The state of Andhra Pradesh keeps the vision2029 objective to ‘build a healthy society by developing a sustainable ecosystem to universalize quality health and nutritional services that is accountable, effective, efficient, equitable and technologically appropriate’ in foreground while making and implementing any health policy. Other than the common national health programmes and schemes, the government of AP has been undertaking several initiatives to specifically target those health concerns that are either left out or are not adequately addressed. For instance, the emergency ambulance service 108 was inaugurated as back as in the year 2005 but to complement and expand its access another emergency ambulance service 104 has been started for rural areas under ‘Fixed day health services’. This emergency van will be equipped with diagnostic kits, medicines as well as a medical officer. The AP government is making special efforts to reduce infant and maternal deaths and bring them to international standards. A dedicated express service ‘Talli-Bidda’ has been started where vehicles are procured to bring and drop back pregnant women and the new born babies from public hospitals to home. Post pregnancy child and mother care kits are being distributed to mitigate infections. The reported number of both maternal and infant deaths has reduced over the last three years (see table 1); though the number for infant deaths spiked in the year 2015. The IMR (Infant Mortality Rate) and the MMR (Maternal Mortality Ratio) are below national average but still AP is far behind the best performing state (see table 2). Similar differences exists between AP and the best performing state in the case of children below 5 years who are underweight and stunted, and women diagnosed with anaemia.
The government has started various supplementary nutritional programmes like ‘Giri Gorumuddalu’, ‘Anna Amrutha Hastham’, Take Home Ratio scheme, for both mother and child to strengthen the fight against malnutrition and anaemia. Proper nutrition becomes important because one third of the deaths of children below the age of ten are due to lack of nutritious food. A ‘Mata-Shishu’ tracking system has also been developed to extend more improved medical aid to the pregnant women and babies. In order to enhance healthcare access the AP government has activated mobile medical units under ‘Chandranna Sanchara Chikitsa’ to provide health services at village level. The government under its flagship scheme ‘NTR Vaidya Seva’ provides free of cost diagnostic lab tests at all public health facilities to every citizen thus reducing out of pocket expenditure on health. The state government provides health insurance for secondary and tertiary level care with the annual cover of Rs 2.5 lakhs to all the BPL families without charging any premium. And for APL families, insurance cover of Rs 2 lakhs is provided under ‘Aarogya Raksha’ by charging a small premium. The state is inching closer to achieving universal health coverage in the coming years.
|Table 1: Reported Maternal and Infant Deaths in AP
Source: Commissioner of Health and Family Welfare KPIMS as on May15 2017
|Table 2: Key Health Indicators
|Institutional Delivery (%)
|Mother who had at least 4 antenatal care visits (%)
|Malnutrition (U5 Stunting) (%)
|Malnutrition (U5 wasted) (%)
|Malnutrition (U5 underweight) (%)
|Children (6-59 months) who are anaemic (%)
|All women who are anaemic (%)
Source: NFHS-4; * value for undivided state (SRS 2013)