Chhattisgarh districts worked its way to top aspirational ranking in Niti Aayog’s list

Making a headway towards universal health coverage and health for all

The districts of Bijapur, Dantewada, and Sukma in the state of Chhattisgarh worked their way to secure the top-ranking amongst the 117 aspirational districts in Niti Aayog’s list despite being affected by the long-drawn conflict between the State and Left-wing extremist (LWE) districts. Through sustained efforts and well-thought-out strategies, the districts embarked upon the journey towards transformation across sectors such as health and nutrition, education, agriculture, and water resources, financial inclusion, skill development, and basic infrastructure. 

The aspirational districts showed substantial improvement in health and development indicators over two and a half years (2018-2020) by improving access to health services through Health and Wellness Centres (HWCs), strengthening of the health workforce, availability of essential drugs and diagnostics, and rational use of available resources.

“With the support from WHO in these three districts, 113 out of 158 HWCs have been made functional to date. The mentorship provided by WHO is enabling an increasing number of medical officers and frontline workers to proficiently utilize existing opportunities to expand the range of essential services delivered - a strong and firm step towards achieving universal health coverage and health for all”, shared Dr S.K Pambhoi, Deputy Director, National Health Mission, Chhattisgarh.

The districts developed human resources for health (HRH) plans to achieve integration of various services under HWCs and strengthening the health workforce in the districts for comprehensive primary health care (CPHC). Monitoring tools were developed to aid the monitoring process of health facilities as well as ensure the availability of essential drugs and diagnostics.

To ensure the functionality of HWCs and rational utilization of resources, rural medical assistants (RMA) and community health officers (CHO) and frontline workers were deployed at HWCs. District HWC committees were established to support the functioning of the HWCs and technical support was provided to the district administration for developing projects led by corporate social responsibility (CSR) funding.

The three aspirational districts reported a positive trend in the progress made across 17 indicators. The overarching principles that contributed to this progress are the convergence of central and state initiatives, the collaboration between the citizens and functionaries of central and state governments including the district teams, and competition among the districts that kept the teams motivated to make sustained efforts that brought about a significant improvement in health and development indicators.

Bijapur topped the list of aspirational districts in the month of July 2019 and has remained high in the ranking throughout 2020. All the three districts improved on the overall health and nutrition scores. Sukma reported the maximum change of 77.2% followed by Dantewada at 75% and Bijapur at 74.5%.  Sukma district reported a significant jump in the percentage of institutional deliveries from 56.12% in August 2018 to 100% in August 2020. The percentage of immunization also improved significantly by 51.24%. All three districts reported a decrease in the number of severe acute malnourishment (SAM) in children under six years. Out of the 17 key indicators, all three aspirational districts made significant improvement in at least 8 indicators, with Sukma taking the lead with improvement in as many as 15 indicators. 

“Dantewada had observed a decreasing trend in the percentage of institutional deliveries during the period. With support from WHO, the district administration and health department are working towards improving the pre and post-natal care indicators. Through innovative measures such as establishing a health call centre to improve the rate of institutional deliveries, reduce maternal and infant death by way of timely dissemination of information, communication and awareness building, the district administration with support from aanganwadi workers (AWWs), ASHAs also known as Mitanins is providing antenatal care and information on nutrition and breastfeeding to pregnant women and mothers”, shared Dr Virendra Thakur, Chief Medical & Health Officer, Dantewada.

The Transformation of Aspirational Districts Programme (TADP) was launched by the Government of India in January 2018. It aims to rapidly transform under-developed districts to improve India's ranking under the Human Development Index, reduce the substantial inter-state and inter-district variations in development, raise the living standards of citizens and guarantee inclusive growth for all. This is in alignment with the Government’s approach of Sabka Saath Sabka Vikas (Collective Effort, Inclusive Development), and its commitment to “leave no one behind” is reflective of the sustainable development goals (SDGs) in keeping with its vision of a New India by 2022.

“Transforming most backward districts of the country is an ambitious and an uphill task. However, local partnerships between district administration, WHO and Tata Trusts alongside close coordination with Niti Aayog and State government are empowering districts like Sukma to overcome challenges of armed insurgency and remote tribal population to transform and strengthen drivers of the public delivery system”, shared Siona Correia, Aspirational District Fellow, Sukma.

“WHO Country Office for India is providing technical support in transformation of Aspirational District Programme in different states focusing on ensuring efficient and effective implementation of health policies and programs to advance towards universal health coverage (UHC), including Comprehensive Primary Health Care (CPHC) roll out and implementation of various components of Ayushman Bharat including the operationalization of Health and Wellness Centers (HWCs). This support is channeled through direct district-level support in three aspirational districts in Chhattisgarh. This is part of the WHO-UHC Partnership initiative of supporting equitable access to essential health services in states with a focus on vulnerable groups through major reforms of primary health care,” shared Dr Roderico H Ofrin, WHO Representative to India.