On the basis of health indicators and performance on GOI pattern two districts - Chamoli and Uttarkashi have been identified as backward and two more districts - Pithoragarh and Bageshwar has been clubbed under the High Focus Districts. Though availability of services and service care delivery system is better in Udham Singh Nagar and Haridwar in the foothills but poor acceptance / indicators are once again the priority district as a major percentage of population resides in these two districts and non-acceptance is an issue that needs attention.
Though now we are in seventh year of NRHM implementation, we are yet to notice a substantial change in health indicators. The access problem and shortage of Medical and paramedical staff is a major hurdle. The presence of private sector is negligible in high hill region and is limited to the few towns of plains and foot hills.
In order to cope up with the problem, following interventions towards Maternal and Child health have been planned. Involvement of ASHA in ANC & PNC, Immunization and Civil Registration has been expanded to cover all districts of the state. As regards institutional deliveries and child care, detailed human resource planning has been done; as also 108 Medical Vans have been involved for the same. Outsourcing of Urban Health Posts and ARSH activity, due to shortage of staff have also been initiated to cover the un-served/underserved locations like urban slums and the adolescent age groups, respectively.
All possible PPPs in terms of outsourcing of health facilities and involving private practitioners for institutional deliveries (only BPL) and family planning services through voucher scheme are on the priority.
To increase the capacity of existing staff all possible training activities have been incorporated. The detail of each activity is mentioned in respective chapters. State is determined to implement NRHM in full swing and with vigour and zeal to achieve its goal in time.