PARTY MANIFESTO LEH RURAL HEALTH SECTOR

James Miahlung

Indian health system inkhaihdiat chhoah a hnuai ber (Primary level)ah Community Health Centre(CHC), Primary Health Centre(PHC) leh Sub Centre(SC) te an awm a. Primary level healthcare hi sawrkar laipui ngaihpawimawh lo ni tawh thin mah se 1980 chho atanga private sector te healthcare-ah lut nasa in, sawrkarin budget-ah hriselna lama hmalakna tur sum a dah tlem tak zel avangin healthcare chu private sector tan sum siamna hmanrua pakhat ni chho in, tawngkam lar tak “commercialization of healthcare” tih a rawn pian phah ta a ni. Tunah chuan health system thuamchak a tihchangtlun aiin damlote inenkawlna senso phuhruk theihna tur insurance lamah sawrkar laipui leh state sawrkarten tan an la zawk niin public health vei mite chuan an ngai.
Private healthcare nasa taka thang mek karah, public health system in mipui mamawh health service an phuruk zo tawh mang lova, health service tam zawk chu private hospital leh clinic ten an pe chhuak tawh zawk a ni. Hemi ina a nghawng chu damlo inenkawlna a mimal sum sen (Out of pocket expenditure) sang zel hi niin, mirethei leh harsa zawkten an tuar nasa hle.
Kumin MLA inthlan lo awm tur atan political party hrang hrangte manifesto/policy document-ah primary health system tihchangtlun a lang vek a. Mipuiin kan hriat tlanglawn health insurance bakah HIV laka invenna leh a veite thinhrik an nih lohna tura hmalak te, human resource lamah siamthat ngai te siamthat a nih theihna tura Mizoram Health Service(MHS) Rules ennawn leh private hospital din turte tan zawm tur kaihhruaina mumal tak duan te hi tun tuma political party te manifesto a chhinchhiah tlak zual te an ni.
Sawrkar damdawi ina thawktu indaih lohna hi Indian health system-ah harsatna lian ber pakhat a ni. Doctor indaih lohna sukiang turin medical college din belh te, MBBS seat tihpun te rawt ni thin mah se, a chinfelna (Solution) an ni kher lo. Tunhnaiah medical college nasa taka pung in doctor an chhuak hnem viau nachungin, sawrkara lut duh erawh an tam phah em em chuang lo. Medical education a hautak em avangin doctor zirchhuak tam takin sawrkar a luh ai chuan khawpui private hospital-a thawh emaw mahni puala private clinic hawna zirna senso hmuhlet vat vat an duh zawk niin a lang. National Sample Survey Office (NSSO)survey 2017-18 in a tarlan danin 2018 khan India rama doctor awm zat atanga chhutin 68.75% chu khawpui (Urban)ah awm in, 65% aia tam chu private hospital/clinic ah an thawk a ni. Health sector siamtha turin medical college hawn belh emaw seat tihpun aiin zirna fee sang lutuk tihhniam a, regulation tihchak hi a pawimawh hmasa zawk niin a lang.
Private sector(Corporates) ten healthcare an luhchilh nasat avangin medical education chu hlep hmuhna(Profit making enterprise)a lo ni ta a, private medical college zingah zirna quality tha mang si loa, fee sang tak tak phut an tam. Hei hian medical education-ah corruption tihluar in, medical education khuahkhirh(Regulate)tu tura din Medical Council of India(MCI)in a tih tur a ti tawk loh avang leh a chhungah corruption a hluar nia hriat a nih avangin Supreme Court leh Parliament Standing Committee on Health & Family Welfare ten an khak a ngai hial a, 2017-ah chuan MCI hi thiah niin Indian Medical Association leh pawl hrang hrangte dodalna karah National Medical Commission (NMC)in a thlak ta hial a ni.
MoHFW-in kum tin a tihchhuah Rural Health Statistics (RHS), 2021-22 in a tarlan danin thingtlang damdawi in CHC-ah Indian Public Health Standard(IPHS)in specialist awm tur a ti han phak lohna a nasa hle a, mamawh zat atangin 79.5% lai indaih lohna a awm mek a ni. IPHS tehfung ang chuan CHC tinah awm ngei ngei tura ngaih Physician/Family medicine specialist bakah naupang doctor(Paediatrician), hmeichhe natna lam zirchhuak(Obstetrics & Gynaecology), zai(Surgery)doctor leh hnimhlum doctor(Anaesthesiologist)an awm duhthusam a ni.
Mizoram bikah PHC-ah doctor leh nurse indaih lohna a awm lutuk loh laiin CHC ah erawh indaih lohna a nasa. IPHS, 2022 tehfung ang chuan CHC 9 tan specialist doctor 36 awm tura duhthusam a nih laiin RHS, 2021-22 ah CHC zawng zawngah specialist an awm lo vek angin chhinchhiah a ni a. Biate CHC bikah community medicine specialist pakhat a awm nia hriat a ni. Specialist bakah General Duty Medical Officer (GDMO)-allopathic pawh an indaih chuang lo a, GDMO(Allopathic) 18 mamawh a nih laiin 11 chauh dah theih an ni. Para medical staff bikah nurse 63 mamawh a nih laiin 37 chauh an awm.
Thingtlang lama specialist doctor indaih lohna sukiang turin Mizoram Health Service (MHS) Rules-ah specialist sub cadre tihlen hi thil tul tak pakhat a ni. Kaisanna leh posting guidelines bakah district lama doctor mamawhna thlir chungin directorate posting siamrem (Rationalise)te, health system-ah clinical doctor ngawr ngawr ni lo Public Health Specialist, Epidemiologist, Virologist, Biostatistician leh a dangte an luh tam theih nan MHS ennawn hi rawtna pawimawh tak a ni. Health ministry chuan nikum khan public health lamah chak zawka hmalak a nih theih nan state sawrkar te public health management cadre ti puitling turin a lo ngen tawh a, vawi leh khatah tihthlawhtlin theih loh a ni pawhin zawi zawia tihlam hawi zawnga inher rem hi a hun tawh a ni.
Mizoramin public health challenge lian tak a tawh mek chu HIV AIDS vei an pung zel hi a ni. District level a thawktute sawi danin khawtlangah thinhrikna a tam avangin mi nawlpui hriat loah testing leh damdawi(Anti-Retroviral Therapy)lak kawnga harsatna a tam hle. Entirnan, thingtlanga HIV positive zingah ART la tura district headquarters ah kal a ngaih avanga harsatna tawk an awm nual a. Invenna lam a pawimawh rualin a vei mek te enkawl leh chhawmdawl kawngah nasa zawkin tanlak a ngai.
Covid-19 len laiin India ram khawpui hrang hrangah private hospital ten damlo tam tak an hnar thu te, damlote atangin enkawlna man sang tak tak an lak thu te media lama hmuh tur a awm a. State thenkhat chuan an dan nei lai kengkawhin private hospital leh clinic thenkhat hremna pek an awm nual a ni. India ram hmun dangte nen khaihkhinin Mizoramah “commercialisation of healthcare” nasa lutuk lo mah se mihring kan pun zel avangin private damdawi in leh clinic a pung zel dawn a, mi rethei leh harsa zawkte dinhmun ngaihtuah chungin private healthcare regulation lamah tanlak nasat deuh deuh a pawimawh ang. Dan dinglai “The Mizoram Clinical Establishment Act, 2014” pawh hi a tul dan azira ennawn nih se, district level-a thuneitu District Registering Authority te pawh a nih tur angin kal theih se healthcare regulation lamah tun aiin hmasawnna a awm ngei ang.
Political party te manifesto-a lang lem lo Mizoram leh India ram pum huap ang pawha hriselna lama harsatna kan tawh mek chu inkaichhawn theih lo natna Non Communicable Disease (NCD) hrang hrang- Thisen sang, Zunthlum, Stroke leh a dangte avanga phurrit (Disease burden)sang zel hi a ni. Tunhnaia World Health Organisation(WHO)in report a tihchhuahah India ramah BP sang nei maktaduai 180 zingah 37 % aia tlemin an dinhmun an hria a, BP sang nei zingah BP control chu 15% chauh an ni. Mizoram Statistical Abstract, 2021 in a tarlan danin 2020 a natna hrang hranga avanga boral mi 3,318 zingah mi 579(17.45%) chu NCD anga ngaih theih circulatory system natna kaihhnawih avanga a boral an ni. NCD laka mipuite an him theih nan leh a vei mekte an an inhriatchhuah hmaa enkawlna an dawn hma theih nan PHC/sub centre level-ah awareness tam zawk a awm a ngai a, health promotion lamah tun aia nasain tanlak a tul.
Primary health system tichak turin kawng hrang hrang- budget a sum leh pai tam zawk dah (Financing), hnawthawktu siamrem (Personnel management), invenna lam (Preventive care), health promotion leh a dangah te hmalak ngai a tam hle a; programme chi hrang hrang tipuitling tura thawktu tam tak awmna health sector ah danglamna thlen turin policy duangtuten political will leh administrative will an neih a ngai ang.
(Thu ziah hi mimal ngaihdan a ni)