Rural health practitioners , Assam

It was the year 2004, dated 18th September,
when the Health & Family Welfare Dept. of
Assam had introduced an act—“The Assam
Rural Health Regulatory Act 2004”. The main
motto of introducing this act is to increase in
trained manpower for rural areas and in the
health sector. A pool of trained physicians,
during time of crisis to increase the
manpower pool in the health sector. At the
same, it is expected that the vacant posts in
rural areas will get filled up which will
regularise and streamline trained manpower
in rural areas and simultaneously increase
access to rural people in Primary Health
Care.
The prime objective of this act is as follows :
i) Opening of Medical Institutes for imparting
education and training for the course of
DMRHC. ii) To regulate and register the
diploma holders in DMRHC. In light of the
above Act Jorhat Rural Medical Institute
started this DMRHC course. The first batch
was started in September 2005. The
practical training for this course takes place
at the Jorhat Civil hospital, Jorhat. For the
first batch of the course 98 students have
been selected on merit basis, and this batch
has passed out in September 2008. On 1st
June 2009 the honourable Chief Minister of
Assam, Mr. Tarun Gogoi gave away
certificates and appointment letters to 92
students who had successfully completed
the course in the Regional Medical Institute.
The qualified medi-care practitioners had
been deployed at the remote, far flung and
rural areas of the state after undergoing
basic internship at various health care
centres in the state. At present in 13 districts
the RHPs are working. District wise posting
positions are as follows--- in Baksa 16 nos.
of RHPs, in Cachar 2 nos., in Chirang 20 nos,
in Hailakandi 6 nos, in Dhemaji 2 nos, in
Dhubri 10 nos, in Jorhat 1 no, in Karbi
Anglong 11 nos, in Korimganj 6 nos, in
Kokrajhar 6 nos, in NC Hills 6 nos, in
Tinsukia 2 nos, and in Udalguri 4 nos. of
RHPs has been posted so far. At present 3
batches of DMRHC are undergoing classes I)
DMRHC /06 batch: 95 students, II)
DMRHC /07 batch: 87students, III) DMRC/08
batch 100students.
As per the act the RHPs have to follow some
particular regulations-- under sub section (4)
every person whose name has been enrolled
in the State Register of Rural Health
Practitioners shall be entitled to have a
certificate issued by the Authority under the
hand and seal of the President and the
Secretary and bearing a Registration
Number and shall be eligible to practice
medicine and Rural Health Care in rural
areas of the State of Assam. Under Sub
Section (5): Every person whose name has
been enrolled in the State Register of Rural
Health Practitioners shall be entitled to have
a certificate issued by the Authority under
the hand and seal of the President and the
Secretary and bearing a Registration
Number and shall be eligible to practice
medicine and Rural Health Care in rural
areas of the State of Assam. Under Sub
Section (6) Provided that no Rural Health
Practitioner shall use the word “Doctor” or
“Dr” before and after his name. However he
may identify himself as Rural Health
Practitioner or RHP. Under Section 21.
Regarding Prohibition of Practice except as
provided in this act. Under Sub Section (1) :
No person whose name is not enrolled or
has been cancelled or removed from the
State Register of Rural Health Practitioners
shall practice Medicine and Rural Health
Care at any place whether rural or urban in
the State of Assam. Under Section (2) : Any
person who contravenes the provisions of
sub-section (1) shall be punished with
imprisonment, which may extend to 6 years
or fine which may extend up to rupees thirty
thousand or with both.
It should be mentioned here that as per the
norms of the stated act the job
responsibilities of the RHPs should be—
He/She will have to attend OPD duty
regularly. He/ She will have to attend
emergency cases which come to the
institution outside the normal duty hours.
He/She will organize laboratory services
for cases when necessary.
Passive Surveillance – Blood Slides are to
be taken for all fever cases and necessary
presumptive treatment or Fever radical
treatment to be given as per new drugs
regime from NVBDCP.
Treatment for minor illnesses/ Common
Communicable & Non communicable
diseases.
He/She will provide quality Ante-Natal
checkup and Ante-Natal care.
He/She will identify High Risk Pregnancy
and arranged referral as the case may be
and motivate Institutional Delivery for all
pregnant women in labour.
He/She will motivate pregnant women to
avail the benefit of Janani Suraksha
Yojana (JSY)
Promote Early (Within ½ hour) breast
feeding up to 6 month followed by
Complementary feeding.
Manage cases of Asphyxia and prevention
of Hypothermia and infection soon after
birth.
Identification of LBW babies soon after
birth and management of LBW new born.
Increase awareness of use of ORS for all
Diarrhoeal diseases.
Provide treatment of Diarrhea and ARI
cases.
Promote home based new born and child
care through IMNCI (Integrated
Management of Neonatal & Childhood
Illness)
Provide Routine immunization and
Vitamin -A supplementation by conducting
Immunization session on every
Wednesday. If beneficiaries are more
Immunization session may be conducted
twice in a week
Associate with Immunization Week and
Intensive Pulse Polio Immunization
programme (IPPI) as per schedule.
Implementation of NRHM, RCH II, NLEP,
NBCP, IDDCP, RNTCP, NCCP & IDSP as
per Guidelines.
Create awareness among the eligible
couple and community about
contraceptive and advantages of small
family.
Provide contraceptives to meet the unmet
need.
Popularize emergency contraceptive (E-
Pill).
Motivate for quality male and female
sterilization. (NSV / Laparoscopic
Sterilization/Minilap/PPS)
Submit report in NRHM reporting format
to the i/c Block PHC on 1st day of the
following month.
It should be mentioned here that the Rural
Health Practitioners receiving an
remuneration of Rs. 13,000/- per month are
presently delivering a worth praising service
in the Health Institutions of the rural areas of
Assam. Also, after appointment of the Rural
Health Practioners more patients began
coming to the health institutions of the rural
and remote areas. Particularly, in maternal
and child health sector the result is strikingly
effective. Apart from performing their regular
duties most of the times they had to attend
many emergency cases. Just to cite an
example, in Pamuapathar SHC, under
Mushalpur BPHC, of Baksa district the RHP
attends all the emergency cases in the
absence of the Regular Ayurvedic MO. In
Pamuapathar SHC an average of 30-35
patients turn up every day for OPD. the
RHPs are becoming more and more popular
among the rural folk of Assam. Previously, in
most of the interior places of Assam the
people had to suffer a lot to avail health
facilities. Even for some minor health
problem they had to travel such a long
distance that until and unless it did not
become serious people are not willing to go
to any health institution which is far away
from their village. The service provided by
the RHPs found to be satisfactory and the
rural people are extending full help to the
RHPs in performing their duty properly.