Prime Minister Manmohan Singh has made high-fertility districts top priority for population control measures, as promised in the Common Minimum Programme. And, the Ministry of Health and Family Welfare has been asked to put together a strategy before he returns from his trip to London and the US.The Ministry, which was busy structuring the policy till now, has shifted gears to finalise the strategy in what is now called the ‘‘high-fertility CMP districts’’. What started as an effort to replicate the success stories of some southern states in 150 high-fertility districts in Uttar Pradesh, Madhya Pradesh, Bihar, Rajasthan and Jharkhand, has taken the shape of a comprehensive strategy that will cover all 210 districts in the five states.The strategy aims at preventing 40 crore unwanted births to ensure these states meet goals of the National Population Policy by 2010. At present, officials say, some of these states have been given upto 2016 to meet the goals.The strategy will aim at creating a network of village-level health workers who will utilise the resources of private hospitals and doctors while introducing greater accountability. The government has suggested that the doctors and health workers be given a package to meet the costs and that doctors conducting sterilisations be insured.The suggested strategy includes: z A proposal to rope in some 2.6 lakh trained birth attendants (TBAs) who can double up as additional health workers in anganwadi centres. The TBA (one for a village) will work with the auxiliary midwife at the district level. • TBA will be the pointsperson in spreading awareness on family welfare issues, including advice on ante-natal and post-natal care. She will ensure timely medical attention and will be paid a ‘‘transaction cost’’ of Rs 400 per case. • The government will also pay private doctors/hospitals Rs 750-800 for each case related to family planning treatment. • Doctors in both public and accredited private facilities, who conduct sterilisation operations, will be covered by a professional indemnity insurance against legal and financial costs. • Quality Assurance Committees will be set up at state and district levels to monitor sterilisation procedures.• Eligible couples at the village level will be given a register number for access to facilitiesThe Department of Family Welfare feels it can undertake this exercise in the current year without any additional allocation. Moreover, the Ministry surrenders more than Rs 700 crore every year.Broadly, the strategy seeks to integrate this plan to a larger rural health care programme that will take into its fold more than a dozen initiatives with independent budget lines. Sources say the department wants the plan ready for the PM to unveil on November 14.
