Social
Assessment Study for Karnataka Health Systems Development
Project
Page
4 of 10
There are few grassroots non-government organisations working
in the tribal areas of Chamarjanagara and Mysore districts
and are doing commendable job. Some of their strategies
such as tribal ANM, mobile dispensary unit, rigorous monitoring
and supervision, forming local groups, setting up of voluntary
counseling and testing centres are worth replication in
other areas.
Need
for Specific Interventions in Health Sector for the Vulnerable
community
The state of Karnataka is yet to include a separate SC/ST/
Vulnerable community development health policy under the
state integrated health policy. Consequently there is no
specific plan for this group till now. There is no separate
budgetary head/ funding under special component plan (SCP)
for SCs and Tribal sub plan (TSP) for forest dependent tribals.
The present budgetary provision being indicated under Zilla
Panchayat sector is only a notional amount towards expenditure
of staff salaries and drugs for functioning of subcenters
and PHCs identified under SCP/TSP. No central assistance
is forthcoming in spite of two mobile health units sanctioned
to serve for the primitive tribal groups (PTGs) Identification
of health management institutions to function
in SCP & TSP is perfunctory and therefore budgetary allocation/
expense is being shown as flow of funds to the SCP/TSP.
Surveys or in-depth studies are yet to be carried out in
the state to explore more details regarding the health of
the SC/ST communities. The availble data are of 1983 and
1995 surveys only. Specific performance reviews of national
and state health programmes directed towards SC/ST population
have not been very serious except the review of expenditure
at quarterly intervals. No incentives as motivation are
available under SCP/TSP for the staff who are working in
the institutions sanctioned / identified under SCP/TSP.
Management of PHC, sub-centre, and mobile
health units is the only strategy for the SCP/TSP since
last three decades and these units are not fully functional.
Karnataka Health Systems Development Project began implementation
of Yellow Card Scheme in November 1996 and extended to all
the districts in a phased manner from 1997. Yellow card
scheme (for SC/STs) is discontinued because of constraint
of funds.
Legal and Policy Framework for the vulnerable community
There are certain legal and policy provisions under the
Constitution of India and State Acts to safeguard the health,
economic and other fundamental needs of the vulnerable communities.
In 1961 census 100 SC and 44 ST groups were enumerated in
the state. National Health Policy 2002
in the operational strategies has recommended mobile clinics
to promote indigenous systems of medicine and to sensitise
the providers to adopt a burden of disease approach to meet
the special needs of tribal and hilly area communities.
During 1997-98 Rural Development and Panchayat Raj Department
of Karnataka identified 20.35 lakh below poverty line (BPL)
families having an annual income of less than Rs.20,000/-
per annum. This is adopted, as the According to the Government
of India there are 31.29 lakh BPL families in the state.
According to planning Commission estimate based on NSSO,
20.04% of the population i.e. 104.40 lakh of people in Karnataka
are below poverty line (25.25% urban and 17.38% rural).
National Population Policy 2000 in the action plan among
other things has formulated various operation strategies
such as convergence of service delivery at village levels,
empowerment of women for improved health, nutrition, child
health and survival, under-served population groups, diverse
Health care providers involvement, collaboration from the
NGO sector, mainstreaming Indian systems of medicine and
homoeopathy, contraceptive technology and research on RCH
and information, education and communication. In the Karnataka
State Integrated Health Policy (2003), it has been reiterated
that the scheduled castes and scheduled tribes will receive
priority attention. Further the policy mentions that innovative,
flexible and collaborative approaches would be adopted for
meeting the health needs of children, out of school, persons
with disability and other vulnerable groups in the community.
