Janani Suraksha Yojana

1.     The JananiSurakshaYojana (JSY) — conditional cash transfer scheme to encourage women for institutional deliveries — appears to have led to a huge increase in the proportion of women choosing institutional delivery.

2.    however, it has substantially deflected attention from what happens to women who do not or cannot reach hospitals. There is also inadequate assessment of the capacity of hospitals to handle this large volume of cases, and whether providers actually manage to provide skilled attention to women who need emergency obstetric care. The issues were raised by participants of a seminar ‘Chronicles of Deaths Foretold — Using Maternal Death Reviews to prevent Maternal Mortality and Morbidity in India’ in the Capital recently.

3.  Discussing the Maternal Death Reviews from Rajasthan, U.P., Jharkhand and Gujarat, JashodharaDasgupta of National Alliance for Maternal Health and Human Rights (NAMHHR) said a common factor in all the reports above is that most of the women approached institutions during labour (as encouraged by the government through JSY) and most of these deaths could have been prevented if adequate skilled medical attention had been provided.

4.   It was also pointed out that while JSY was popular, there was lack of awareness about the JananiShishuSurakshaKaryakram that entitled pregnant women to free delivery and the mother and new born babies to free treatment and food in public health institutions up to a month in addition to free pick up and drop from home to the health facility and back or to a referral hospital as the case may be. Even the staff was unaware of the scheme in the hospitals, thereby depriving the women of this entitlement.

5.    Poor tribal women showed that many had died of malaria or hepatitis or severe anaemia that could not be prevented only by hospital care during childbirth

6.    Haemorrhage is one of the main causes of maternal death followed by unsafe abortion, severe anaemia, sickle cell disease, hypertension, sepsis, hepatitis and malaria. Lack of transport or delay in arranging for transport has also resulted in women dying en route to a health facility.

National programme for health care for elderly

1.      The elderly people will reach by 350 million by 2050 and a large population would be women  and currently the elder people are 90 million. So the 12^th year plan has  host of provisions  to provide health services at various levels

2.      The ambitious National Programme for Health Care for Elderly (NPCHE) in 2010-11 to provide separate and specialised comprehensive health care to the senior citizens, the Ministry of Health and Family Welfare proposes to develop two National Institutes of Ageing in the 12th Five Year Plan

3.      The two institutes will be set up at the Madras Medical College and AIIMS, New Delhi with an objective to undertake research on ageing in addition to other things like providing health care to the senior citizens

4.      The institutes are part of the NPCHE which also proposes geriatric departments in eight regional medical institutions and State Medical Colleges

5.      The programme also provides for dedicated health care for elderly persons in 91 districts of 20 States with a geriatric unit at the district hospitals, rehabilitation units at community health centres and weekly geriatric clinic at primary health centres

6.      Under the 12{+t}{+h}Plan, it is also proposed to develop 12 additional Regional Geriatric Centres in selected medical colleges of the country (in the first three years) while covering the remaining districts in a phased manner.

7.      The NPCHE had been approved in 2010 at an expenditure of Rs. 288 crore for the remaining period of the 11{+t}{+h}Five Year Plan. This includes 20 per cent share of the State governments (excluding the expenditure on Regional Medical Institutes) amounting to Rs. 48 crore while the remaining is to be borne by the Centre

8.      As of now, the programme has been implemented in 70 districts and is expected to cover the entire country during the 12th Plan. Its main objective is to provide preventive, curative and rehabilitative services to the elderly persons at various levels of health care delivery. It also aims at strengthening referral system to develop specialised manpower and to promote research in the field of diseases related to old age.

9.      The regional institutions are expected to provide technical support to the geriatric units at district hospitals whereas district hospitals supervise and coordinate the activities at the community health centres, primary health centres and sub-centres.

10. Close to 65 per cent senior citizens suffer from a chronic ailment of which arthritis/rheumatism, hypertension, cataract and diabetes are the most prevalent. About one-third suffer from two or more chronic ailments simultaneously. In general, morbidity levels tend to be higher among females across all age groups of elderly and also associated with socio-economic classes with expected rural-urban differentials

NATIONAL INVESTMENT BOARD

·        National Investment Board, a proposal made by the Finance Minister P.Chidambaram is widely approved by the corporate sectors(marketing, industry and infrastructure)

·        Why this NIB?

o   For any project to be approved by the govt. of India is a huge task.

o   The project has to be approved by various govt. departments/ministries for clearance.

§  For example, a thermal power project in order to be cleared nearly 17ministries have to approve it through 65 clearances. This is a rigid task which takes more time to approve the project.

o   The clearances involve various approvals in the same ministry.

§  For example, the Environment ministry involves clearances/approvals from environment dept. and forest dept. too.

o   So it consumes more time for the project to be cleared and the projects are prone to delay which is a serious matter for the development/growth of the country.

o   So some industries asked for the constitution of a body that gives the approvals in a less span of time with due considerations and constraints. So far, there have been four models discussed: first, a Fast Tracking Board under Cabinet Secretary. Second, an Infrastructure Ministry. Third, a Foreign Investment Promotion Board(FIPB) and lastly, a high-powered institution like National Development Council(NDC) that also includes even the presence of Chief Ministers in the clearance and approval of the projects. Finally, the Govt. has decided to constitute an NIB which is a combination of both Fast-Tracking Board and FIPB.

o    NIB is obligated to reduce the time consumed for the clearances and there by speed up the process of the approval of the projects.

·        How NIB is constituted?

o   The NIB is chaired by the Prime Minister Manmohan Singh and an empowered standing committee of Cabinet Secretary. The Board also includes key ministries like Finance and Law & Justice as its members.

·        What does NIB do?

o   NIB handles the projects of above Rs.1000Cr. and it initially focuses on the projects that are run for a long time like roads and petroleum etc.,

o   The Department of Economic Affairs (DEA) of Secretariat identifies such projects and assigns them to the NIB.

o   It also deals with the projects that are delayed for a long time and takes an appropriate decision in the approval of the projects. (If the deadlines for the particular ministry are crossed and still it is unable to take a clear statement about the clearance of the project in that respective dept. then the ultimate decision is left to NIB)

o   NIB meetings are held at least once in a month.

·        What are the drawbacks in the constitution of the Board?

o   The autonomous decision for the concerned ministry will be lost if the project clearance deadline is not met. (The reason is that there is lack of the staff and it takes more time to clear as it considers various issues of the subject).

o   There may be lack of consensus between the ministries.