The Telegraph
Since 1st March, 1999
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PM push for health in Bimaru states

New Delhi, Jan. 14: Prime Minister Atal Bihari Vajpayee, in a rare move, has summoned the chief ministers of the four Bimaru states to Delhi to push them into acting on population stabilisation and health programmes.

The meeting, scheduled this Thursday, would also focus on the sluggish utilisation of funds and the large gaps in the public health delivery system in Bihar, Madhya Pradesh, Rajasthan and Uttar Pradesh (Bimaru).

Vajpayee has a list of specific complaints for each of the four states, which have always lagged behind in health and education.

Bihar is yet to formulate a population policy a year after it drew up a draft policy.

The governments of Madhya Pradesh, Rajasthan and Uttar Pradesh have formulated population policies, but these go against the letter and spirit of the national policy adopted two years ago.

These three states have offered incentives and disincentives to restrict the number of children in each family to two.

In Madhya Pradesh and Rajasthan, party nominees with more than two children are ineligible for municipal and panchayat polls.

In Uttar Pradesh, the government is proposing to assess the performance of medical and health officers according to their levels of achievement in the family planning programme.

In Andhra Pradesh, the Telugu Desam Party government has declared a series of benefits for couples sticking to the two-child norm.

The Union health ministry has repeatedly made it clear that such policies of incentives and disincentives have an ingrained element of coercion and the states should immediately discontinue these.

But the states have not heeded the appeal, taking refuge in the fact that health is a state subject, which allows the state governments to tread their own path. Officials in the health ministry hope Vajpayee’s initiative will now turn the heat on such states.

It is rare for the Prime Minister himself to take the responsibility of talking to the states on health or education. Usually, the matter is left to the Union health minister.

Vajpayee’s summons to the chief ministers, and not the state health ministers, also indicate the seriousness of the proposed meeting.

The Union health ministry has drawn up a detailed note of the large gaps in the states’ health delivery system. For instance, in Uttar Pradesh, the use of modern contraception methods is low. Caste, religious prejudices and misconceptions have prevented pulse polio programmes in this state from yielding results.

Pre-natal and post-natal care, too, continue to be dismal in Uttar Pradesh with the state failing to fill up most posts sanctioned for the primary health centres. The picture is much the same in Rajasthan and just a shade better in Madhya Pradesh.

The National Family Health Survey shows only 30.9 per cent women in Bihar have been to an ante-natal clinic. Post-delivery complications there are as high as 64.5 per cent.

In Uttar Pradesh, 48.7 per cent women suffer from anaemia and only 1.6 per cent undergo full ante-natal care.

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