This book presents a systematic mid-term evaluation of the processes of the National Rural Health Mission (NRHM), India’s biggest rural health program. Data from District Level Health Surveys (DLHS), National Family Health Surveys (NFHS) and Sample Registration System (SRS) as well as primary data collected from field surveys and interviews with health functionaries have been utilized for undertaking empirical analysis in the study. The book draws from data collected in field visits in the three states of Madhya Pradesh, Uttar Pradesh, and Rajasthan. After assessing the NRHM processes and progress achieved so far, it discusses important ground realities, identifies the gaps and bottlenecks in the implementation of the Mission and recommends corrective actions.

From the Field: Uttar Pradesh, Madhya Pradesh, and Rajasthan

From the field: Uttar Pradesh, Madhya Pradesh, and Rajasthan

1. Uttar Pradesh (UP)

UP HAS the second highest maternal mortality rate (MMR) in the country, 440 out of 100,000 live births (India - 254), as per the 2004–06 Special Survey of Deaths estimates.1 Infant mortality rate (IMR) in UP stands at 69 per 1,000 live births as per the 2008 SRS survey.2

1.1. Manpower

1.1.1. Medical Officers

There is a serious shortage of staff especially medical officers (MOs). Typically only 50 percent of positions are filled at the centers we visited in Jalaun, Jhansi, Lalitpur, Varanasi and Allahabad.3 With the new policies, particularly Janani Suraksha Yojna (JSY), the workload of the MOs has certainly increased dramatically. Often, one MO is doing ...

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