The health sector is on a roll with schemes in place to widen the reach of medical services Aprofessional trying to become a politician. That is the best description of the 39-year-old Union Minister for Health and Family Welfare, Dr Anbumani Ramadoss. An alumnus of Madras Medical College, this Pudu-cherry-born medico is the youngest minister in the United Progressive Alliance (upa) cabinet. Well-acquainted with the lack of good healthcare facilities at the grassroot level in villages and districts across the country, he is working on bringing in reforms in the sector. In an interview, he talks about the National Rural Health Mission (nrhm). Excerpts: Q: Why is there a need for nrhm? A. After taking over as Health Minister, during my first meeting with the Prime Minister, it was advised that the mission of the government and health ministry will be priority to rural health. It took about eight months to conceptualise the nrhm programme before it was launched by the Prime Minister on April 12, 2005. It is not just another project; it is a seven-year mission programme and is different from other projects we had till now. As you know, about 73 per cent of our people live in rural areas but they have access to only 25 per cent of medical facilities. So, nrhm is directed towards providing accessible, affordable and accountable quality health services to the poorest households in the remotest regions of the country. As the reach of health services is not adequate, the mission's focus is on establishing a fully functional, community-owned, decentralised health delivery system with inter-sectoral convergence at all levels. Q; How is nrhm different from other health schemes? A. In a sector known for its fragmentation and compartmentalised perspectives, nrhm has provided a platform for community health action at all levels. Through a concerted effort at decentralised planning and through preparation of District Health Action Plans, the programme has managed to bring about intra health sector and inter-sectoral convergence for effectiveness and efficiency. In a way, it envisages people's involvement at the grassroot level. It has enlisted Accredited Social Health (asha) workers who are trained and paid by the centre. An asha worker is trained to handle health problems in her village such as post-delivery check-ups and post-immunisation. One of the aims of nrhm is to bring down infant mortality rate and maternal mortality rate. Apart from these, the mission takes care to improve the existing medical infrastructure available at village and district levels while simultaneously working towards building new and modern infrastructure. For this, community health centres are being modernised and upgraded continuously. Even labour rooms are being modernised and we have got tremendous results in this direction. The programme has employed 2,000 chartered accountants, mba graduates, data and it professionals and accountants at district and state levels to track health-related information. Q; What's the response to the mission? A. The programme is not even two years old and already there are some very significant gains in the health sector. Reports from different states show great success and high acceptability rate of the mission. For instance, in Bihar, the average number of patients visiting a primary health centre every month has gone up from 39 in January 2006 to 3,015 in August 2006. Reports also show significant increase in institutional deliveries because of demand of the financing scheme under Janani Surakhsha Yojana (jsy). From six lakh jsy cases in 2005-06, over 24 lakh beneficiaries have been covered under it with institutional deliveries being 21 lakh. The states have also put in place effective systems of procurement of drugs. Nearly 13,000 Rogi Kalyan Samitis and hospital development committees have been set up. Also, 3,190 specialists, 3,494 doctors, 9,533 staff nurses, 17,736 anms and 17,903 paramedic staff have been appointed on contract and positioned during 2006-07. It is heartening that all states are cooperating fully with nrhm. I can proudly say that it is the country's biggest ever programme in the health sector. It is also one of the successful programmes of the upa government. Q: What are your other priority areas? A. The experience of the past two years gives us confidence that we are on the right track and that we need to deepen institutional reforms and effective decentralisation through a concerted effort at capacity building. Apart from nrhm, two other programmes have been launched recently. They are National Programme on Prevention of Cardiovascular Diseases (Diabetes and Stroke) and National Programme on Speech and Hearing. We are also in the middle of setting up a National Drug Authority, which will be in place by next year and a new concept of a National Food Authority.