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Indian Journal of Community Medicine

IAPSM Resolution for Achieving Millennium Development Goals

Author(s): Editorial Staff

Vol. 30, No. 2 (2005-04 - 2005-06)

Indian Association of Preventive and Social Medicine (IAPSM), an organization of public health professionals observes with satisfaction the declining fertility and mortality g rates in India. However, the challenges of achieving the millennium development goals (MDG's) are enormous. The Ministry of Health and Family Welfare, Government of India must take following actions for making rapid progress towards achieving MDG's.

1. Strengthen National Health System

a. Public Health Professionals - those having a Post Graduate Degree in Preventive and Social Medicine or Community Medicine (MD PSM/CM) or Master of Public Health (MPH) or Diploma in Public Health (DPH) - must be placed in key administrative posts at block, district, state and central level for managing the National Health Programmes. MOHFW must make this a pre-condition for National Health Programs’ Posts for which GOI provides grants to states, e.g., Reproductive & Child Health/ Family Welfare/ Mother and Child Health/ Immunisation/ TB/ Leprosy/ Malaria/ HIV etc.

b. Public Health Resource Centres must be established in all the Departments of Preventive and Social Medicine in a phased manner by providing extra resources (Health Management & Health Promotion Specialist with secretarial and travel support), for competency based training should be arranged for planning, organising, monitoring and evaluating National Health Programmes at district, state and union territory level.

c. Male Health Workers must be funded by GOI on the lines of Female Health Wor kers to strengthen Communicable and Non Communicable Diseases surveillance and control activities.

d. Male and Female Health Supervisors (LHVs & HIs) must also be funded by GOI to strengthen supervisory systems.

e. A graduate course in Public Health (BPH) should be star ted in selected National and State Health Institutions/medical colleges to prepare competent Public Health Supervisors of Primary Care Workers.

f. A postgraduate course in Public Health (MPH) should also be started at selected national and state heal institutions/medical colleges to prepare competent Public Health Specialist for National Programme Management at Block and District Level.

2. Improve Maternal and Child Survival

In view of perennial shortage of specialists, doctors, and health workers following actions must be taken immediately to improve access to EmOC & Neonatal Care.

a. Auxiliary Nurse Midwives/Female Health Workers, Anganwadi Workers (AWWs) and Village Health Workers (VHWs) who have training equivalent of AWW must be allowed to give oral antibiotic and ORS to cases of pneumonia/sepsis and diarrhoea respectively among neonates and children. If required, competency based training for management of pneumonia and neonatal sepsis should be arranged for them who are in service, and necessary changes must be done in their curriculum.

b. Nurses, who have taken Midwifery Course, must be authorised to conduct normal delivery and for providing emergency first aid to obstetric and neonatal cases and sick children. If required, competency based training should be arranged for them who are in service so as to re-certify them, and necessary changes must be made in the curriculum of Nursing Courses in consultation with Nursing Council and Medical Council of India.

c. All MBBS doctors must be instructed to conduct deliveries including assisted vaginal delivery and conducting caesarean section if needed under local anaesthesia in emergency cases, conduct MTP using MVA and to manage sick neonates and children. If required, competency based training should be arranged for them who are in service so as to re-certify them.

d. MBBS doctors should give anaesthesia. If required, competency based training should be arranged for them who are in-service so as to re-certify them, and necessary changes must be done in the curriculum of MBBS in consultation with Medical Council of India so that MBBS doctors are competent in giving general and spinal anaesthesia for surgical and obstetric cases.

e. MBBS doctors should run blood bank or blood storage facility. If required, competency based training should be arranged for them who are in-service, and necessary changes must be done in the curriculum of MBBS in consultation with Medical Council of India so that MBBS doctors are competent in managing
blood banking and transfusion service for surgical and obstetric cases.

f. Incorporate Hepatitis B vaccination in the National Immunisation Schedule and provide Auto-Disable Syringes and Safe Waste Disposal Equipment.

3. HIV Control

a. HIV Epidemic is very heterogenous so surveillance must be expanded to all districts of the country among ANC women, STD attendees, IDU's and sex workers, and women, STD attendees, IDU's and sex workers, and district-wise data must be published every year.

b. Expand targeted intervention to ensure 100% condom use among all core groups (Sex Workers, IDU's and those having Multiple Sex Partners.)

(Resolution submitted to Honourable Health Minister, Govt. of India on 13.4.2005, vide Letter No. IAPSM/2005/49)

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