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The
Rajiv Gandhi Missions arose
from an effort to convert selected programmes into a
‘mission-mode’, to address critical issues of human concern
with a sense of urgency, purpose, direction and a time span. The
Rajiv Gandhi Mission for Control of Diarrhoeal Diseases was one
of seven such missions initiated by the Government of Madhya
Pradesh in 1994. |
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It
was observed that in 1993 the Infant Mortality Rate of Madhya
Pradesh was 106, which was much higher compared to 17 of Kerala
and 79 for India as a whole. Diarrhoea has been identified as a
major cause of childhood mortality accounting for 28% of deaths
among children. It is estimated that in early 1990s, diarrhoea
claimed nearly ten lakh children in the age group 0-5 years,
every year. |
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The
objectives with which this mission was taken up were reduction
in mortality due to diarrhoea by 30% by the year 1997, and by
70% by the year 2000, plus a reduction in the incidence of
diarrhoea. |
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The
strategy used included increased access to Oral Rehydration Supply
to
80% by 1995 and 100% by 1997 as well as promoting Oral
Rehydration Therapy and fluids available at home to minimise
dehydration and related deaths.
Breast-feeding was to be promoted and efforts made to
ensure that 80% of mothers breast-feed their children upto 18
months by 2000 AD. Efforts were to be made to improve maternal
knowledge on diarrhoea management and to create awareness among
health workers, social workers and panchayat members about
Diarrhoea management. A major social mobilisation and
communication campaign in the form of an ORS yatra to increase
awareness about cause and prevention in the community was to be
launched. It was decided that it was necessary to network with
grassroot level functionaries of the government. Other measures
to reduce the mortality rate would include ensuring availability
of safe drinking water and sanitation, identifying and mapping
epidemic prone areas and preparing an action plan for epidemic
prevention.
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These
measures would be implemented mostly by state agencies like the
State Level Mission Unit, the Health Department, the Public
Health Engineering Department, Panchayats and Zila
Saksharata Aur Swasthya Samitis. These would work in
collaboration with NGOs, other Related Departments of the
Government like WCD and PR, Medical Colleges, Associations of
Doctors, Pharmaceutical Companies, International Organisations
like UNICEF and WHO, National Bodies like the NICD and NICED and
Local Bodies. |
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At
the end of three years, by January 1997, Diarrhoeal deaths had
reduced by 48%. The case fatality rate or the number of deaths
per 100 cases of diarrhoea had come down from 2% to 0.8% in the
first two years. 11,086 villages had been identified as high
risk villages, a data base had been created for the first time
and an action plan launched. A Safe Water and Health campaign
was launched in all these villages and included ensuring safe
water supply, using water testing kits to check water sources
and creating awareness through health education. |
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The
responsibilities relating to drinking water, environment,
sanitation and health care have been entrusted to elected
community representatives, what remains is motivating them to
take sustained action in this area. |
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