (P-1 i
efforts to establish herbal gardens and en
courage low-cost, indigenous herbal medi
cine which is easily available and of certifies’
quality (P-15); and
for mobilising additional resources for he:: I ..
promotion, ensuring that the community
shares the costs of the seivices (P-16)
All these, for providing adequate care and ire,.'
ment to those entitled to free care. (P-9)
The policy refrains from providing advice on how
this can be done, beyond the pointers it puts ....
Tills gives us a wonderful opportunity to initial
measures to
take into account local realities in the area oi
health and development;
understand peoples' priorities in health an :
the reasons thereof; and
consider a vailable resourcesand constraints.
while designing a flexible process suitable
for implementation.
Voluntary agencies and their federations have been
interacting with the Government of Karnataka at
meetings and workshops at various levels, and
different limes, initiated both by the voluntary
agencies as well as the government. Our experi
ence in Karnataka in the last 5 years has shown ti.:.<
with adequate openness and enthusiasm on both
sides, ihis is a creative possibility and can be
operationalised. Even though this may not have
brought any miracles in Karnataka as yet, the stage
is set fora close and meaningful collaborate e cl ion
in the decade ahead. Some aspects of this collabo
ration are:
1.
The formation of a Consultative Committee
by the Ministry of Rural Development and
Social Welfare comprising of Secretaries ol
all key government departments and rep:
sentatives of NGOs in Community Dex elopment, Education & I leallh. This was formed
‘ Community Health Cell, 326, V Main Road, I Block, Kot amangala, Bangalore -56003d.
ai the initiative of the Planning Commission
and lias been sustained by tlie enthusiasm of
a series of Development Commissioners and
Rural Development Secretaries.
The Consultative Committee has sub-committees including one on Health ip which
NGO’s dialogue with the Director df Health
Services and his colleagues orr health
programmes.
2.
Dialogue of NGO’s with Perspective Plan
ning Committee of Government of Kama taka
on Health, Welfare and Educational
Programme.
3.
Dialogue with NGO’s by Director of Health
Services at various levels.
a) Sub-committee of consultative commit
tee.
b) 8th Plan document preparation
c) Dialogue on government programmes
organised by Voluntary Health Associa
tion of Karnataka.
4.
Steps to prepare a comprehensive directory.
5.
Steps to increase such dialogue at the district
level.
6.
Exploration of collaborative efforts.
as isst|e-]-.|jsers, dcpiand creators, builders < it
awnrenossqiKl alternative plannersare largely
Ignored if not also seen as threats to the
Government plans.
p)
Jl jngores [jie feedback and the elaborate
process (lie voluntary agency initiates to
phng about peoples participation, since it
(gay mean modification of plans to suit
peoples' necc|s,
d)
■pie Government tends to off-load many of
its responsibilities on to voluntary agencies.
and puts demands and pressures beyond
voluntary agency resources and capabilities
without adequate support. The top-down
planning npd issue of operation guidelines
stifle voluntary agency innovations and cre
ative approaches. Also, vertical programmes
and focus on selective primary health care
programmes are at the cost of comprehen
sive primary health care.
0)
The people’s image of the P.II.C. and Gov
ernment Health.staff is very poor. Corrup
tion, inefficiency, political interference and
mismanagement are seen to hold sway. They
are unhappy with the functioning, altitudes,
and quality ofsetvicesat Government Health
Centres.
The key process in all this is frank discussion,
feedback from grassroots and mutual consultation
in a non-threatening, interactive ethos and a gen
eral commitment to exploring the idea of working
together.
The voluntary agency plea to tone up the
existing governmental system anti bring in
greater accountability as well as qualitative
improvement In their services is largely ig
nored.
At this juncture, a purposefully critical collection of
impressions of voluntary agencies in their interac
tions with the Government are called for to under
stand the varying levels of success in the process of
Government - Voluntary agency collaboration.
a)
Pariticipation sought of Voluntary Agencies
in government initiated meets are at very
short notice, on matters which have been
already decided upon and more for pur
poses of form than actual concern. Also,
when government officials attend Voluntary
agencies sponsored meets,, the response is
desultoiy, condescending and defensive if
at all.
t
b)
Voluntary agencies are seen by the govern
ment as only alternative service providers or
associates for implementation of their
programmes. The voluntary agency’s roles
Tlie Government's understanding ip that
Involvement of Voluntary agency's repre
sentatives ip consultation automatically
jpeans ‘peoples Involvement’ or'community
A fall-out of this was seen in the negative
experiences of the government health ser
vices, with the Pnnchayat Raj system.
The Governmental Health Services has also
been pre-occppied for loo long in Infra
structural development, resulting in mere
structures and no useful function.
; p
There has been no change in the
Goveniment’s perceptions about people
working outside the system (.NGOs/Volags)
or about peoples' capabilities In planning
and implementation of programmes.
The VIII.ig/.- I li-alth Workvr::, I li-alth Guide.-;,
Anganwadl workers and oilier;: ■ •.■' ... ..ere
possibilities in peoples' parlicij.uilon have
been co-opted by the system and become
lackeys in the governmental process, de
manding recognition, more salaries, ; -. ,ks,
etc.,
that .’.upplemendng pai li-'lp.illi‘ii wiili ■■•hi
cation i Holts coo..’ . Ireiiglhen building ol
health communities.
c)
people.-;’ percepuims of the working ol
projects and programmes o: their own re
sponses lo problems must be seen as equally
important as statistlcal/profcssional/tecl- .
cal situation analysis. This can be .-■.ought for
by informal focus group discussions rather
than formal surveys. When faits an- placed
before people, in an understandable mantlet.
it is seen that cducaiion/tvchnical expertise
is not a preco.i.lilion to evolve inrmvaii.c
solutions. These methodologies used by
Voluntary agencies in their work can easily
be . :,..rcd with governmental agencies.
d)
Increasing Involvement of Vphmiary
Diversity of local culture and uaditions and
respect for it have never been a siting in
Governmental bureaucratic processes. So have
the traditional and indigenous systems of
health caresuffercdand failed to be recognised
for their potential in the domic- nee of the
Allopathic approach to health care.
Is it any wonder, then,
that people do not participate as much as
desired?
agency secti >r In the r< >l>- ol m< mil< a.-, evalu
ators, issue mlsots, demand < n-alots and
trainers ami not just
progiamme
implementors'.
- that privatisation and commercialisation ol
medical services Is die norm?
- dial people have to take up the call for
national Drug and Technology policies?
and
Itcoricntatlon programmes for stall at all
e)
levels of the existing infrastructure about this
alternate concept of people as participants.
where voluntary agencies could share lite
approaches they adopt.
- that Health policies designed for the poor
and marginalised do not reach them?
If community participation as envisaged in
the National I Icallh Policy is to make an
Impact on peoples' health, it needs to in
clude processes dial enhance the following:
f>
Monitoring and record-keeping systems
that arc not only quantitative. I ml a iso quali
tative and allow feedback from people and
from lower level functionaries of tl-v system
who are in closer contact with the people.
I lii- motivation of health stall at da- Imvri
levels is al a low ebb as they face prat tnal
difficulties in their work with people, -.\ hit li
they do not seem to have, the required
continuing education and support to ileal
with effectively. Voluntary agencies timid
help re-orienting them.
Information tfansferand:i'"'e re ties build
ing programmes for the people - prob
ably die most important and credible step,
considering that tills Is die weakest link of
the present system.
People need to know the whys and hows of
each programme, and also to discuss them to
explore Ideas of how to do them better.
Voluntary agencies have something Io offer
to the Government in ways of Interacting
with the community as well as creative lowcost communication, which considers people
as participants-in a process of development
rather than ‘target-groups’ or 'beneficiaries'.
Understanding that people are not a
homogenous mass, and arc stratified by
class, caste, education, culture, gender
and other factors. Positive discrimination
towards groups who do not benefit from
existing programmes, because they do not
participate. In local decision making should
be a focus. Voluntary agencies have experi
ence in working with such group-; and I Ind
•
Ail these call for moving awav from top
down models to more deccntr.Hl.svd ami
flexible approaches to the ..liwisity of <>p
lions likely to emerge. We can share the
positive and negative experiences of both
Government and Voluntary agency efforts
especially in the past two decades, learn
from each other and evolve more effective
methods towards health.
To conclude, we have
a positive approach to the National Health
Policy,
an opportunity to make ouraj-pr;inches llextl >le
to meet -oples' needs,
a rich experience between ns to learn from, and,
in Karnataka, a healthy trend of collaboration.
Let us make use of these and get down to making
I 1EALTI 1FOR ALL by 2000 A.D. a reality in Karnataka.
REFERENCES
1.
Statement on National Health Policy - Gov
ernment of India, Ministry of Health & Fam
ily Welfare - 1982.
2.
Perspectives in I lealth Policy and Strategics
lot the State of Karnataka - a response from
Cl IG - Bangalore.
3.
People's Invol vent' in in Pianningand Imple
mentation Ptocess - a CHC's response to
Planning Commission Initiative
zl.
Beyond Policy Rhetoric, Statistics and
Infrastructural Development : The (asks loi
the 1990's - A working paper from Cl IC lor
the Regional Review meeting on Primary
I lealth Care System Development for South
ern Zone.
Specific comments on Perspective Plan lor
Karnataka - drawn up lor Department oi
Health and Family Welfare
r . i es
Karnataka.
Perspective Planning in Health Ar p.-rt
the Expert group of perspective planning.
sei up b\ the G overt! me nt of Karnataka
Buil'linelhe Nev. P-uadigm- X.'lurly lv Ik
n< »n- \ciion expcnim. i>i tn Ci>mm> ini'y 11- ail >
in India - Cl IC
Towards a People-1 ’limited Alternati
I lealth c’lie System - Pi i tin.'van
On average, the governments of the
developing world are devoting only
about 10% of their budgets to
meeting the basic needs of their
people. More is still being spent on
the military and debt servicing than
on health and education.
28
VIEW OF PEOPLES’ REPRESENTATIVES
IN NATIONAL HEALTH POL,ICY
• Dr.M.V.Kulkariii
*• Dr.G.N.Prabhakara
INTRODUCTION
They should recommend the Government encoui
aging and ensuring their participation.
The character for India's Socio-Economic Develop
ment through specific programmes, as a Health
Policy was approved in 1983 by Parliament, laying
greater stress on MCH care following targets by
2000 A.D. were fixed.
Small political units or communities can take car.of ‘Whole Person's needs' rather than a Govern
ment which take compartmentalised bureau .ra;.-.
activities.
I.M.R.
Perinatal Mortality Rale
Pre-School child mortality
(1-5 years)
M.M.R.
Babies with Birth weight
below 2500 g
Birth rale
Family size
ANC to pregnant women
Deliveries by TBA
Immunization
- below 60
- 30-35
- 10
- Below 2
2.
The Fundamental policies for health that are to bconsidered are as follows:
I.
Health is a light and is a social goal
- 10%
- 21
- 2.3
- 100%
- 100%
- 100%
We have seen integration of Family Planning with
other sector and also a change in the Organisations
pattern of MCH & FP Seivices, both in Rural and
Urban areas. Training of Dais, ICDS and U1P have
been best examples of effort in this regards.
People’s Representatives’ main objection has been
that NHP never takes Social Justice and only talks
about poverty alleviation and health care. Further,
they are also of opinion that there is no spirit of
partnership by agencies.
People have the right and duty to participate in the
process for the improvement and maintenance of
their health.
FUNDAMENTAL POLICY
2.
3.
Inequality in I Icaltli is a concern.
Peopleshould participate in planningand
implementing Health care.
4.
Government is responsible for adequate
health of people.
Self reliance is possible by peoples' active
participation
5.
6.
Intersectoral co-ordination is the back
bone.
7.
Utilisation of a vailable resources loi health.
3.
ELEMENTS TO BE CONSIDERED
The elements that are to be mentioned for the
people’s Representative are:
1. Awareness of health problems
2.
Means to solve health problems
3.
4.
Safe water, sanitary latrines affordable by
the people
Providing rural quota to rural instead of to
an Urban area
Dia: 1
Appropriate Planning
Starts with people
Professor and Head of tbe Department
Lecturer, Depanment of Preventive and Social Medicine, Government Medical College, MYSOIll:.
___________________________ _ _______ —----------------------------------------- ----------------------------- --- 29
5.
Legislative support, gathering lor above
b)
No aminities for safe water and sanitation
items there is a need of more sub-centres.
c>
community health cent res, Trained I lealth
guides and trained Dais.
Over reliance on Mass Media is becoming
dangerous
cl)
Poor education becoming carrier for
utilisation of knowledge.
Involvement of all category of People’s Represen
tatives from the existing Infrastructure have been
there from time immemorial. These ate (a) Corpo
ration (,b)Muncipality(.c) Boards (d) Village Panchyat
(e) Mandal Panchyat (f) Zilla Parishat (g) Religious
Bodies (If) Co-operative bodies (i) District Health
and F.W. Offices (j) Director of 1 lealth and Family
Welfare (k) State Ministry (I) Union Ministry (m)
Voluntary Health Organisation.
People representatives should have a note of the
following elemental ies
1.
All people in every country will have at
least readv access to essential health care
and to first level refcra) facilities.
2.
All People will be actively involved in
caring for themselves and for their fami
lies as far as they can and in community
action lor health
3.
People shall share responsibility with Gov
ernment for health care of their members.
4.
Government should assure overall re
sponsibility for health of their people.
5.
Safe drinking water and sanitation facili
ties will be available to all.
6.
All people to be adequately nourished.
7.
All children and pregnant mothers to get
immunised
8.
Communicable diseases shall no more be
a public health problem.
9.
Look into non communicable diseases
and Mental I lealth by controlling life style
and psychosocial environment.
10.
Availability of essential drugs.
Successful pursuit of health policy will depend on
the authority being responsible for it, on behalf of
Government. Al present those are (a) Ministry (l>)
Directorate (c) Corporation and Municipality (d)
Zilla Parishat at different levels, Here ensuring
political commitment is to channelling health ac
tivities to the people.
4. EXISTING PROBLEMS IN HIE AREA
Our great problems is not that of promoting the
pursuit of new knowledge, it is the suitability and
adaptability of existing structure and functioning of
Health Services at large that mallets in Health for
All.
It is still being observed that —
a)
Raising cost of Medical Treatment
30
A)
PROBLEMS IN APPROACH:
-lACKOl'CLI'ARNA I K 1NAI.I IEAI.TI I P< JI.ICY
• POOR LINKAGE OF HEALTH SERVICES
WITH OTHER NATIONAL DEVELOPMENT
- LACK OF CLEAR PRIORITY
- NO COMMUNITY INVOLVEMENT
- INAPPROPRIATE TRAINING OF HEALTH
PERSONNEL
Bl
PROBLEMS IN RESOURCE:
- INADEQUACY AND MAI.DISTRIBI.II ION
- NON-UTILISATION OF ACTUAL AND PO
TENTIAL RESOURCES
- RESTRICTED USE OF PUBLIC HEALTH
WORK
- INCREASING COST
C)
PROBLEMS IN GENERAL STRUCTURE:
- NO EFFECTIVE PI.ANNIN<I
- WEAK DEVELOPMENT OF CONCEP T OF
TOTAL SYSTEM
D)
PROBLEM IN TECHNICAL ASPEC T:
- NO HEALTH EDUCATION
- NO BASIC SANITATION
- NO COMMUNICATION
-NO TRANSPORT
- NO HEALTH INFORMA TION
5.
GENERAL FORCE INVOLVED:
Support by other related sectors viz
Agriculture.
Housing, Waler supply. Sanitation. Public Works
and Communication, Education. Mass Media are
most important.
People's Representatives In | oral < iovernmenl can
ensure that community interests are properly taken
into account in planning and implementation of
programmes. Public services should be account
able to the communities ’The desirability of co
ordinating al the local level, the activities of various
sectors involved In Socio-economic development
and the crucial role of community in achieving
them, make peoples representatives an essential
and effective component.
A cipar national health policy is needed which will
promote community cohesion around efforts for
healthand related development, will Ibstertheco
ordination at the local level ol all sectors
programmes that have a bearing on I lealth Care,
will build up the capacity of communities to make
up their health and othersocial aspirations known,
and will ensure that the community controls both
the funds it invests and personnel providing it.
Mutual support between Government and people
should be reinforced by mutual information feed
back. It is the responsibility of Government to
stimulate this kind of support to set up necessary
intersectoral co-ordination and different adminis
trative level to pass legislation, to provide suffi
cient human, material, technical and financial
resources. For public reach, it needs easy access to
the right kind of information concerning their
health situation and how they themselves can
help to improve it. In certain area or situation,
people’s participation can be legislated.
Non-Government Organisations can make a veiy
useful contribution to health services, precisely
because of working within the community. They
have same responsibility as Government Agencies
in the sense that they provide technical and
financial support to nation and would do well to
ensure that these are channelled into the Health
Service System.
shows the link between health and socio-v •>nomic conditions.
Among the organisations that have been used or
suggested for mobilising support for Primary I lealth
Care as National Health Programme an- < a» I'oii
cal parties fb) Women Organisations (c) I'outl;
organisations (d) Trade Unions and (e) Religion'.
or Ethnic bodies. Whenever possible, local plan-.
and priorities should be based on informal!' m
about the actual health needs and problems oi all
members in the community. Groups at risk can I .■
identified along with special needs and prior-it :<. s
can be established and progress monitored on the
basis of information.
Individuals and families should assume responsi
bilities for their own health and welfare This
entails penetration of services to target popula
tion.
In our Society, stress is laid on overall political and
economic context; power, finance, decision mak
ing all not by people, but normally by people
representatives. Hence country side effort is nec
essary fora common setting of peoples represen
ta lives.
6. WOMEN FORCE INVOLVED:
women a force for renewal of Health Activities in
a nature of policy is attributed. Women influence
health care in many ways, as mothers bearing the
main responsibility, for family health, as Agricul
tural workers, as Primary Health Centre Workers,
birth attendants, Educators and members of com
munity groups. If an educational programme does
not recognise women as important agents of
change and learning, it will not succeed in devel
oping full community involvement and cannot
obtain the people’s responsibility.
7. NATIONAL PICTURE:
In India, at least 3 forms of influential environment
can be seen. They are (a) Political environment (b)
Religious environment and (c) Social reform envi
ronment.
High technology medicine is getting quite out of
hand and leading health systems in the wrong
direction, i.e., away from health promotion for
the many, towards expensive treatment for the
few.
Modern Medicine, is not accessible to the poorer
social classes. And most forms of disease are mon?
prevalent among people living in poverty. This
Elected bodies of citizens have been put incharge
of local health and social services at District and
Regional levels. Here wide involvement of people.
in the improvement of their own health will not be
there. Appointment of representatives to the
adivsory board of local health facililies is to be
geared up.
The financial contribution by voluntary
organisation is relatively small, but their contribu
tion to health is often significant. Those local
National and International Organisations hare
their own motives and provision in the allocation
of resources. This factor should be carefully con
sidered when assessing that role in health care.
They direct their limited resources to die most
needy segment of population.
8. COMMUNITY EFFORT
Cultural, economic and political circumstances of
India influence all aspect of support to I lealth
services. There is need for understanding ol ti.
relations between effective community invoh
ment and propitious political and economic con
ditions.
The mobilisation of people for health develop
ment requires their participation.
3'
lite collective organisation in India has been as
follows:
10. COMMENT FROM THE PEOPLE:
In British ruling without any contribution people
used to get services. Now also that strong tradition
has been seen in our country. Wc have organisations
disharmony. Various social and political forces play
in every Mandal Panchyat and Zilla Parishad ham
pering the participation. Hence peoples involve
ment is slow and halting. What people see as their
real need arc not seen by service givers. This
amounts to ignoring peoples need. A professional
man always says that he is better qualified and that
he knows better than any one.
Following upbridged comment demarcate people
view in National Health Policy.
- Health Facility to one and all, equal w ith
Urban-Rural, Male-Female, Young-Old.
- Poor to have free service. Rich to have paid
service.
- Political unrest, violence and law breaking
are by lack of understanding; provide I >:er
understanding.
- Region, District and Urban should haw
programmes by Regional. District and Cor
poration Offices.
- Without potable water and sanitation
health facility?
- India is not poor, money is going <’■ >wn the
drain, use for proper health care.
- Older have struggled. Younger ,.i\ vet to
realise the importance of sweat and toil.
- Administrators, both Government and elected
body, have done considerable harm by
undermining the concept and need of excel
lence in every sphere of action.
- Democracy run on present election procedure puts a premium on powers.
- No Co-operative community' care by' Zill:'.
Parishat.
- No copying from USA or UK. Make I iealili
available to all in their economic status.
- Health care is not just lay doctors. But by'
others also. Say' Health Board
- Hospital admission criteria is priority' to cer
tain groups. Why not policy common to all?
- Allow us to have Home, Herbal or Nature
even. Do not insist with chemicals.
- Field workers of all departments to help
Health services.
9. INTEGRATED ACTION:
Discussions and conclusions at the Joint Confer
ences of the Central Council of Health and Family
Welfare and the National Development Council
have always been directed towards a common
pattern of infrstructure in Health and Family Wel
fare Services in India. Whether it is in Medical
Education, Legislation, Standard maintenance of
vaccine ordrug; there has been common consen
sus for a common pattern.
Evolution of National Health Policy is one such
major step for an integrated action in achieving this
goal.
Communication strategies to motivate a positive
attitude could have been another step in achieving
a goal of National Health Policy.
Thus all our departments, which contribute for
socio-economic development of India, rely upon
intimately related sectors of administration and
politics. Il is of vital importance to ensure effective
co-ordination between Health and People's Repre
sentatives. Contents and priorities of programmes
are to be viewed by people or people’s Represen
tatives in their effective implementation. Integrated
Programme of Rural Development (IRDP) is a
standing example in this regard.
3.2.
11. CONCLUSION AND REMARKS:
National Health Policy' is an expression of our
Health. Hence national strategy should include
broad lines of action in all sectors involved to giv
effect to that policy. What has to be done? Who I ins
to do it? During what time? With wiiat resources?
It is a framework leading to more detailed pro
gramming, budgeting, implementation and evalu
ation.
We mean Health that begins at home, schools,
factories. It is there, where people live and work
that health is made or broken. It does mean
people will use better approaches than they do
now for preventing diseases and alleviating tin
avoidable disease and disability' and have better
ways of growing up, growing old and dying
gracefully.
Let this mean even distribution among population
whatever resources for Health are available.
Peoples Representative in Health Policy is a sober
one. But related strategy appears good, clear cut
and defined. They deserve giving effect to these
actions. Here achieving acceptable level of health
as part of socio-economic development in the spirit
of social justice is to be indicated.
Why should we not involve General Practioners
and Link Insurance Scheme? This can be answered
in the policy.
Simplified Medicine programme or elementary
Health by any body should be envisaged in the
policy.
Two way Radio scheme foradvice and supervision
seems to be very good.
In each action involvement of people and/or
peoples Representative has an effect on any policy
making.
In view of problems posed, we should make an
endeavour to provide basic amenities, to provide
essential drugs, to provide basic education.
Women force and community force are an assets
in our endeavour of uniform pattern of Health
Services.
Integrated Action is an injectable solution, which
lias a miracle in community healing.
REFERENCES
1.
Alma - Ata Ten years after - WHO 1986<Near
letter No.20)
Alternative Approaches to Health care 1CMR New Delhi 1977
Alternative approaches to meeting basic
Health needs in developing countries.
UNICER - WHO Joint Study - WHO 1975
2.
3.
FORMAL
HEALTH
SYSTEM
COMMON -> TRR'DITIONALHEALTH 5 Y3TEA7
MAN
—> /NroflM AL
HeAL-TH SYSTEM
Global strategy for UFA by the year 20(X) WHO 1981
Health for all by the year 2(XX), the role of
Health Education VTH Gunaratre hit. Jour
nal of B.E. Vol. Will No. I, 1980.
4.
5-
Health System support for Primary Health
Care - P.H.Paper No. 80 W1 IO 1981.
6.
In the above figure it is pointed out how we are
driving behind man, whereas Man is tunning
behind Traditional and informal system.
Hence we should think of
a) Co-operative Rural Dispensary
b) Family Survival Assurance Plan
c) Integrated Child Care
d) Integrated Health Nutrition
e) Integrated Maternal Care
f) Integrated Family Care
7.
8.
Leadership for Primary Health Care P.H.Paper No. 82 WHO - 1986
Managerial process for National Health De
velopment - WHO 1981
9.
Medical Care, the changing needs and pat
tern - Sir Godber Ciba Foundation Lecture 1970.
10.
National Health Policy - Statement - Govt, of
India Ministry of I lealth and Family Welfare,
New Delhi - 1982.
11.
Planning India’s Health - K.S.Sanjivi, Orient
Longman 1971.
J,
12.
Primary Health Care - Joint Report WHO &
I 'NICER - Wl I' > 1978
IMPLE PI ENT.
13.
Primary Health Care - The Chinese Experi
ence, WHO 1983
14.
Text Book of Preventive and Social Medi
cine, B.K. Mahajan, Jaypee Brothel'S 1991.
15.
Text Book of Preventive and Social Medi
cine, J.E. Park, 12th F.dln. 1989.
•, PEOPLE
PROGRAMMERS' |
x”
AE PRoGAAPinjE <--- ------ . EVALUATE
7
T
INFORMATION
'
SUPPORT
33
CLARIFICATIONS
The papers evoked great interest among the partici
pants. The members required many clarifications
and made various comments. They wished to have
a discussion on certain issues raised by the resource
persons. Hence the discussions were continued for
45 minutes after lunch. There was a lively and
useful discussion. Among the issues raised were
Voluntary organisations operated more in
the urban areas.
Voluntary organisations are not utilising fully
government facilities
*
Zilla Parishads are strong links and have to be
involved actively in health care.
'
With the existing budget and release of
funds, it is not possible to achieve the objec
tives.
•
The department of Health and F.W. Services
does not have the organisation to implement
the Policy.
District health committees should be reacti
vated with representatives of Voluntary Agen
cies.
Dr. T. Ranganath Achar made a number of useful
observations. The implementation of the programme
is often slow inspite of Government efforts. People
are not often prepared to accept the programmes.
He assured full co-operation with Voluntary agen
cies. Governmental responses to Voluntary initia
tives will be good.
Dr.C.M. Francis, Moderator, complimented the
Resource Persons for their well searched presenta
tions. The participation from Government and
Voluntary organisations was simply wonderful.
The presence of the Director, Regional Director,
Additional Director, Joint Director, Divisional Joint
Directors and seventeen out of the twenty District
Health Officers showed the interest taken by them
in achieving the objectives of the National Health
Policy at the State and District levels.
GROUP DISCUSSIONS
9.4.1992
10.4.1992
: 2.30 p.m.
: 9.00 a.m.
- 5 00 p.m.
- 1.00 p.m.
Group discussions were held during the afternoon
of day - 1 and continued till the afternoon of day 2. Four groups, with representatives from both
Government and Voluntary sectors were formed.
The issues discussed were
PRIMARY HEALTH CARE
HEALTH EDUCATION
INTER-SECTORAL CO-ORDINATION
HEALTH INFORMATION SYSTEM
The following process was followed in general :
The group
34
*
*
*
goes through the National Health Policy,
with particular reference to the specific
topic,
discusses lite issues and identifies the
areas which need strengthening, and
prepares a plan of action and recommen
dations
The discussions were lively with active participa
tion by all. Both departmental officials and repre
sentatives of Voluntary agencies found the exercise
rewarding. The Rapporteurs presented the recom
mendations at the plenary session on the alien toon
of the second day.
GROUP -1 , PRIMARY HEALTH CARE
1.
2.
3.
Dr.J.P. Gupta
Regional Director
Health & F.W. Services
Government of India
Bangalore.
13-
Dr.K.V.Venkatesh Babu
Medical Officer
MYRADA/Plan
Madakasira
Sr.Alphy Kattupnrambil
Registered Nurse
Holy Cross Hospital
Kamagere P.O.
Kollegal '-j.
Mysore Taluk.
14.
Dr.Mira Shiva
Head, Public Policy Division
Voluntary Health Association of India
New Delhi.
Mr.Abdul Gaffoor
Health Officer
MYRADA/Plan
H osur
15.
Dr.G.Viswanath
Joint Director (Health & Planning.)
Directorate of Health &
Family Welfare Services
Bangalore.
16.
Dr.Prnsad K.N.
Lecturer in Community Medicine
St.John’s Medical College
Sarjapur Rond
Bangalore - 34
17.
Dr.Pramod M.G
Post Graduate Student in
Community Medicine
Bangalore Medical College
Bangalore.
18.
Dr.N.S.Range Gowda
Post Graduate In Community Medicine
Bangalore Medical College
Bangalore.
19-
Dr.H.Sudarshan
Vivekananda Girijana
Kalyana Kendra
B.R.Hills
Via Chnmrajnagar
Mysore District.
20.
Dr.S.Pruthvisli
Programme Adviser
(Disability)
Action Aid. India
P.B.No. 5406
3, Rest House Road
Bangalore - 1.
21.
Dr.H.R.Narayana Murthy
Divisional Joint Director
Bangalore.
4-
Dr.Upendra Shenoy
Co-ordinator
Arogya Vikasa Prakalpa
Shimoga District
5.
Dr.S.B. Kurtkoti
Divisional Joint Director
Health & F.W.Services
Belgaum Division
Bclgaum.
6.
Dr.S.B.Shyama Rao
Surgeon, L R P H
Gulbarga
7.
Dr.Patil S.H.
District Health & F.W.Officer
Gulbarga.
8.
Dr.S.R.Bilgi
District Health & F.W.Officer
Chitradurga
9.
Dr.P.N.Parameswar
District Health & F.W.Officer
Shimoga
10.
Dr.M.Gangadhara
District Health & F.W.Officer
Bangalore Rural District
11.
12.
Bangalore.
Sri.R.Somashekar
Programme Officer
Indian Health Organisation
Bangalore.
t
Sr.Libia
Hospital Incharge
Vimalalaya Health Centre
Hebbagoid P.O.
RECOMMENDATIONS
1)
Health Budget There is need for a substan
mented by Volunlaiy servic ,'s.
7)
tial increase in the budget allocation to the
Health sector. There must be equity in die
allocation of health budget to the rural and
urban areas based on population.
2)
3)
The Volunlaiy Organisations may; suppoit
the institutions under PI IC or in their area
by establishing the curative centres, enhanc
ing the Government efforts. They' need to co
ordinate with the Government health institu
tions for necessary laboratory Investigation,
etc. The government institutions can pro
vide logisticand technical support including
Continuing Medical Education.
District Health Policy Decentralisation of
planning, implementation and evaluation of
the health and health related programmes to
the district level so as to formulate a District
Health Policy' according to the needs of that
particular district. Procedures to be simpli
fied for the involvement of the Voluntary
Organisations to facilitate proper function
ing.
8)
Existing PHCs Existing health centresshould
Referral system Community Health Cen
9)
tres and sub district level hospitals must be
well equipped and specialist posts filled up.
5)
10)
11)
- The quality of training must be maintained.
- More involvement of women volunteers to
be encouraged for better community partici
pation.
t
6)
District level Epidemiological Cell
-Need fora full fledged epidemiological cell
at the District level with field stations comple
36 __________
Integration of indigenous systems of
medicine
There is need for integration of indigenous
systems ofMedicine with Modern (allop uhic)
Medicine in Primary Health Care as regards
curative, preventive, promotive and reha
bilitative services to the extent possible.
- Required technical skills are to be passed
on to the workers
- Reorientation of Voluntary Workers from
time to time.
Mobility
Availability of adequate mobility' may' be
ensured to all level functionaries in govern
ment and volunlaiy' sectors to facilitate pro
vision of health services.
Training and Reorientation
- Facilities are to be ensured for training
various Voluntary'workers for Primary Health
Care both by Voluntary' Organisations and
Government.
Mental Health care programme
Programmes to provide the physical and
social rehabilitation may be expanded in a
phased manner. Voluntary' Organisations
may be involved in this programme
- National norm for the proportion of CHC to
PHC may be maintained.
- Specialists at CHC and Sub District level
hospitals may provide their services to the
neighbouring PHCs as per the needs.
Specialised Care
The Non-governmental organisations
equipped with the specialised curative .sei
vices may' supplement the Government
Organisations not having such facilities lo
cally by providing free care to the poor
people and running paying clinics for the
aflluenl sections.
be made fully functional before any expan
sion programme is taken up, except for
tribal, hilly and backward areas where there
is a need.
4)
The support of Primary Health Care
11)
a) Orientation of staff
There is need for orientation of existing
health staff.
b) Adequate budget allocation is needed for
comparative research.
c) Prescribers of drugs (whether they
belong to the allopathic or indigenous
systems of medicine) should have suffi
cient knowledge and skill in their use. If
necessary, they' may be given short train
ing programmes.
12}
Central registration of all formulation-.
whether they be allopathic, ayurvedic other preparations should be mandator,-.
5. Drug control machinery must be strength
ened.
6. Control of drug pricing must be ensured
7. Drugs should be made available under ge
neric names
4.
National Drug Policy
It should be an integral part of the National
Health Policy
1. There is need for a Rational Drug Policy.
2. There is need for formulation of essential
drug lists for the various levels of health care.
3. Adequate production and distribution of
essential drugs are to be ensured.
GROUP -H:HEALTH EDUCATION
1.
Dr.C.M.Francis
9.
Dr.G.Gururaj .
Associate Professoi
Dept, of Epidemiology
N I M 11 A N S
Bangalore.
Director
St.Martha’s Hospital
Nrupalhunga Road
Bangalore - 9-
2.
Dr.G.V.Nagaraj
Joint Director (Immunisation)
Health & F.W.Services
Government of Karnataka
10.
Dr.Subhascha.ndra Mudgal
Dist. health & F W.Officer
Dharwar District
Dharwar.
3.
Dr.H.A.Prasanna
Joint Director
Public Health Institute
Sheshadri Road
Bangalore.
11.
Dr.G.K.Basavaraju
Dist. Health & F.W.officer
Tumkur
12.
Sr.M.Aquillina Schwodiover
Goretti Hospital
Kaliinnpur
Santhekatle Post
D.K. - 576 125.
4.
Dr.Gundappa
Joint Director (Communicable Diseases)
Health <Sc F.W.Services
Government of Karnataka
5.
Dr. (Mrs) M.K.Vasundhaia
Professor and Head of the
Department of Community Medicine
Bangalore Medical College
Bangalore.
6.
7.
8.
Dr.M.V.Murugcndrappa
Dist. Health & F.W.Offlcer
chickmagalur District
chickmagalur
Dr.R.S.Gonghadi
Dist.health & F.W.Officer
Karwar District
Karwar
Dr.Sr.Reglna Squares
lately Medical officer
Nirmala Hospital
Bhadravalhi
The Group focussed on Health
Education
The Group first determined what aspects of health
education shoukL-b'e discussed and for whom ft
should be. The consensus was that the group'
discusses Education for Health, with locus on
People in general
I.
Why Health education?
1.
2.
3.
4.
Make people Health conscious and develop
the knowledge, skills and altitude of the
people to lake action for better Health.
Make people competent to identify the health
needs, available services and ask for those
services as needed.
I teip people avoid superstition, haimlul ti-a
dillons and customs and irrational medical
practices, and promote the customs and
tradition which have a positive impact on
health.
Improve life styles for health and quality ■:
life.
n.Present status of Health education
1.
A dent has been made in health education.
There is a Health Education Bureau at the
Statcand District level. District health educa
tion Officer and other personnel and infra
structure. But Health education is not given
adequate priority.
2.
The staff do no.t know their job well. Their
services are often used for other purposes.
Funds available are not properly utilised.
3.
Health education administration is too much
centralised. There is not enough flexibility at
the District or peripheral level. Funds are
often released towards the end of the year.
4.
Communication strategics are often out
moded using inappropriate language. Often
negative methods are adopted.
5.
General literacy, especially of girls, is low.
There is not much Health education material
in general education, books and syllabus.
6.
Situations like out-break of epidemics give
us opportunities for health education but are
not utilised effectively.
7.
Not enough attention is given to improve life
styles. Some of the measures of Government
affecting the use of tobacco and alcohol are
counter-productive.
8.
Voluntary Organisations are not able to use
lite health education resourcesand materials
available with the government and vice
versa.
7.
Better rapport between health work-is i<>
the Government and Voluntary sector to
make belter use of a vailable materials There
must be better co-ordination and co-opera
tion between various sectors.
8.
Committees must be formed or reactivated at
various levels
(i) PHC/Block level
(ii) District level with the Disl. Health & FAX'.
Officer as chairperson
(iii) State level - Apart from the health, other
sectors and Voluntary Organisations must
be members, as health is not the domain of
health sector alone.
A Directory, if not available, should be
prepared of all the Voluntary Organisations
working in the different areas and levels.
The available Director)' may be updated.
9.
Reorientation is necessary for both Volun
tary Organisations and government func
tionaries.
10.
The possibility of Voluntary Organisations
adopting PHCs or sub centres must be con
sidered.
11.
Duplication of work by Government and
Voluntary Organisations should be avoided
to the extent possible demarcating areas of
activity.
12.
The possibility of bringing out a Newsleltei
(monthly/quarterly) should be explored.
13-
There are guidelines given by Government
of India with respect to co-operation be
tween Govemmentand Voluntary agencies.
This must be made known to the Voluntary
organisations. Wherever necessary, modifi
cation should be brought upon.
14.
We must involve local and national leaders
and elected people’s representatives. There
is need for political commitment.
IH.What should lx: done?
1.
2.
Emphasise positive aspects.
3.
Qualitative improvements of health educa
tion and its evaluation.
4.
Give greater priority for health education.
There is also a need for better supervision.
5.
Better education materials for school chil
dren and educational institutions, debates,
quiz programmes and essays. All teachers
myist be trained in health education.
6.
3S
Better use of media, including the Mass
Media, Street Plays and Folk Media, pictorial
representation for illiterate people (wall
posters, paintings etc.); personal communi
cation is veiy important.
A local or District Committee could suggest
ways and means of health education and
periodical Assessment.
FV.PLAN OF ACTION FOR COMMITTEES
1.
'Committees’ must be formed at the Block
(PHC) level, District and State levels within
6 months.
Where committees are dormant, they must
be reactivated.
2.
The committees will have wide membership
with officials, including related sectors. Vol
untary organisations and elected people’s
representatives.
(a) Block level committee:
Functions
Mcmlxirship: Officials belonging to health,
education, agriculture, animal husbandry
and other sectors.
Representatives of Voluntary organisations
working at block level. Elected representa
tives to the mandal panchayat.
(i)
The Committee will have the following func
tions:
Identify 'local health problems’, find out
their causes and the reasons for persislance
of such problems.
(ii)
Identify ‘barriers of communication'.
(iii)
Prepare and implement a calender for action
on annual basis and evaluate the perfor
mance at the end of each year.
Help and guide health education at the
village level.
(If considered desirable a committee can be
formed at the village itself), and
Meet once a month.
(iv)
(v)
(b) District level committees
The D.H. & F AV.Officer will be the chair
person and the DHEO will be the mem
ber-secretary; other officers including
officers drawn from the Information
Department will be members. There will
be representatives of Voluntary
Organisations functioning in the field of
health in the district and elected repre
sentatives of the people (Zilla Parishad).
The Committee will
review activities of health education.
integrate the functions of different secloi =
with respect to educational activities and
government guidance to the Block level
committee helping them to solve their | >robleins; wherever necessary and feasible, the
committee will visit the block, and
(iii) the meetings will be held quarterly.
(i)
(ii)
(c) State level committee
-
-
The Director of Health & FAX'.Services will
be the Chairperson.
The Joint Director (I IE& T)of the Directorate
of Health & FAV .Services will be the mem
ber-secretary.
The representatives of District 1 Icalth Office
and other.sectors. Representatives ol Volun
tary Organisations workingat (he State level.
Elected people's representatives (Ml .As) and
other leaders.
Functions
(i)
(ii)
(iii)
The Committee will
review, integrate and monitor health educa
tion at the state level and also other levels.
ensure that the health education materials
are updated regularly and
meet half yearly.
IMPLEMENTATION
A plan of action has to be drawn up with a time
frame for all the recommendations as detailed
above.
39
GROUP - IH : I1WEKSECTIIONAL CO-ORDINAT1ION
jin health CARE DELIVERY
1.
2.
Dr.C.R.Krishnamurthy
Addl. Director (Health & F.W.Services)
Government of Karnataka
Sri S.M.Subramanya Setty
Asst. Professor,
Dept, of Health Education
. N1MHANS, Bangalore.
3.
Dr.(Mrs) Sona Kalyanpur Rao
Medical Officer cum Co-ordinator
Holdsworth Memorial Hospital
Mysore
4.
Sri Mohammad Safruddin
Block Development Officer
Tq. Javargl
Gulbarga District.
5.
Dr.N.Nagappa
Dist. Health & F.W.Officer
Bellary
6.
Dr.H.H.Naik
Dist. Health & F.W.Officer
Hassan
7.
8.
Dr.S.D.Rangappa
Divisional Joint Director
Mysore
Dr.Veerabhadrappa S.Emmi
Dist. Health & F.W.Officer
Madikcri
Disl.Kodagu
9.
Dr.R.K.Kumarswamy
Dist. Health & F.W.Officer
Bangalore (Urban) District
Bangalore.
10.
Sri.S.Vijayakumar
Project Manager
SIBS
Bangs rpct
11.
■■■
40 ___
Sri K.Ganesh
Social Worker
‘PRAYOG’
Muladenahalli Post
Malur Taluk
Kolar Dist.
,
----------------------------------------------
12.
Smt. P.K.Vimala
Health Worker
Vikasana
Melkote
Mandya Dist.
13.
M.A.Konnur
Lecturer
Dept, of Social :Work
Gulbarga University .
Gulbarga
14.
Dr.K.Y.Vijayakumar •
Post Graduate ;
Student in Community Medicine
Bangalore Medical College
Bangalore.
1^
>i I As Mohammad
Asst. Professor
Dept, of Community Medicine
St.John’s Medical College
Bangalore.
GROUP III :
INTERSECTORAL CO-ORDINATION
IN HEALTH CARE DELI VERY
The Group discussed al length "Intersectoral Co
ordination" in Health care Delivery keeping in the
background relevant sections in the National I lealth
Policy Document and arrived at following conclu
sions :
Public Health Act
There is need to have a comprehensive Public
Health Act taking into account new problems like
environmental pollution. The existing old Public
Health Act is not relevant. The new Act must extent!
to the whole of Karnataka State,
„.
>
Health Insurance
May be promoled’among the people to participate
economically for utilisation of available Health
Services. The group further recommend constitu
tion of an Expert committee to go into the details
of scope of Health Insurance anti how people can
participate economically.
The Group felt that Intersectoral lommlnees i.e
formed al different levels to facilit.ite cllectlve
intersectoral co-ordination. The group delineated
who all should be the members of the committees.
I.
Village level Committees
Village Accountant - Chairperson Auxiliary
Nurse Midwife - Member Secretary
Agricultural Asst., Anganwadi workers,
Teachers, Presidents of Mahila Mandals,
Mahila Swasth Sanghas and Youth Clubs
(Members).
II. Sub-Centre level committee
Mandal Secretary - Chairperson
Auxiliary Nurse Midwife - Member Secretary
Agricultural Asst., Anganawadi Worker,
Teachers, Presidents ofMahila Mandal, Mahila
Swasth Sanghasand Youth Club (Members).
HI. Primary Health Centre
Tahsildar/Asst. Commissioner - Chairperson
Medical Officer, PHC-Member Secretary
Block Development Officer; Asst. Director
of Agriculture; Child Devi. Project Officer;
Asst. Education Officer, Asst. Executive En
gineer, Social Welfare Officer, Range Forest
Officer, Asst. Director of Animal Husbandry,
Head Master of High School, Representa
tives of Voluntary Organisations (Members).
IV. District level Committc
Existing Committees to have additional rep
resentatives of Voluntary Organisations as
Members.
V. State level Committees
Existing Committees to have additional rep
resentatives to Voluntary Organisations as
Members.
The Committees at Village, Sub-Centre and Primary
Health Centre levels to meet once a month; District
level Committees to meet once in two months; State
level committee to meet once in three months.
The Groups further delineated functions of com
mittees as follows;
(i) identify existing health problems;
(ii) problems of health and health related sector
to be addressed with a wholistic approach
ensuring co-ordination ofactivities ofall the
Government Departments and Voluntary
Organisations;
(iii) plan programmes to be implemented tal-.ii ig
into consideration all locally available re
sources - Technology, Material and M t
power etc.;
(iv) committees to take note of banned drugeducate gramsabhas regarding prevvnlio •
and control of various diseases and banned
drugs;
(v) review and evaluate programme-: periodi
cally in the meetings;
(vi) 'Hie proceedings of the meetings -o
recorded and made available to meml. :
and to higher and lower functionaries • . .
the people.
(vii) The District level Committees to recom
mend to authorities concerned to proem.only essential drugs and supply to health
centres.
The
(viii)
State level committee to recommand to
authorities to procure only essentia! drugs.
in adequate amounts and to match the
drugs procured with the existing health
problems.
(ix) The available infrastructure lor training in
the Government to be made open foruse In
voluntary Organisations also. (Health and
Family Welfare Training Centres; District
Training Institutes) and vice versa.
GROUP IV: HEALTH INFORMATION SYATEMS (HIS)
1.
Dr. T. Annappa Rao
Deputy Director (NMEP)
Directorate of Health & F.W. Services
Government of Karnataka
2.
Dr. S.P. Takur
Consultant Paediatrician
Community Health Cell
Bangalore
3.
Dr. S.M. Jarigay
Dist. Health & F.W. Officer
Bidar
4.
Dr. M.V. Sampath Kumar
Dist. Health. & F.W. Officer
Kolar
5.
Dr. Reyhold G. Washington
Tutor & Post Graduate Student
in Community Medicine
St. John’s Medical College
Bangalore.
o.
7.
8.
Sr.M. Winifred D'Souza
Staff Nurse
Gorclti 1 lospllal
Kallianpur
Udupi
Mrs. Philomena Joy
Community Organiser
RLH P
Mysore
Mrs. Usha
Health Worker
RLH P
Mysore
9.
Sri. Premananad N. Thambi
Co-ordinator
SIBS
Bangarpet - Kolar Dist.
10.
Dr. M. Annamma
Medical Officer
Hoskote Mission Medical Centre
Hoskote
11.
Smt. Jayashree Ramkrishna
Professor and Head of the Dept, of
Health Education
NIMHANS
The Group discussion started with reading the
relevant parts of the National Health Policy state
ment focusing on this topic.
The group decided to focus first on how the system
is at present operating and consider the positive
aspects and lacunae.
1.
Channels of Information
to
Field Staff to
PHC to
DI IO
DJD to
Directorate of 1 lealth Services
There is a feed-back system going back along the
same channel. The information transmitted is mainly
in the form of figures (numbers) while the other
details are also present at the point of collection
2.
Data collection
The chief person collecting information from the
field is from the Government - Dept, of Health &•
F.W., to be specific, the Female and Male I lealth
Assistants.
Voluntary agencies collect different types ol infor
mation depending on their activities. They may
transmit it to the government on request, and that
too, at different levels.
eg: Vital statistics (Binhs/Deaths) are given to
PI IC/ Panchayat level.
Disease profilesare transmitted directly to Direcloi •
ate of Health Services once a year from the I lospitals. There is no duplication of reports in services
like U 1 P., where vaccines are involved, but it may
occur in other areas.
3.
At Field Level
The information collected is incomplete becuase ol
various problems :
Educational and language problems ol lea)
male health assistants.
lnformation may be second hand
b)
Eg: ANM collects from Anganwadi worker.
Too much of data. Each programme has its
c)
own needs to be fulfilled. Hence the worker
in the field is over burdened.
The reporting formats are complicated and
d)
are not easily understood by some field
workers.
4.
At P H C Level
Bangalore.
a)Compilation of reports from field.
b)ln addition, data generated at I* 11 C Itself
from its out-patient/In-paiient records.
Here again, there are problems of classi
fying data fraom inadequately main
tained registers.
eg: Disease Statistics Register has 150 dis
4.Computerisation of informulio system
at DUO level. Hospital data from volun
tary agencies In the district to be sent t
D II O level
5.
Voluntary agencies io attend P 11 C meet
ing every month and exchange daia anil
information and avoid duplication.
6.
A mechanism of involving local people
like in Arogya Mahila Sangha at Mandal
Panchayat level with members from each
village
eases classified
(This lias recently been reduced to 27)
5.
AtDIIOLcvcl
a)Compilalion of reports from I’HCs.
b)Thc '•lata compiled undergoes a 10%
verification by statistical officer and 2%
verification by D II O,
The amount of data here Is very large and
requires about 3 days of compiling work,
There is data generated al District Sur
geon level in Govt. Hospital as regards to
number of patients treated IN as well
OUT patients. This is to be sent directly
to Directorate for further comilation.
ALL DATA GENERATED HAVE TO BE
FOR RELEVANT EPIDEMIOLOGICAL
NEEDS OF HEALTH OF THE PEOPLE.
No incentives or honoraria should be
given for helping In II 1 S. Only transler
of knowledge; especially on health takes
place for the local group.
The group then decided to focus on National
Health Policy guidelines and priorities it sets in
the following areas;
1.
Nutrition: There are various programmes
which have gone through the stages of
base line survey and partial implementa
tion.
6.
General Comments
eg: Vitamin A prophylaxis/Anaemia (Iron
& Folic Acid) Goitre/ICDS - supplemen
tary nutrition etc.,
- Concurrent evaluation of these programmes
is to be done for upgradation, stopping or
adding on services.
■ Strengthening of Research tspcct m the
HIS at State and District level for ulilizating
HIS data well.
- 'leaching, trainlngand other Research Meilical/Health Institutions to be utilized for
focussing on Public Health Problems.
a)Vital statistics reporting (Births and
Deaths) has improved after statutory re
quirements have made recording neces
sary for various reasons where Birth and
Death certificates arc required.
b)NoliflabIe Diseases/Epidemic occur
rences reporting Is mainly If the diseases
arc of fatal nature, or create problems,
eg : in Gastro-enterilis reporting.
SOLUTIONS
2.
l.Only one person/agency in an area Is to
be responsible for HIS collection, pref
erably the Government Agency.
2. A simple format of reporting for field
worker - preferably one page.
eg : I E C proforma intorudeed 3 years
back of a single page can be updated and
used.
Also adequate printed forms Is required
to be supplied.
3.
A simple and standardized coding sys
tem at P II G corresponding to W H O
classification of dcseascs to be worked
out for Disease Statistics Register.
Food/drug adulteration
- Incidence of Food poisoning and unusual
health effects of durgs are to be reported.
- Drug inspectorate work is to he intensi
fied to generate data, as the people are
made aware of this problem.
- It would be needed to make N 11 P priority
areas to be reported as part of H I S
- We also need qualitative data in addition
to quantitative data. Though this cannot
be done routinely, it can be done with
local peoples organisations.
For occupational diseases, no system for
reporting or studying Is available
This has to be created, with special locus
on Agriculture and rural occupations.
1
PLENARY SESSION : 2.00 p in.
: Dr. C.M.Francis
Moderator
Individual groups presented the observations, recommendations and conclusions of each group
Group I
:
Group II
Group 111
Group IV
:
:
Primary Health Care
Presented by
Dr. H.R. Narayana Murthy
Div. Joint Director
Bangalore
Health Education
Presented by
Dr. G.V. Nagaraj
Joint Director (Immunization)
Health & F.W. Services
Bangalore.
Intersectoral Co-orcliation in
Health care delivery
Health Information system
Hon. Health Minister of the Government of
Karnataka. Sri. G. Puttaswamy Gowda, joined the
plenary session. Dr. H. Sudarshan,Treasurer, VHAK
welcomed thellon. Health Minister. Dr. S. Pruthvish,
Member, VHAK presented the conclusions anived
at the -workshop, on behalf of the participants and
organisers.
After the presentation of conclusions, the Hori.
Health Minister asked for clarifications on the
recommendation for Decentralisation of planning,
implementation and evaluation. The participants
deliberated on this issue. It was observed that
Karnataka is one of the states which has attempted
to decentralise planning to District level. Appreci
ating this aspect the group felt that there is much
scope to improve in thia area. Dr. T. Rangahatha
Achar, Director os Health & F.W. Services, Dr. C.R.
Krishnamurthy, Addl. Director, Health & F.W. Ser
vices, Dr. C.M. Francis, Director, St. Martha’s Hos
pital and Dr. FI. Sudarshan, Treasure VHAK pro
vided clarifications to the Hon. Health Minister.
Hon. Health Minister Sri G. Puttaswamy Gowda
addressed the gathering. TTiis attempt by VHAK,
VHAI and Department of Helath & Family Welfare
ScrivceS in organising two days workship and
forwarding their recommendations to the Govern
ment is commendable.
Presented by
Mr. S.M.Subramanya Setty
Asst. Pofessor in Health Education
NIMHANS, Bangalore.
Presented by
Dr. S.P. Tekur
Community Health Cell
Bangalore.
Role of Voluntary’ Organisation in Health Care
assumes major importance. This is a model as well
as guiding example. Since both Government and
Voluntary'Organisations will be involved in similar
type of activities, confusion is possible. Keeping
this in mind, it is advisable that Voluntary Agencies
decide their area of work and concentrate on tinsame with the collaboration of Government
At Field level, there is necessity' for local officers of
Health Department to join hands with the Volun
tary Organisationsand identify the local needs and
help the Government.
lack of thought and concern appears to be evident
among people concerned with respect to bannable/
banned drugs. In this situation it Is difficult to
implement the policy' recommendations. But, it has
to be done. There is necessity of service mind.
The drug Policy' unfortunately is in the hands of the
Ministry' of Petroleum and Chemicals. There is need
for amendments in the same for the good. The State
Government intends to communicate to Central
Government in this regard.
Benefits are required to reach the rural and
marginalised people. The administrative structure
needs to be more active.
There are attempts at decentralisation and I 'i irict
Health and Family Welfare Officers arc in<!- pen
dent to a large extent. Their duties and resp<>i> abili
ties with respect to adminsistartion of Health is to
be exercised consciously.”
The Hon. Health Minister hoped that the outcome,
conclusions and recommendations be supportive
to the progress to the Society: He wanted the
dalibcrations of the workship and the recommen
dations to be sent to the Government. They will
receive the earnest cosideration of the Government
and implementation to the extent possible.
Dr. T. Ranganatha Achar, Director of Health and
Family Welfare Services, Dr. C.R. Krishnamurthy,
Addl. Director ol 1 leallh & Family Welfaie Servii vs
and Di. Sona Kalyanpur Hao, Secretary VI IAK
thanked the Hon. Health Minister.
Preparation of the report of the pro
ceedings :
A Committe of five members was constituted .■. itli
the responsibility of preparing the final report of
this workshop. The draft will be circulated to all the
participants, who will be given one month time to
respond to the draft. The same committee will then
prepare the final draft which will I)'.- submitted to
Government by August 1992 and copies sc nt to all
members (through (lie Director of I leallh Services
as there may be transfers). The members of this
committee are :
(a)
Dr. C.M. Francis
Director, St. Martha’s Hospital, Bangalore.
(b)
Dr.C.R.Krishnamurthy
Addl. Director, Health & F.W. Services Government ol
Karnataka
(c)
Dr. H. Sudarshan
V G K K, B R I lills, Mysore District. Treasurer. VI I AK
(d)
Dr. G.V. Nagaraj
Joint I )i rector, I leallh \ F.W. Sen ices Govei nmeitt < I
Karnataka
(e)
Dr.S. Pruthvish
Programme Adviser, Disability Division. Action Aid
(India) and Member, VI IAK.
lZ7e has gone to his parents' house
and has taken his children.
His flat is quiet.
As I dust his furniture,
As I straighten his books,
the anger grows.
As I sweep his floors.
As I make his beds,
the anger grows.
As I wash his clothes,
As I iron his shirts,
the anger grows.
As I clean his balcony,
As I water his plants,
the anger grows.
He returns to his home laughing.
A Room of My Own
He has brought along his friends.
"Four teas, please Meera", he shouts to me.
The anger grows.
Then he comes to the kitchen saying “Here, let me help
you".
"No!", I bark.
Fangs bared, guarding my domain.
The anger overflows.
“This is my kitchen. I'll do it".
He steps back quickly.
He has been hurt - he doesn't know why.
I've hurt him - I don't know why.
He returns to his friends, hiding his wound.
I retreat into my room, to tend to mine
... and prepare the tea.
—U.K. Rajani
*5
CONCLUSIONS AND MAJOR RECOMMENDATIONS
The Bangalore Workshop on National Health Policy,
organised by the
Voluntary Health Association of Karnataka,
Voluntary Health Association of India, and
Directorate of Health & F.W. Services, Govern
ment of Karnataka,
Exchange of resources of Government and
Voluntary Organisations could avoid dupli
cation and wastage.
2.
Decentralisation of planning, implement:.
lion and evaluation of health and health
related programmes is necessary. Attempts
towards this end by the States through Zilla
Parishats were appreciated. There is need to
evolve a District'Health Policy.
with participants drawn form the Government and
Voluntary Health Secotrs, meeting al the Institute
forSocial and Economic Change, Bangalore, on the
9th and 10th April 1991,
Having had the benefit of well searched presenta
tions and papers on
National Health Policy - an overview,
Current Health Status in India,
National Health Policy from the point of
view of Government of Karnataka,
National Health Policy as seen by Voluntary
Organisations, and
View of Peoples’ Repressentatives on Na
tional Health Policy,
2.(a) The District Health Care ptogammes will be
based on the Karnataka State level health
policly to be formulated hereafter, based on
the findings, conclusions and recommenda
tions of the workshop.
3.
4.
A list of essential drugs appropriate lor each
level of use must be prepared. Essential dings
must be made available in adequate quantiles
and dosage forms for use al all levels of health
care. There must be quality assurance of
drugs. Adulteration of food and drugs must
be prevented.
Have come to the following conclusionsand major
recommendations:
Increased Budget Allocation
There is urgent need for increasing the bud
get allocation for the Health Sector, which is
totally inadequate at present. It should be at
least 5% of the total budget and progressively
increased to 10% by 2000 A.D. Due impor
tance should be given to equitable distribu
tion to rural and urban areas based on
population coverage.
Distortions in the allocation of expenditure
for preventive, promolive and rehabilitative
care on one hand and curative services on the
other must be avoided.
National Ding policy
A comprehensive Drug policy should be
evolved as part of the National Health Policy
Reflecting further in the plenary session on the
various suggestions and recommendations,
1.
Referral System
A good referral system, utilising and im
proving the available facilities. Govern
mental and Voluntary, should be worked
out. Proper linkages must be forged be
tween Primary, Secondary and Tertiary
levels of health care.
Taking note of the impact of the New Economic
Policy on Health; Deliberating in groups on various
issues in Health, especially focussed on
Primary Health Care,
Health Education,
Intersectoral Co-ordination, and
Health Information System,
District Health Policy
(a)
5.
Health Education
Priority must be given to health education. H
is necessaty to make people health con
scious, become aware of health problems
and develop altitudes, skills and knowledge
to lake action for better health. We should
enable people to be healthy and maintain the
health of individual, family and community
Health Education must be carried out utilising
all types of media, as may be appropriate in
the given siltfalion.
5.(b)Education of health professionals
The group expressed concern over the in
creasing numbers of Medical and other health
care professionals’ colleges. Capitation fee
should be abolished.
6.
Public Health Act
The existing Public Health Act is no longer
relevant.There is need fora new comprehen
sive Public Health Act, taking into account
problems such as environmental pollution.
7.
Epidemiologic Unit at District level
There is necessity to establish one
epidemiologic unit in each district. All data
generated in the Health Information system
should focus on giving epidemiological in
formation relevant to the health needs of the
people.
Data collection and re porting must be stream
lined. They must be communicated in all
directions.
8.
Mental Health
As part of comprehensive health care, mental
health should be given adequate attention,
especially community mental health.
Rehabilitation services for the mentally handi
capped must be expanded.
9.
Political commitment
For action for better health of the people,
there is need for political commitment. With
out political will, adequate action cannot be
taken.
The local and state leaders and elected
peoples’ representatives must be involved.
10. Training and re-orientation
All persons engaged in health care must be
trained for Primary Health Care, Utilising the
resources of both governmcnland Voluntary
Organisations. The quality of training must
be assured.
The health wokets must receive re-orientation
from time to time. There is need for continuing
education ofall health professionalsand woikeis.
11. Adoption of health centres by Vol
untary Organisations
Recognised Voluntary Organisations may be
encouraged to adopt health centres or sub
centres in their totality, with the government
placing at theirdisposal all resoixiccs, includ
ing manpower, equipment, materials and
finances. A lifet of Voluntary agencies at the
local and District level may be prepared.
12. Intersectoral Committees
Intersectoral committees should be formed at
different levels to bring about effective co
ordination for better health. These commit
tees should have governmental and non
governmental presonnel involved in health
and health related activities including food
and agriculture, education, social welfare.
engineering, water and sanitation, animal
husbandry and others.
The committees may be formed at various
levels - Village, block, district and state - will i
appropriate membership.
13. Indigenous systems of Medicine
Indigenous systems of medicine must be
promoted. They must be available to people
to choose according to their wish. They must
be integrated with the health system to the
extent possible.
14. Improving existing system
Existing health care systems must be strength
ened before expanding the services.
15. Occupational Health
Greater attention must be paid to occupa
tional health and diseases associated with
occupations, whether agricultural, industrial
or otherwise.
There should be co-ordinated activities with
the department of labour.
WORKSHOP ON “NATIONAL HEALTH POLICY”
Organised By VHAK, VHAK And Directorale Of Health And Family Wel
fare Services, Government Of Karnataka At IISEC, Bangalore on
9lh And 10th April 1992.
Working Group
1.
2.
Dr. C.M. Francis
Sr. S.V. Rama Rao
3.
4.
Dr. I I. Sudarshan
Dr. (Mis) Sona Kalyanpur Rao
5.
Dr. Dara S. Amar
6.
7.
Dr. S.P. Tekur
Dr. S. Pruthvish
: Director, St. Martha’s Hospital, Bangalore.
: Rid. Director of Rural Health Services and Training
Programmes, St. John's Medical College, Bangalore
: V G K K, B.R. Hills, Mysore district
: Medical Officerand Co-ordinator, Holdsworth Memo
rial Hospital, Mysore.
: Prof, and HOD, Community Health Depl., St John’s
Medical College, Bangalore.
: Community Health Cell, Bangalore
: Programme Adviser, (Disability) Action Aid India,
Bangalore
Resource Group
1.
Dr. C.R. Krishnamurthy
2.
Dr. C. Prasanna Kumar
3.
Dr. Patil Kuikami
4.
Dr. (Mis) M.K. Vasundhara
5.
Dr. G. Rangaswamy
6.
Dr. M.K. Kuikami
7.
Sri. S.M. Subramanya Setty
: Addl. Director, Health & F.W. Services Government of
Karnataka, Bangalore
: Rtd. Director, Health & F.W. Services Government <>l
Karnataka, Bangalore.
: Rtd. Chief Health Officer, Corporation of the City ol
Bangalore.
: Prof. & HOD, Dept, of Community Medicine, Govt.
Medical College, Bangalore.
: Deputy Director (Family Welfare) Health <& F.W
Services, Government of Karnataka, Bangalore.
: Prof. & HOD, Dept, of Community Medicine, Govt.
Medical College, Mysore.
: Asst. Professor, Dept, of Health Education, NiMl IANS,
Bangalore.
Workshop Secretariat
1.
2.
Miss. T. Ne'erajakshi
Mr. Ramappa C. Hadil
3.
Mis. Indira I.L
4.
Mr. Shivaraju D.N.
: Promotional Secretary
: Programme Co-ordinator
: Typist
: Office Assistant
VOLUNTARY HEALTH ASSOCIATION OF KARNATAKA
The need fora state level apex organisation in the
Voluntary Health Sector based on secular prin
ciples was fulfilled in the formation of Voluntary
Health Association of Karnataka in the year 197
*1,
based in Bangalore. The VHAK starting initially
with 25 institutions has grown into a big institution
with a membership strength of 150 institutions
spread all over Karnataka.
Act or any other Act The Organisations should I >
non-profit making and non-sectarian in then ap
proach.
VIIAK brings together the Voluntary Organisations
both in health and Non-health areas and Govern
ment agencies to thrash out belter collaborative
mechanisms and co-operation among them for a
unified comprehensive development of the State.
*
Membership isopen to all Health and Development
Organisations (having Health as one of their com
ponents) which are registered under the Societies’
Highlights of its approach include:
•
*
*
•
*
•
Helping to create the atmosphere for building
up a peoples’ Health movement
To act as a liason between voluntary institu
tions and government agencies
To help in co-ordination of Health care activi
ties in voluntary sector
To help member institutions in organising
trainig programmes, seminars, workship, etc..
Information dissemination and networking
Studying, documenting and promting alterna
tive systems of Medicine and
To mobilise the resources of both Govern
ment and Voluntary sector.
Further Details on VHAK can be had front:
Voluntary Health Association of Karnataka
No. 60, Rajini Nilaya
Ramakrishna Mutt Road Cross
Ulsoor, Bangalore - 560 008.
Telephone No. 576606
EXECUTIVE BOARD OF VHAK
Fr. Bernard Moras
President
Director
Fr. Muyller's Hospital
Kankanady
Mangalore
Dr. Sr. Teresita
Vice-President
Medical Superintendent
St. Martha’s Hospital
Nrupathunga Road
Bangalore - 560 009
Dr. (Mrs) Sona Kalyanpur Rao
Hon. Secretary
Medical Officer & Co-ordinator
Holdsworth Memorial Hospital
P.B. No. 38
Mysore
Dr. H. Sudarshan
Hon. Secretary
Vivekananda Girijana
Kalyana Kendra
B.R.Hills, Mysore Dist.
•
Dr. B.D.R.Paul
Director
Holdsworth Memorial Hospital
P.B.No. 38
Mysore
*
Dr. Dani S. Amar
•
Mr. Premananda Thambi
Prof. & Head,
Community Health Department
St. John’s Medical College
Sarjapur Hoad
Bangalore - 3'1
Co-ordinator
SI BS
Bangarpet, Kolar Dist.
•
Dr. Upendra Shenoy
Arogya Vikasa Information
Resource Centre
K.ti. Nagar
Bangalore.
•
Dr. S. Prulhvish
Programme Adviser
Disability Division
Action Aid, India
Bangalore.
OFFICE STAFF OF V1IAK
Miss. T. Ncerajakshi
Promotional Secretary
Mr. Ramappa C. Hadli
Programme co-ordinator.
VOLUNTARY HEALTH ASSOCIATION OF ilNIzN.
The need for a national apex organisation in the Voluntary Health sector based on secular principles ••
strongly expressed in a meeting of leaders of Voluntary Hospitals and Health care Institutions in Ind: :
a meeting held in Bangalore in 1969. This started a process which culminated in the formation of Volun:;.:
Helath Association of India in 1974 based in Delhi with a clear mandate to promote the concei-:
Community Health in the country in order to correct the prevailing imbalances in the Health care deli'. .
system due to our emphasis on expensive Hospital oriented curative Health services. In its 15 >■ ars o;
existance VHAI has established links with more than 3000 health and Development organisations s|" • ■
all over the country.
VHAI works to promote Social Justice in the provision and distribution of Health. Its major activities a.
aimed at achieving the following objectives :
*
Helping to create the atmosphere for building up a peoples’ Health movement through ellccii- >•
networking, lobbying, campaigning and public affairs related activities.
•
Helping in the evolution of lowcost, appropriate and people oriented health programmes in harmony
with lhe traditional knowledge and skills of the community.
•
Providing support services to Community Health programmes taken up by members and Associates
These activities are carried out by the various divisions of VHAI, viz
TRAINING
COMMUNICATIONS
PUBLIC POLICY
PUBLIC AFFAIRS
STATE VHAs
VHAI is a federation of 19 state level Voluntary Health Associations. Membership of VIIA1 is thorugh
VHAs and is availbel to all health and development institutions and programmes run on a no-proiir ■
irrespective religion, caste or creed. VHAI collaborates with State VII As on areas of common concern white
supporing them in their infrastructural and planning activities. While initiating the formation of new VI lAs,
VHAI is also involved in the revamping of some existing ones.
Further details on VHAI can be had from :
Voluntary Health Association Of India
No. 40, Institutional Area (Near Qutab Hotel)
New Delhi - 110 016
Telephone : 668071, 668072, 665018, 655871, 652952
ACKNOWLEDGEMENT
*
•
*
•
•
•
t
Dr. A KM Naik Secretary - II,
Department of Health & Family Welfare Services, Government of Karnataka.
Dr. T. Ranganatba ZcZtnr Director, Health & Family Welfare Serivces, Goven'.n.enl of Karanataka
Dr. C.R. KrishnamurthyAddl. Director, Health & Family Welfare Services. Governin' m of Karam 11
Sri. T.R. Satisb Cbandran Director, Institute for Social and Economic Change. Bangalore.
Dr. CM. Francis Director, St. Martha’s Hospital, Bangalore.
All Members of the working Groups, Resource Persons, Resource Group ant! Participants
VHAI, New Delhi for financial support.
The Voluntary Health Association of India (VHAI) is a non-profit registered society
formed by the federation of Voluntary Health Associations organised at the level
of States and Union Territories. VHAI links over3000 grassroots-level organisations
and community health programmes spread across the country.
VHAI's primary objectives are to promote community health, social justice and
human rights related to the provision and distribution of health services in India.
VHAI fulfils these objectives through campaigning, policy research, and press and
parliament advocacy; through need-based training and provision of information
and documentation services; and through production and distribution of innovative
health education materials and packages, in the form of print and audio-visuals, for
a wide spectrum of users — both urban and rural.
VHAI tries to ensure that a people-oriented health policy is formulated and effectively
implemented. It also endeavours to sensitise the larger public towards a scientific
attitude to health, without ignoring India's natural traditions and resources.
Intersectoral Cooperation
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KARNATAKA AND INDIA
AT A GLANCE
2uodo
(As on 31-3-1992)
(31 -3-19923g
o3)
Published By
MANAGEMENT INFORMATION AND EVALUATION DIVISION
DIRECTORATE OF HEALTH AND FAMILY WELFARE SERVICES
BANGALORE-560 009
^350035 35,503
rfjaioS ftrfFaJra
w6js>ert4
rfcarfrf assart
tfey9sta iSesSrttf adfetfjjaooi)
28orttfja&-35S.O OOF
KARNATAKA AND INDIA AT A GLANCE
tffsaFll^
&ja$t3
yaddd
(/Is on 31-3-1992^ ^Oo3)
1-
General Information/w^ja^ s±ro£o3
Karnatakal^^^m
Area in Sq. Krns./^jrar
Indialt&tt
1,91,791
32,87,263
No. of Revenue Divisions/da&a^ az^arW soa3s
4
NA
No. of Districts/^dDitf soaJ4
20
412
No. of Sub-Divisions/w3j SzpartrW ^orf£
49
NA
No. of Taluks/ssyjaozri^ soa3.
175
NA
No. of Towns and Cities (1991 Census)/^^ gtoda, Srtdrto xfos34
(19916 srfnraS) (sa^Cu)
254
3,768
27,024
5,57,137
44,806
8,44,324
22,846
NA
21,960
NA
20.66
23.56
30-91
25-72
Density of Population per km
*
(1991 Census)/^ z&;de.aoa.rt
234
(1991 ftrfrtaa)
Sex Ratio (No. of Females per 1000 Males)
961
©co
(a^s 1000 ^do^ort' a5:2os?o3;d;)
267
No. of inhabited villages (1981 census)/adaSS3 ^dasd na^arte x>csJ6
(19810 tsdrtraS)
2. Demographic Features (1991 Census) (Provisional):
(orFod Krfrtras) (sasa^^)
Population (in 000s)/K«soa3. (OOOrteg)
Male Population (in 000s)/rtoc&jd
(OOOrtVg)
Female Population (in 000s)/a5odSd ass&oal (000 rttfg)
Decinnial Growth Rate (1981-91)/1981-910 tidodoa^d
zdjz&ara
Percentage of Urban Population to Total Population
z->uo.
ed
o d dzScsaajada zssSsoalt>
(a) Percentage of Literacy [1991 Census)
Male/^daaida
Female/V^do
929
^aodd (199Id zsrfriraS)l 55.98
52.11
67.25
44.34
63.86
39.42
64-15
65-30
60 6
61.7
(6) Expectation of life at birth (in years) (1991-96) (Projected)
K«?S senO aoejs ecrix! t^sfcara (asaFrttf©) (1991-96)
Male/^jdazdda
Female/sfc^odjtfo
(c) No of Eligible Couple Protected as on 31-3-1992
(as worked out by Minister of H & FW)
49.4
ezdF ijcaterte dgraa a^zdaara Osacd 31 -3-1992dg
(edjazrr
44.1
(199H
ua. $. g©a6ro szSasaoabc! uJaa^zeadidcd)
(d) Percentage of Married Females to total Females in the
age group of 15—441^5-446 sdOjjazedrarfidSjS
76.08
80.51
25.86
19.21
23.29
18.33
afortsd©
CCTtodoazj slaJe^cdado-SeijroOTda (198Id K?srira3)
(e) Mean Age at Marriage of FemalelMale (1991 Census)
cocrfad/rioc^d aroaod soa^o
Male/^d^da
Female/’vs^j
(198Id Kdricai)
Karnataka/tfsarus
1SSS~Sa
current prices
-oasrado e^oja-l 988-89 (djasroo&aritfe)-^^ ddcig)
3.
Vital Statistics/fciriri-rfodcaritf eo
*
3787-00
Ind/ia^tit
3835-30
ejodrttfo
(A) Fcrtility/sjia^g
(a) Birth Rale^ttci a^sjjsrs
(Provisional
1990/33Hai©tf (orro)
Rural/na^era
Urban/aj^ra
Combined/doojxu,
(6) Age specific Fertility Rales (1986)!^jt>iti^S3Si5z
28.8
31.5
24.8
24.4
27.8
29.9
$d (OfGL)
Years/^rri^o
15....19
88-8
91.1
20-24
230-2
252-8
25 - 29
180-3
216-4
30-34
103-9
139-2
35 . 39
60-4
78-6
40 - 44
22-8
37-7
45
6-9
14-9
Rural
3-7
4-5
Urban 1^^
2.9
3-1
Combined/zfcofa)^,
3-5
4-2
Rural/n3jaaa?ra
2-1
2-2
Urban/sj^ra
1-6
1-5
Total/^Oj
2.0
2-0
49
(c) Total Fertility R iles (1986)1^^
^d (OfSL)
(rf) Gross Reproduction Rate (1986)1^,13^ dosadjasdjSj
(0R5L)
(B) Mortality/rfadra
(a) Death Ratefifain Bestow
Provisional (1990) sasa^On (OfTO)
Rural/napx’»
8.8
10.4
Urban/si^fs
6.1
6.7
Combined/sooio:^
8.1
9.6
Rural/najSaera
81
86
Urban/«^4jra
39
51
Combined/Sooiw^
71
80
(b) Infant Mortality Rate^^tiss SjStaro
(Provisional [9901^^^ 1990)
(c) Neo-nataland Post natal Mortality Rates (1986)
ddJJad &da dadro yd (OFCL)
Neo-natal,'«sfcadodd 3L odrte
54.4
59.8
Post-natal/Kdrarfcid ol aaDocd ai.os adds' t^rt
18.8
36.6
India/t&oz
Karnataka
4.
Percentage of Population below Poverty line (1987-88) (Provisional)
zjrferfw
rarf^oaB.
(os’eja.-tfes) (<rs;ro,atf)
Rural,rra,aura
5.
32.66
35.87
Urban, ’SU.ra
NA
NA
:^:®,
*
Combined/
31.98
29-23
Per Capita (Public Sector) Expenditure on Health (Medical
and Public Health) and Family Welfare (86-87) (In Rs.)
radrsait a&raert) rfoSb,
yfijsert. (^c^oto
Soasrado (sarfrwf)^ rfooia)
6.
^o^ra
(orest-aa) dua. rttfg
Health/«djifr(6
40.59
54.57
Family Welfare/d:irfcu coa4ra
9.59
7.61
293(p)
10172©
1262
20531©
(«) Health and Medical Institutions
yduaeri,0 rfo&i
—2 s3.rS,-&eodo
d Q
cp
General Hospitals, Major Hospitals and District Hospitals
sasdrssad ess
rfjsS es,^>ritfj siada, ctera ess d>rtsb
Primary Health Centres/sra^aiu odjaeri4 deoc^n^a
Primary Health Units/Dispensries/^O- a. ^adritfa/Edcpaoafori
*
831(p)
28304©
No. of Beds/^a^tf serf.
48439(p)
625418©
No. of Sub-Centres/wrfdeoid/^ ^orf4
7,793
13090©
Rural Family Welfare Centres/rrajicera dauacta 6oa£ra SeocJ,nsb
269
5345 V
Urban Family Welfare Centres/Srid sataaow eoa.ra dfot^rtoa
102
1941Q
Post Partun Centres/^rao^a Sseaa deod/Wa
103
1501°
Medical Termination of Pregnancy (MTP) Centres/
471
NA
5
NA
s3 tu esoda rhprzros (iacU&) dfo-jrto
Health and Family Welfare Training Centres/
edaaert.z> adada.
-3 daUxza doa.ra
0 a dates dsor.rWa
(6) Institution Population Ratio/i^deeda SaS_eSsorf£ a^sdaara
1: 21.740(F)
1 : 1000°°
1: 1355(F)
1 : 1398v
(For Census Population of 1991)/(1991 d zsrfriradoda zsSSorf^)
(c) Bed Population Ratio/csasd-tsedsorf. a^doara
(d) Doctor Population Ratio (Govt.)]^^^ Ksssorf4 rf,;djara (sssfO)
Excluding Teaching Staff/^-’^s
aojsdd^QX)
1 : 2450
*
1 : 10.230
NA
1: 8418
NA
For Total Population/t-KSj Krfscrf.rt
1: 4.904
1 : 2036
*
(/) Nurse Bed Ratiosasrt s^^jsra
1: 8
1 : 300
Including Teaching Staff/^^c
(e) Auxiliary Nurse Midwife/Midwije Population Ratio (Govt.)l
—SScoSOrf,.
(S53c 0)
(P) Provisional as on 31-3-92
“ 31-3-1987
© as on 31-3-90
O 31-3-89
* 1985
▼ 1986
00 1-1- 1988
(p) Provitivnal
axcjjra :
^esjjoj: trusty aj-'n^rasutsi'
TABLE-9.4
Selected Indicators of Vocational Education in Karnataka
Item/Unit
1990-91
1991-92
1992-93
1993-94
(?.nt icipat ed)
283
328
474
589
14,500
16,000
25,000
30,600
11.58
-
-
296.34
267.00
600.00
1342.42
152.16
6
177.85
43.67
1. No. of Inrtituti ons
2. No. Enrolled
3. Expenditure:
(Rs. lakhs)
(a) Plan
i) State Plan
ii)Centrally Spon - 172.73
sored Schemes
(b) Non-Plan
168.17
Source: Department of Vocational Education.
2.
HEALTH AND FAMILY WELFARE
The Department of Health and.Family Welfare tab the
responsibility of providing comprehensive health cere
facilities through various programmes, schemes and
various types of health institutions.
The main
objectives of the Department are as follows:
- To
effect improvement
in Medical care and to
provide Medical Relief.
- To
undertake,
National Health Programmes for
control and
eradication
of
communicable
diseases and ocher major diseases.
- To promote
education
hea1th development.
in health protection and
- To take sui tabj.e measures to prevent food
adulteration.
c
- Tc provide services, like
maternal and
child
health, family welfare, immunization, prophylaxis
against nutritional
anemia
and
control of
blindness; and
- To
promote, health education and
various medical disciplines.
242
training
in
,;.4
Primary Health Care
Primary health care is one of the items under the
restructured 20 - point programme.
The State is
following the national pattern of three tier health
infrastructure in rendering primary health care through
Primary Health Centres, Sub-Centres and Community Health
Centres.
The policy of the Government is to establish
one primary health centre for every 30000 population in
plain areas and for every 20000 population in hilly and
tribal areas, one sub-centre with a female health worker
for every 5000 population in plain areas and for every
3000 population in hilly and tribal areas and one
Community Health Centre for one lakh population or one
out of four primary health centres to be made to
function as referral/specialised institution for the
rural population.
The earlier scheme of establishing Primary Health
Centres has been discontinued and the existing Primary
Health Units will be upgraded .into Primary Health
Centres in a phased manner.
At present there are 176 hospitals, 198 Community
Health Centres, 1297 Primary Health Centres, 622 Primary
Health Units and 7793 sub-centres functioning in the
State.
Government has sanctioned the following Schemes
during 1993-94:
1.
2.
Trauma Care Units to Community Health Centres:
i) Challakere, Chitradurga District.
ii) Bhadravathi, Shimoga District.
iii) Nanjangud, Mysore District.
Maternity Annexes to:
i) Begewalu PHC, Arasikere Taluk, Hassan District.
ii) Kallur KHC, Gubbi Taluk, Tumkur District.
\
3.
Modified Leprjsy control unit to Nelamangala and
Kumta.
4.
Urban
Leprosy
Centres
Jamkhandi(Bijapur Dt).
5.
Blood Bank .at Chamarajanagar General Hospital,
Mysore Dt.
at
Shimoga
Filaria Control Unit at Ilkal.
Filaria Clinic at Kamatagi, Bijapur District.
100 beds for maintenance of Leprosy patients
voluntary organisations.
243
- JTT
&
by
9.
10.
11.
12.
Enhancement of bed strength from 60 to 100 in
M.C.M.
General
Hospital/
Mudigere
Taluk,
Chickmaglur District.
Enhancement of bed strength from 50 to 150 beds, of
General Hospital, Chinthamani, Kolar District.
Establishment of 49 Primary Health Centres.
Establishment of 14 Community Health Centres.
Tables 9.5, 9.6 and 9.7 present basic indicators of
health facilities and impact, indicators of health and
quality of physical life and plan and non-plan
expenditure on Health and Family Welfare.
TABLE-9.5
Selected Indicators of Health Facilities and Impact
Physical Indicators
1990-91
1. No. of Primary
1198
Health Centres
2. No. of Sub-Centres
7793
3. Crude Birth Rate
27.9
4. Crude Death Rate
8.7
5. Infant Mortality Rate
80
6. Life Expectancy - Male 62.15
Female 63.31
7. Eligible Couples
7170720
Estimated
8. Couples Protected
3410953
9. Proportion of Couples 47.6
protected (per cent)
1991-92
1992-93 1993-94
(Anti.)
1248
1297
1357
7793
•27.8
“ 8.1.
71
—
7793
26.8
9.0
77
—
7793
26.8
9.0
77
-
7293680 7416597 7416597
3583323 3726870 3726870
50.3
50.3
4?.l
Source: Department of Health and Family Welfare Services.
244
TABLE-9.6
Indicators of Health and Quality of Physical Life
Karnataka and India
Karnataka
Indicator
1. Birth Rate (1991)
27.8
Rural
23.9
Urban
25.8
Combined
2. Death Rate (1991)
9.7
Rural
6.9
Urban
9.0
Combined
3. Infant Mortality Rate (1991)
87
Rural
47
Urban
77
Combined
4. Expectation of Life at Birth
64.15
Male
65.30
Female
•
5. Dependency Ratio:
(No. of persons m the age group 858
of 0.14 and 60 and above per
1000 persons in age group 15 -59)
India
30.8
24.1
29.3
10.5
7.0
9.8
86
52
80
60.6
61.7
354
Sources: Department of Health and Family Welfare Services.
TABLE-9.7
Plan and Non-Plan Expenditure on Health and
Family Welfare
Rupees lakhs
Year
1990-91
1991-92
1992-93 (RE)
1993-94 (BE)
Plan Expenditure
8341.63
9504.85
13874.84
18472.77
Non-Plan Expenditure
16616.56
20559.96
25206.06
28483.26
Note: These figures are compiled from Finance Accounts
and AFS - different issues.
245
3.
ENVIRONMENT
I. HOUSING
Food, clothing and shelter are the three minimum
basic needs of people. Increasing population, pressure
on land and infrastructure and associated high costs
have made proper housing inaccessible to the poorer
segments
of
the
population
necessitating
state
intervention initially as a welfare activity and now
recognised as a social and economic imperative. Keeping
this in view the policies and programmes have been
formulated to fulfil the housing requirements of
majority of economically vulnerable sections as well as
to create an enabling environment to accomplish the goal
“Shelter for all" on a self sustaining basis. The main
objective of the programme is to provide sufficient
units for the economically weaker sections.
a)
Housing scene
As per 1991 census, there were about 79.6 lakh
dwelling units in Karnataka out of which 54.2 lakhs in
rural areas and the remaining 25.4 lakhs in urban areas.
■ b) Rural Housing
The scheme of allotment of housesites and
construction assistance to rural landless workers and
artisans including Scheduled Castes and Scheduled Tribes
was initiated as a Central Sector Scheme which was later
transferred to State in 1974. It is a part of Minimum
Needs Programme. Upto the end of November 1993 about 17
lakh beneficiaries got house sites (Appendix 9.6).
During 1991-92 a little over 4 lakh sites have been
distributed. In the following year 1992-93, it was 1.57
lakhs. From the year 1992-93, a Massive Programme of
distribution of house sites and providing construction
assistance were launched under ASHRAYA
salient feature of this scheme are’ :
SCHEME.
The
(i)
to provide shelter to the economically weaker
sections of the society as quickly as possible;
(ii)
to eliminate the houselessness by the turn of the
century by adopting a new housing strategy for the
target groups;
(iii)
to enable the local bodies/corporations to serve
the public and contribute and implement the
project ir; a more effective and efficient manner
by providing adequate technical and financial
support;
246
(iv)
to rehabilitate the slum dwellers in the City of
Bangalore in a phased manner;
(v)
to'' promote the usage of locally manufactured
building materials with pre-fabricated technology
in the long run.
The main
Scheme are:
target-group
eligible
Ashraya
under
(i)
people whose annual income falls below Rs.8,400
in Rural and Urban areas in the State excluding
Bangalore City;
(ii)
the slum dwellers of the Bangalore City whose
income is between Rs.8,401 and 18,000 per annum.
The unit cost of a house under Ashraya Scheme is
as follows
Unit cost
Rs.
Loan
Rs .
Subsidy
Rs .
Rural
15,000
10,000
5,000
Urban
16,000
14,000
2,000
Banglore
33,000
28,000
5,000
(50% of the cost of the site in Urban areas
contributed by the beneficiary).
is to be
ft
The progress achieved under the various
of construction of houses in rural area from
upto December 1993 is given in Appendix 9.7.
schemes
1973-74
The target fixed under Ashraya Scheme during
1993-94 was to construct 1.06 lakh E.W.S. houses and
distribute 1 lakh sites. Out of which 0.19 lakh houses
were constructed and 0.48 lakh sites were distributed
upto the end of Nov. 1993.
Neralina Bhagya:
In addition to providing sites and construction of
houses under Ashraya Scheme, a new scheme called
NERALINA BHAGYA was introduced during 1993-94 with the
object of replacing thatched roof with tiled roof at a
unit cost Rs.3,000/- per house.
247
C)
Urban Housing
Housing Schemes implemented in urban areas are. as
under:
(i)
housing schemes for different income-groups
operated by Karnataka Housing Board;
(ii)
„
Sites distribution in Bangalore City by Bangalore
Development-Authority and by Urban Development
Authorities in other urban areas;
(iii)
construction of EWS houses for slunv dwellers by
the Karnataka Slum Clearance Board;
(iv)
housing and shelter upgradation scheme for urban
poor as a part of -Nehru Rozgar Yojana (NRY).
o
construction of quarters for Govt, employees in
Bangalore and other places.
(v)
About 92 thousand houses were constructed in urban
areas under the schemes of Bhagya Mandir, Middle Income
Group, Low Income Group and Economically for Weaker
Sections from 1970-71 to 1992-93. The scheme-wise
progress achieved is presented in Appendix.9.8.
II
RURAL WATER SUPPLY AND SANITATION
Rural
a)
Water Supply
The total population of the State as per 1991
census was 449.77 lakhs out of which the rural
population was 310.69 lakhs which constitutes 69 percent
of the total population. This rural population is spread
over 29,193 revenue villages and 27,496 habitations
(hamlets, Thandas, Janatha Housing Colonies).
Karnataka is one of the pioneer states to provide
atleast one safe drinking waterosource for all the
revenue villages by 1986 itself.
Even,
all the
habitations like Hamlets, Thandas, Janatha Housing
Colonies have also been provided with atleast a single
drinking water source before March 1993. At the begining
of VI Five Year Plan, Government of India came forward
to support the State Government financially by providing
additional financial inputs under the Central Sector
Scheme called: Accelerated Rural Water Supply Programme
(ARWSP). After conducting a survey, for identifying
problematic villages, 20,003 villages were identified as
problematic villages out of the revenue villages in the
State. All these villages were provided with atleast
single drink,ing water source by 1986.
24R
During VII Five Year Plan (1985-90), modified
norms were followed for identifying the problematic
villages/habitations. In addition to the 1980 list,
17,132 habitations out of 25,595 habitations were
identified as problematic habitations. All the un
covered villages have been covered.
The status of the coverage of the problematic
villages/habitations as on 1-11-1993 is as detailed
below:
Number:
Villages
& Habi
tations
Villages
Habita
tions
1980
list
1985
list
Total
Not
covered
20,003
5,397
25,400
Partially
Covered
-
11,735
11,735
Fully
covered
-
—
Total
coverage
as on 1-11-1993
Identified as
Problematic
Catagory of
Villages/
habitations
1980
list
241
19,762
20,003 17,132
1985
list
Total
9,252
9,493
7,880 27,642
37,135 20,003 17,132 37,135
The water supply schemes for other villages and
habitations (Non-problematic ) are tackled under the
State Sector Schemes namely 'Minimum Needs Programme'
(MNP). Water Supply to Rural areas is accomplished
through piped water supply, mini water supply and
borewells fitted with hand-pumps. Of the total 29193
revenue villages (as per 1991 census) in the State 7818
villages were covered under piped water supply scheme,
6726 villages under mini water supply schemes and 14649
villages under borewells programme. The achievements
under Rural Water Supply from 1970-71 upto the end of
November 1993 are presented in Appendix 9.9.
249
Rural
b)
Sanitation
Improved Sanitation is considered as an important
element of basic needs of the people. It is also
recognised that improvement in sanitary conditions is
more effective and at the same time less expensive than
any other preventive health measures to combat water
borne and excreta-borne diseases. Hence the State
launched construction of low cost pour flush water seal
sanitary latrines in rural areas during 1984-85. This
pilot Project contemplated construction of 1600 latrines
to individual households at a total cost of Rs.16 lakhs.
But actually 1016 pour flush water seal latrines with
two leaching pits could be constructed during the year
at . an expenditure of Rs.9.75 lakhs. The beneficiaries
were identified amongst the economically weaker sections
of the rural population.
To augument the efforts made by the State
Government in promoting better sanitary habits amongst
the rural folk, the Government of India launched a
massive rural sanitation programme (RSP) with 100%
central assistance, and also made provision for taking
up works under RLEGP and NREP. Under CRSP, beneficiaries
were selected from among the people belonging to SC/ST
and those below the poverty line. Government of India
has now extended this benefit to selected Anganawadis
also. During 1992-93 as many as 4202 latrines were
constructed as against 897 latrines constructed during
1991-92. For the year 1993-94 Rs.115 lakhs, and Rs.266
lakhs have been provided for State and Central Sector
Programmes respectively for construction of 9908 units
both under State and Central Sector. During 1993-94
(upto the end of December 1993) Rs.26.3 lakhs has been
spent and 2246 latrines were constructed.
Since inception and upto the end of December 1993,
about 65579 individual household latrines have been
constructed in the rural areas, out of which, 40418
units have been completed under Nirmala Grama Yojana and
the rest have been constructed under CRSP and MNP Funds.
Urban
c)
Water Supply
The Karnataka Urban Water Supply and Drainage
Board (KUWSDB) was set up in 1975. It is responsible for
planning, designing and execution of Water Supply and
drainage Schemes in Urban Areas of the State except
Bangalore City. Karnataka Urban Water Supply and
Drainage Beard has jurisdiction over 172 Urban Areas of
the State, covering a population of nearly 90.90 lakhs.
The Board is executing the following Water Supply and
Sewerage Schemes.
250
Piped
i)
Water Supply Schemes
The works under this scheme are taken up in urban
area where the population is less than 20,000 as per
1991 Census with 100 percent grant from the Government.
Since inception as many as 125 towns have been covered
upto 1992-93 under this scheme covering a population of
19.35 lakhs. As many as 10 towns were covered under PWS
during 1992-93, while the likely coverage during 1993-94
is 8 towns.
Urban
ii)
Water Supply Schemes
Urban areas with a population of above 20,000
comes under this catagory. These schemes are financed
partly by LIC/HUDCO and Government as loan to the local
Authority which would be responsible for its repayment
with interest. The remaining amount would be financed by
the concerned local body viz., CC/CMC/TMC itself
depending upon the pattern of funding approved by the
Government.
Three towns each were covered under urban water
supply scheme during 1991-92 and 1992-93 with an
expenditure of Rs.10.53 crores and 21.90
crores
respectively. The anticipated achievement during 1993-94
is 9 towns.
Board
iii)
Water Supply Schemes
The Board Water Supply schemes are executed by the
Karnataka Urban Water Supply & Drainage Board as per the
directions of the Government after obtaining loans from
Government and LIC. The repayment of loan (with
interest) thus raised will have to be made by the Board.
Further, the board also maintain the works completed
under its water supply schemes. One town during 1991-92
and 2 towns during 1992-93 were covered with an
expenditure of Rs.8.50 crores and Rs.10.72 crores
respectively.
iv)
Underground Drainage Schemes
All Urban areas irrespective of their population
come under this category of schemes and they are
financed partly by LIC and HUDCO. The underground
drainage schemes were completed in two towns during
1991-92. The anticipated achievement for the year 199394 is 3 schemes.
The progress under the above Water Supply and
Drainage Schemes from 1986-87 to 1992-93 is given in
appendix 9.10.
E.S - 34
251
Ill
SLUM IMPROVEMENT
In all, 1615 slum areas have been identified with
an estimated population of 20 lakhs upto the end of
December 1993. The board is implementing two schemes
namely
(1)
Slum
Improvement
and
(2)
Clearance
Schemes(Construction of EWS Houses).
1. Slum Improvement
Under this scheme, the Board is providing the
basic amenities like Roads, Drains, Street lights,
community bathroom,
community
latrine,
sewerage,
community halls, drinking water to the slum areas. So
far 9.39 slum areas have been improved by spending an
amount of Rs.1,461.76 lakhs.
2. Clearance Schemes (Construction of EWS houses)
Under this scheme, the Board is constructing EWS
houses either in a slum area itself by clearing the huts
or in the available vacant land to rehabilitate the slum
dwellers. Upto end of March 199 3 , the Board has
completed 10791 houses by spending an amount of Rs.2002
lakhs.
Apart from the above two schemes,' the Board has
introduced a new scheme called "Site and Service" for
the upliftment of the slum dwellers from 1991-92
onwards. Under this scheme, the sites will be formed
with all infrastructure facilities and distributed to
the,slum dwellers.
The Board is also constructing the "Sulabha
Shouchalayas11 in the busy areas of the town limits. So
far 5 6 Shouchalayas have been completed at a cost of
Rs. 90.72 lakhs.
The details of progress achieved from the year
1986-87 to 1992-93 under the programme of environmental
improvement of slums are given in Appendix 9.11.
4. NUTRITION
The Nutrition programme in the State has three
components viz., (1) Supplementary Nutrition Programme
in ICDS (Women and Child Development Directorate); (2)
Mid-day Meals (Education Department) and (3) Supply of
Foodgrains to the poor at subsidised rates (Food and
Civil Supplies Department).
252
'.*C^>|-’
... ■■■•^.Y^--r ,
.
»...............
. .
a) Supplementary Nutrition Programme in ICDS
The Supplementary Nutrition Programme is one of the
most important components among the package of services
offered under the ICDS programme, which was launched in
the State from
December 1975 with a pilot project at
T.Narasipura in Mysore District.
Selected children
below 6 years, pregnant women and nursing mothers
belonging to weaker sections of the society are the
beneficiaries under this programme.
They are given
Supplementary Nutrition worth 75 paise per beneficiary
per day for 300 days in a year.
There is a proposal to
increase this to Rupee 1.00 per beneficiary per day,
shortly. Expert opinion claims that there is a deficit
of 300-500 calories ‘of energy and 10-12 grams of
proteins in a normal Indian child.
Likewise pregnant
women, nursing mothers and severely malnourished
children need an additional 500 calories of energy and
20-25 grams of proteins. With a view to compensate this
deficiency, the Government of India has introduced
Supplementary Nutrition Programme with State expenditure
in the ICDS Programme. Double feeding is being given to
the pregnant women, nursing mothers and severely
malnourished children in the Anganwadis.
27% of the .
total beneficiaries belong to Scheduled Caste and
Scheduled Tribes
and 12% belong to the minority
communities.
Presently in the operational 148 ICDS
projects Supplementary Nutrition is being provided.
The
Supple-mentary Feeding pattern is detailed as follows:
No.of Existing
Projects
Feeding Pattern
a) CARE projects:-
65 grams CSM/CSB and 8 grams
S.Oil + ingredients worth 20
paise per beneficiary per day.
97
b)
Non-CARE projects:49
c)
Bangalore(U)
Projects:-
2
100 grams of wheat recipes for
2 days,100 grams of rice reci
pes for 2 days and 80 grams
energy food for 2 days.Feeding
cost is 75 paise per beneficia
ry per day including ingredients
used in the preparation of
recipes.
2 slices of Milk bread per
beneficiary for children
(1-6 years).pregnant women and
nursing mothers; cost per
beneficiary per day is 90
paise.
253
While the cost relating to the Supplementary
Nutrition is entirely borne by the State Government, the
entire administrative expenditure in respect of 118
central projects is met by the Central Government
(including ICDS cells).
b. Mid-Day Meals Programme
The Mid-Day Meals Programme was started in 1963
with the assistance of CARE as an incentive programme
for Primary School Chidren. The main objectives of this
mid-day meals programme are:
(1)
to provide supplementary nutrition to the Chidren
in the age group of 6-11 years, particularly of
weaker sections of the
Society and thereby
to
improve the health status of the Children;
(2)
to
(3)
to facilitate rentention of the enrolled children in
the School.
fecilitate to improve enrolment of children; and
The programme has been classified into two
categories according to the nature of food assistance to
the beneficiaries:
I) CARE assisted Mid-day Meals Programme.
II) Energy rood Programme.
I) CARE Assisted Mid-Day Meals Programme
The food commodities such as Bulgar wheat and salad
oil are provided by CARE free of cost.
Food will be
prepared by cooking at the rate of 80 grams of bulgar
wheat and 5 grams of salad oil per day per beneficiary.
This CARE-assisted Mid-Day Meals Programme for Primary
School Children was closed at the end of 1992-93.
II) Energy Food Programme
In addition to CARE food programme, Energy Food
Programme was started as a supplementary programme from
1980-81 in Karnataka.
Food supplements like CSM, Balahar are blends of
unroasted
material
reguiring
eloborate
cooking
arrangements at the point of distribution.
Bread,
Biscuits, Extruded Foods are pre-cooked food but are
costly.
Therefore, Central Food and Technological
Research Institute (CFTRI) suggested a product called
"Energy Food", which is pre-cooked'weaning food formula,
developed by them for "India population project " in
254
- M'd
hiaiiiilW:',
Chitradurga District.
Due to its success over a period
of five years Energy Food formulation was adopted to
Energy Food Project. Accordingly five units located at
Mysore, Belgaum, Chitradurga, Raichur and Doddaballapura
are in operation.
UNICEF has provided machineries for
these units.
Remaining assistance is provided by
Government of Karnataka for setting up of these units.
Energy Food is a weaning food formula consisting of
Sweet blend and pre-cooked wheat, Bengalgram Dhal, Steam
treated Soya Dhal, Jaggery, Edible groundnut cake,
Edible Grade Soya Flour, Vitamins and Mineral Mix.
100
grams of Energy Food gives 12-14 grams of protein and
380
calories and adequate
vitamins
and mineral
supplements.
It is ready to eat and does not require
elaborate cooking arrangements at distribution point.
The Energy Food supplied to the individual feeding
centres is distributed to School Children particularly
of weaker sections studying in l-7th Standards in the
Lunch break at the rate of 100 grams per child per day.
For this Energy Food Programme Rs.109.00 lakhs is
provided under Plan (State and District Sectors
together), Rs.11.00 lakhs is provided under Tribal Sub
Plan and Rs.34.24 lakhs is provided under non-plan
during the year 1993-94.
2.04 lakhs beneficiaries are
expected to be covered under this Energy Food Programme
during 1993-94.
Table 9.8 indicates trends in expenditure over the
years 1990-91 to 1993-94 and number of beneficiaries
under both the Nutrition programmes (See Appendix 9.12
for details).
TABLE-9.8
Nutrition Programme in Karnataka
Item/Unit
1990-91
A. Supplementary Nutrition
Programme:
1. Plan Expenditure
709.12
(Rs. lakhs)
2. Beneficiaries ('000s 1281
B. Mid-Day Meals Programme:
1. Plan Expenditure
30.36
(Rs. lakhs)
2. Beneficiaries
(lakhs)
- CARE Food Programme
7.00
- Energy. Food Programme 5.62
Source: A
B
1991-92
1992-93
661.09
894.53
1026-.00
.
•
1993-94
(Anti.)
1673
a
36.89
1875
2263
72.00
120.00
4.66
6.79
2.34
4.76
2.04
Directorate of Women and.Children Welfare
Department of Public Instruction.
255
c. Subsidised Foodgrains for the Poor
There are two schemes implemented viz., Green Card
(Tri-colour) scheme and scheme for supplying Foodgrains
at subsidised rates to the population in Tribal Areas.
The main objective of both these schemes is to ensure
supply of essential commodities to the needy and
vulnerable sections of the community.
i) Green Card (Tri-colour) Scheme
Government introduced a scheme of supply of
foodgrains at subsidised rates to the rural poor in
1985.
Families in rural areas whose annual income did
not exceed Rs.3,500/- were given green cards.
However,
from October 1991
the income limit for green cards is
enhanced to cards were replaced by tri-colour cards. A
massive resurvey of beneficiaries was taken up all over
the State.
There were 31 lakh green cards before
survey.
So far, 46 lakh tri-calour cards have been
distributed in the State.
*
Further,
the benefit of tri
colour cards is also extended to the declared slums in
urban areas. These tri-colour card holders are entitled
for a mix of 10 Kgs of rice and wheat at subsidised
rates (i.e. Rs. 4.15 per Kg of rice and Rs. 2.75 per Kg.
of wheat).
However, the green card holders are
entitled for more quantity beyond 10 Kgs, under the PDS
at normal rates.
A unique feature of the above scheme
involves the responsibility of the State Government in
transporting food grains from taluk level to the doors
of the Fair Price Shops in rural areas.
A provision of
Rs.70 crores has been made
for the current year 199394 to meet the subsidy and transportation charges.
ii) Scheme for Supplying Foodgrains at Subsidised Rates
to the Tribal Population
This is a Government of India scheme under
implementation since 1986.
It is being implemented in
23 blocks in the districts of Chickmagalur, Kodagu,
Dakshina Kannada and Mysore.
The card holders are
entitled to 10 Kgs of rice and 5 Kgs. of wheat per month
at subsidized rates under this programme.
To ensure
smooth functioning of the scheme, Government of India
had sanctioned Rs.50 lakhs for introducing Mobile Fair
Price Shop vans and the KFCSC purchased 13 mobile fair
price shop vans.
2 56
__ _______ -
■
■ ■
5.ROADS
One of the basic requirements for the allround
development of rural economy is the accessibility of
villages by all-weather roads and. thereby remove their
isolation and pave way for the integrated development of
rural areas in the State. The road transport is becoming
increasingly important because of its reliability,
quickness and flexibility. This is particularly so in
view of the fact that the villages entirely depend on
road communication facilities for the transportation of
their Agricultural products/commercial goods either to a
market place or to the railhead. The- accessibility of
villages means providing all-weather roads upto their
periphery. The road length which was 0.84 lakh Km during
1970-71 has increased to 1.34 lakh Km. by 1991-92. In
other words, over a period of 22 years about 50 thousand
Kms. of road length has been formed (Appendix. 9.13)
i
As at the end of March 1992, 12649 (47%) villages
were connected by all-weather roads, 6747 (25%) villages
by fair weather roads, 7433 (27%) villages by Katcha and
non-motorable roads and 199 (1%) villages were not
connected by any roads. (See Appendix.9.14 for details)
The accessibility of villages according to the
population range and village roads by type is as
detailed below.
Accessibility of Villages by road as on 31-3-1992
Popula
tion
range
No. of
villa
ges
Not
connected
by any
Number of villages
connected by
roads
Katcha &
All weather Fair
weather non-motor
able roads
roads
0-499
11,289
3,167
2,989
4,952
181
500-999
7,343
3,220
2,204
1,910
9
1000-1499
3,461
2,284
816
354
7
1500 & above4,935
3,978
738
217
2
27,028
12,649
6,747
7,433
199
Total
257
S.
SOCIAL SECURITY:
The process of development also brings to the fore
problems
of
destitution,
desertion
and
family
disintegration. Several Programmes are being implemented
for the welfare of destitutes, the handicapped, the
elderly people having nobody to support.
(i)
Handicapped Persons
For the welfare of the handicapped, a financial
-assistance at the rate of Rs. 50/- per month is being
given_to each handicapped. About 2.84 lakhs handicapped
persons were covered upto the end of September 1993.
(ii)
Aged Persons
o
The Scheme of Old Age Pension to cover elderly
persons aged 65 and above without any means of support
is being implemented. A pension of Rs.75/- is being
given to 5.05 lakh elderly persons during 1993-94.
Destitute
(iii)
Widows
A programme of providing financial assistance to
destitute widows is being implemented since 1984 and a
pension of Rs. 50 per month is being provided to those
whose annual income does not exceed Rs.1500 per annum.
About 4.86 lakh beneficiaries were covered under this
programme upto the end of September 1993.
The scheme wise expenditure incurred and number of
beneficiaries covered under the above schemes are
presented in Appendix.9.15.
(iv)
Distribution of Sarees and Dothies
A scheme of providing sarees and dothies at
subsidised rates to the green-card holders is being
implemented since 1985. Annual income limit for the
beneficiaries -has been enhanced from. Rs.3,500 to
Rs.10,000.
The beneficiaries
covered under this
programme are landless agricultural labourers, village
artisans, small and marginal farmers
old age and widow
pension beneficiaries , plantation workers,
workers
quarring
workers beedi workers and sandle stick workers. During
1992-93 an amount of Rs.5.05 crores has been spent
..towards this programme arid 28.12 lakh beneficiaries were
covered.
258
------ L -i
.x.............
(v)
Maternity Allowance
Woman who belong to the group of agricultural
landless labourers constitute one of the weakest
sections of the community and they suffer from
malnutrition due to inadequate financial support for
getting medical care and for earning their livelihood
during pre-natal and post natal period. Therefore, a
scheme for the grant of maternity allowance of Rs.100
per month to all women agricultural landless labourers
is being implemented since 1984-8§. This allowance is
payable to them for the birth of first and second child
for a period of three months in all covering pre-natal
and post-natal periods. An amount of Rs.24.93 crores has
been spent towards maternity allowance and 8.31 lakh
beneficiaries have been .covered from 1984-85 to 1992-93.
The yearwise expenditure incurred and number of
beneficiaries covered under the scheme of distribution
of subsidised sarees and Dothies and Maternity Allowance
are presented in Appendix.9.16.
259
£5- 35,
fT_
u.
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0
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3 60,000
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Target:
)
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33
0
z
Target
AddO£
92’2.
3 80 000
& G3 2Sy .
C9..3
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3 00 000
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CQ-2.,
3 57 000
<2 83 12.C
79-3
1 9-0 000
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11 ^5 800
JO88OG3
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8 37 957
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/( 8-3-800
1 DC) 10 Q3
%-o
12 23 3£>7
837 657
68- 1
3 .
B cq
It 85 800
11874^1
too-3
172-3367
7 9-6 E7<>
77-0
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122-3367
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63
TAULE NO.26
IMMUNIZATION
PROCHAHHE
EROH
ANTIGEN
1 .
2'.
5.
1988-89
1989-90
1990-91
1991-92
Target
900000
1201700
1148400
761050
84.6
900000
883043
1101100
Achievement
Percentage
950000
856018
90.1
912903
1150591
1065616
98.1
82.9
95.7
92.8
I
POLIO
9bu000
804695
84 . 7
900000
871275
96.8
1101100
908705
82.5
1201700
1156211
96.2
1148400
1067586
S3. 0
900000
792462
88.1
950000
936707
98.6
900000
995848
110.6
1101100
1067960
97.0
1201700
1225048
101.9
1148400
1133730
98 . 7
11 */ g o o
»(S94Gf
i
Target
350000
800000
Achievement
Percentage
179667
51 . 4
609146
76.1
814000
681395
1101100
733224
1148400
970836
83. 7
66.6
1201700
992704
82.6
'' S > g q o
'0134S-{7
85-5
620000
589482
95.1
700000
731642
104.5
620000
347474
56.9
68.6
S^O'l
MEASELS
933000
920800
714751
76.6
731945
79.5
917300
846137
92.2
1298000
1174829
897500
872120
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Target
A ». h j c v c- m e a c
Percentage
T.T
(10
T.T.
(16
900000
7S3123
1000000
942625
1117000
972970
1207800
1042119
3 7.0
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Target
Achievement
Percentage
vX'/b'leo
•;
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Target
Achievement
Percentage
I
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Ta rgec
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1 <-£& oGz,
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900000
748753
83.2
Target
7.
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Achievement
Percentage
6.
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1987-88
Target
Achi evemen t
Percentage
4.
to
STATE
1986-87^
Target
Ac hlevament
Percentaga
3.
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RF_DEV_9_A_SUDHA.pdf
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