After 10 yrs of rural health mission, doctor shortfall up

Subodh Varma





Samarin Bai, a 50-year-old Baiga tribal woman from Mahamai village lives in the dense Achanakmar forests of Bilaspur district, Chhattisgarh. A few days back, she decided to see a doctor for the big lump that had developed at the base of her neck and various other problems. Although there is a government sub-centre 6km away , she knew that there was only one auxiliary nurse cum midwife (ANM) who wouldn't be able to help.So she trudged through 14km t of rain-soaked forest to a health centre in Bamhani vill lage set up by a local NGO, Jan i Swasthya Sahyog (JSS). A doctor visits this centre every week and he diagnosed a dangerous thyroid enlargement which needed quick surgery . i Samarin Bai waded across a monsoon swollen river and was transported by the JSS f van to their hospital at Ganiyari, some 70km away .Yogesh Jain of JSS narrates this story as an example of what is routine in the area.Healthcare delivery is so patchy and deficient that peo ple travel dozens of kilome ers to get treatment. “In the 10 years since the NRHM was aunched, some improvement s there, but doctors and key healthcare personnel are still deficient,“ he told TOI.
Recently released government data on the rural health nfrastructure and personnel confirms that Samarin Bai's problem is not a rare example rom some inaccessible forest.At the country level, there is a staggering shortfall of 81% of specialist doctors, 12% of general physicians, 21% of nurses and 5% of auxiliary nurse cum midwives. Among technical support staff, shortfalls range from 29% for pharmacists to 45%for laboratory technicians and 63% for radiographers.But since a decade ago, many of these shortfalls have increased except for nurses and ANMs.
A bizarre aspect of this data put out annually by the ministry of health is that in many categories of health personnel, some states have surplus appointments while others have shortfalls. For example, at the country level, 25,308 doctors are required going by the Indian Public Health Standards (IPHS), which says that one doctor is needed for every primary health centre (PHC).But actually , there are 34,750 doctors sanctioned. 25 states have surplus doctors, the total surplus working out to 5,115.On the other hand, the remaining states have a combined shortfall of 3,002 doctors.
T Sundararaman, professor at the Tata Institute for Social Sciences and former executive director of the National Health Systems Resource Centre says, “IPHS recommended two doctors and one ayush doctor per PHC. In 2011, the doctors per PHC was revised downwards. But doctors are -unlike ANMs -paid only by the states. So many states, like Tamil Nadu, have two doctors per PHC as sanctioned. The `required' number is the statistics department's interpretation of IPHS to mean that only one doctor is required per PHC. They have no basis to do this, and one doctor per PHC is not viable. The short falls are genuine -the over appointments are not,“ he told TOI.
The surpluses in healthcare personnel arise because goal posts are shifted by lowering requirements. In reality the shortages are all round.
For the full report, log on to http:www.timesofindia.com

AP signs MoU with TISS

Andhra Pradesh government and Tata Institute of Social Sciences (TISS) have signed a Memorandum of Understanding (MoU) for implementing programme activities of ‘Andhra Pradesh University Students Employability Skill Development Programme,’ a flagship initiative of the state government.

Chief Minister N Chandrababu Naidu and Minister of HRD Ganta Srinivas Rao were present during signing of the MoU, said an official release. “We aim to transform Andhra Pradesh state into a knowledge hub by providing quality education and giving opportunities for students to develop employability skills among the Universities and Colleges in the state,” said Naidu.

The MoU has strategic partnership with civil society organisations, public sector bodies, private sector institutions and social entrepreneurship organizations, etc. to complement the efforts of the AP state Knowledge Mission.  TISS will be working for the implementation of National University Student Skill Development Programme (NUSSD), which aims to enhance employability skills of students. The skill development model develop by the institute will have elements of English, communication and soft skill, digital/computer skills,  financial literacy, legal literacy, entrepreneurship, leadership development. The model will help to make the graduating youth employable.

The Source of Ego
Ramana Maharishi of Arunachalam said that one should search for Self-identity by asking, “Who am I?“ In meditation, one should ask the question and with gradual evolution find calmness and peace. The question really means, what is the source or origin of ego?
To find the answers, you need to be free of attitude. Give up the bhavana that you are the body related to name, profession, region, language and other such acquired identities.There is no need to have an attitude about your real nature.It exists as it always has.

But Self-enquiry is not done in vain. The very purpose is to focus the entire mind at its source. The state of self-awareness is termed as sat-chitanand, or total bliss.

Be what you are. Lose your ego. Self-enquiry leads to knowledge of Self. One is aware of the Self even though the Self is not objectified. When you say you do not know the Self, it means absence of related knowledge because we are so accustomed to relative knowledge that we look for same.

Because of this, the goal of Self-realisation appears to be distant. Feel yourself dismantling the false i that is ego and establish yourself in the real I and the answer to the query “Who am I?“ becomes evident.

To gauge progress on the journey of Self-realisation, see the degree of absence of thoughts. Self-realisation itself does not admit to progress.The obstacles are thoughts.Progress is measured by the degree of removal of these obstacles. All that we need to do is to keep quiet.

President gives Awards to best institutions

8th September has been proclaimed as the International Literacy Day by the United Nations Education Scientific and Cultural Organisation (UNESCO), with aim of highlighting the importance of literacy among communities, societies and individuals.

To confer the academies, President of India, Pranab Mukherjee and Union Minister of Human Resource Development Smriti Irani along with Minister of State for Human Resource Development Upendra Kushwaha and Dr. Ram Shankar Katheria, awarded Saakshar Bharat Awards for best performing institutions to mark the occasion of International Literacy Day.

More than 3.65 crore adult learners were certified as literates and more than one crore beneficiaries mobilised and facilitated to avail benefits of social security and financial inclusion schemes of Government of India.

On the occasion Smriti Irani “The International Literacy Day is not only an occasion to reaffirm our resolve to eradicate illiteracy but also to acknowledge the crucial role played by adult education functionaries and volunteers in helping us to move towards our ultimate goal of creation of a literate and sustainable society.”

In the last one year, efforts for propagation of literacy have been intensified. As a result a record number of 1.91 crore learners have appeared for assessment of their literacy skills in the tests held in March and August 2015.

Besides, the scope of literacy has been widened to include empowerment especially of women through special initiatives undertaken for their financial inclusion and social security. The strenuous efforts made by the literacy functionaries in undertaking mass campaigns to take these initiatives to the doorsteps of our target groups are commendable. These efforts have yielded notable results in facilitating opening of over 1 crore Bank accounts under Pradhan Mantri Jan Dhan Yojna and mobilisation of around 93 lakh persons to avail benefits under the Pradhan Mantri Suraksha Bima Yojna.

President of India to present Gandhi Peace Prize 2014 to ISRO 

 The President of India, Shri Pranab Mukherjee will present the Gandhi Peace Prize for the year 2014 to Indian Space Research Organization (ISRO) tomorrow (September 9, 2015) at a function at Rashtrapati Bhavan. 

The Gandhi Peace Prize was instituted by the Government of India in 1995 on the occasion of the 125th birth anniversary of Mahatma Gandhi. This annual award is given to individuals and institutions for their contributions towards social, economic and political transformation through non-violence and other Gandhian methods. 

Tuesday, September 08, 2015

A blow for gender parity

It took the Delhi High Court to set right last week a largely inexplicable instance of official gender discrimination: it ruled that the Indian Navy must grantpermanent commission to women as well, as the Army and the Air Force had to do following a 2010 order by a different bench of the same court. Until now, women could qualify only for the Navy’s Short Service Commission with a tenure of up to 14 years; this made them ineligible for pension and often unable to find other work they were qualified for, virtually midway through their working lives. Following the latest ruling, women who qualify for permanent commission will be able to work until the age of 54, as their male counterparts do. The 19 women who filed petitions before the court argued that they had received the same training as their male counterparts and worked for a comparable number of years in different departments, but could go no further for the only reason that they were women. The High Court rightly ruled that it could not support any provision that would restrain the professional advancement of women. Grant of permanent commission would allow women to rise in rank along with the men, and gain pay parity.

In the Army, since the grant of permanent commission to women began, 340 women have been granted such positions, Defence Minister Manohar Parrikar recently told Parliament. The latest order will open the doors for women in the Navy too. However, the Defence Ministry and the armed forces must go further. For one, the forces must tackle entrenched sexist attitudes towards women that were in evidence when the Army argued before the Supreme Court against the grant of permanent commission for them, saying that junior officers from rural areas would not be willing to accept a woman as a leader in front line situations, or that society was not yet willing to accept women in combat roles. The proportion of women in India’s armed forces and the police forces is low in terms of global comparative figures, and recent research indicates that persistent bias is a strong ground that drives women away from seeking to serve in them. There has been little effort to go the extra distance to increase female representation: India’s first woman in the Army to receive a gallantry award, Lt. Col. Mitali Madhumita, had to move the Supreme Court for permanent commission after she was denied it on the ground that she had earlier turned it down. Suicide rates among women in the forces have also been disproportionately high, and they do not seem to be getting enough support in coping with the dual tasks of handling work and family life. India’s armed forces must do more now to transform themselves into a space of truly equal opportunities.

Keywords: Indian Navy, permanent commission for women, Delhi High Court

ET Q&A - Make in India is Great, Make it Happen in India is Even Greater

JOE KAESER CEO, SIEMENS





Siemens chief executive says the softer capabilities in India are huge and if we combine that with the automation that Siemens has, the combination would be hard to beat

Siemens Chief Executive Joe Kaeser is betting big on India with plans to invest another ¤1 billion and expand its workforce. In an interview with ET's Satish John and Himangshu Watts, Kaeser explained his strategy in India and other plans.Edited excerpts:The board of Siemens AG is here. What is the significance of the event?
We had the whole Siemens managing board come to India, visit India and listen to our (local) leadership team on the opportunities and the things we could do to help push the country to the next level. We do that every year. One of the things is that India was the partner for the Hanover fair in Germany, the world's largest Industrial fair which is important. The PM announced in the event on `Make in India' and the priorities he's been setting for affordable, sustainable and reliable energy to healthcare to infrastructure and industrial automation. That's what our company is about. We believe there is a massive opportunity for the country and for us as a company and if we can bring those two things together then it would be good for everyone.
You are meeting the prime minister for the fourth time in two years?
I've met the prime minister three times now. The first time was immediately after he took office in Delhi. Then we met at the Hanover fair where he was visiting the Siemens exhibition, then we met him at Berlin at the Siemens education center, where he looked at how Siemens does vocational and industrial training.
Has the business environment in India changed to your satisfaction since the first time you met him?
What I still see and what I am really impressed about is his determination and his will to bring his country and his people to where they deserve to be. A better life and a better society and a better living and become an industrial power in the world. It is very exciting if he can make a meaningful contribution. In Egypt under President Abdel Fattah el-Sisi, Siemens got its biggest-ever order (close to ¤8 billion) in quick time, but in India big orders take ages. President el-Sisi of Egypt took over in a very complicated environment. He needed to give a new direction. It is quite a difficult job. In Egypt, he (el-Sisi) needs to establish a lot of basics such as energy supply, which in India is well established.
Despite all the challenges and the opportunities we've in India, there is still a well-established constitutional process. The energy agenda in India is okay. It can be much better but there is electricity available in India. So, it all depends on the circumstances, I wouldn't say this is faster or that is slower. There are reports that suggest that Alstom may win the large railway tender for locomotives.Does that change things for Siemens?
First of all, we are in the middle of the whole process. We'll see how it goes. So there's nothing more to talk about at this time. We are not dependent on one single order. We have always made it very clear that India is a very attractive country. We've been here for more than 100 years.Our founder himself has laid the first telecommunication cable from Kolkata to London which was a fascinating innovation at that time.
So in the meantime, even in the last 10 years, we have invested close to ¤2 billion in India. We have 16,000 people in India, and out of that more than 4,000 engineers are in R&D. We expect to bring at least a billion euros in the next few years into manufacturing engineering and building India as a competence centre for mobility and infrastructure.So, we are here for a grander scheme of the market and not a single order.
That's why it is important and our decision to build our activities in India. The prime minister talked about make in India. Siemens has 22 factories in India and we are going to build more.We'll invest a billion euros in the next few years to come. This investment will be in engineering and manufacturing.
It is exactly around the agenda of the Indian government. That is, efficient energy, energy management like transmission, distribution, smart grids to manage the grid and of course renewables.So, the less gas the country uses for its energy needs, the more gas you can use for fertilisers, which is also important to feed the people.
The softer capabilities in India are so huge. The best software companies in the world are the Indian companies like the Tatas, Infosys and others. If we come together and combine softer capabilities in India with the automation that Siemens has strengths in, the combination would be hard to beat in the world.
So that's why it is attractive. We believe we can have an edge here because we already have more than 20 factories and others are still debating whether they still want to invest in a second one or not. Do you think India can improve your profit margins, which has been your target but your rivals have been doing a bit better? Well look. Our business also has to be economically viable. Firstly, we believe there is good opportunity and there's long-term aspects. If you typically invest a billion euros, you must generate at least a billion euros as annual revenues as a rule of thumb. Of course, economic return from our investments has to definitely come along. Many CEOs are worried about China? What's your take on China? After many years of growth, China has been forced into reforms. There are structural challenges that they need to reform. Steel industry, mining industry and cement industry have all of a sudden been confronted with a need to reform and they haven't had for many many years. So they are not used to this. There is a need to be done before China moves to the next level. Having said that China with a new normal of 7% GDP growth, may be even 5 or 8% (GDP growth) is still twice as much of the whole world. Therefore, one needs to look at it in a relative way. Europe will be extremely happy if they have 5-6%.
I think, over time, in the life cycle of industry there needs to be restructuring. In China it had to happen and it will go through it and emerge as a different economy. India has a benefit that it has a demographics pyramid which is the benchmark of all countries in the world, so there is no need to restructure but a need to build. So there is a different environment. So it always depends there is no one size that fits all in this world.
You mentioned about India's software . strengths. How will you draw from it, will you build, will you do M&A?
We have 4,000 engineers and 75% of them are software engineers. We've a good foundation already. Ideal situation would be to partner up or team up with a software company, we cannot rule out that there could be an M&A, but bringing the skills together of a manufacturing and engineering company and software skills for systems integration would be a very rewarding capital efficient way to grow the business without jumping into big acquisitions. We'll see how it goes.Today, we talked about India. Not about Siemens as a legal entity but about Siemens India as a legal entity globally. I was very impressed with the managing director and also with the management team. They have great ideas and are very dedicated and we'll provide the resources to make this a big success in the next four to five years. Modi said at the Hanover fair he always thought of Siemens as an Indian company.So there was this talk that you'll retain Siemens as a listed entity in India?
Look, we have no plans to delist. Formal aspects is one thing, but growing the business in a comprehensive way by getting all the resources of global Siemens to focus on success is the other view. As a global company, we have abundant resources in both capable people and capacity and also competency to make a success in India. But first customer and business matters and then we will sort it out in a formal way.
In your Vision 2020, where is India placed?
There is a reason why the managing board is here.visit India four to five times a year. Next six weeks I'll be here three times. Next visit will be with Chancellor Merkel, beginning October and then there will be strategic review where I will be participating to see how the formal Siemens India's global plan will evolve and formulate a strategy. We need to ensure that the global approach and the limited approach are tied together in a meaningful way.
Make in India is great. But make it happen in India is even greater. Make it happen in India is more than manufacturing. It's about training, about education, about societal development and automation and engineering and precision power being brought into the country.
We'll continue to invest in India. We spent more than ¤2 billion in the last 10 years and we'll spend ¤1 billion in the next few years to significantly participate in make in India and make it happen in India.
Would you shift any of the global functions to India?
I would not rule it out. If you look at the country's agenda which is independent of the current government saying infrastructure has to be optimised and mobility has to be a major challenge and opportunity.
For full interview, log on to http:www.economictimes.com