C M Y K
www.morungexpress.com
FriDAY • April 07 • 2017
DIMAPUR • Vol. XII • Issue 94 • 12 PAGes • 5
T H e
ESTD. 2005
P o W e R
o F
T R u T H
A poem begins in delight and ends in wisdom — Robert Frost CM inaugurates Senayangba GHSS Science cum Admin new building
Parl clears decks for GST rollout from July 1 pAGE 08
Chelsea win but Tottenham keep the title race alive
PAGE 02
PAGE 12
nagaland: regional disparities in healthcare
Government critical to healthcare but underperforming Moa Jamir Dimapur | April 6
The overall status of maternity care and child immunization in Nagaland State is abysmally low, not even reaching half of India’s average on most indicators. Within Nagaland, meanwhile, there are sharp regional disparities and the provision of healthcare remains highly skewed, calling for reorientation of priorities from all stakeholders. An analysis of the recently released National Family Health Survey - 4 (NFHS-4; 2015-16) reveals district wise inequalities in health provision is staggering in Nagaland State. Maternal and child care best in Mokokchung Though much below national average, according to the NFHS -4 data (see table), Mokokchung is the best performing district in maternal care followed by Kohima and Dimapur. On the other end, Longleng has the lowest percentages in maternal care while the indicators in Zunheboto, Mon, Kiphire and Phek are also appallingly low. In the case of child immunization and nutritional status, Mokokchung tops the indices, while Kohima and Peren closely follow. Full child immunization, however, is highest in Kohima. Five districts – Phek, Wokha, Zun-
reflections
By Sandemo Ngullie
heboto, Mon and Longleng — were below the State’s level in full immunization of children.
Maternal care
Mothers who Mothers who Mothers who Mothers had at least consumed iron folic received postnatal who had full 4 antenatal acid for 100 days care from health antenatal care visits or more when they worker within 2 days care (%) (%)* were pregnant (%) of delivery (%) Mokokchung 35.8 4.3 7.5 36.9 Kohima 30.5 6.4 8.6 34.9 Dimapur 26.5 4.5 7.7 35.3 Wokha 25.8 4.8 9.9 25.6 Peren 13.1 4.1 7.5 30.5 Tuensang 4.8 0.3 2.5 20.4 Phek 6.6 0 0.9 11.5 Zunheboto 5.9 0 0 14.2 Mon 3.4 0.3 0.7 4.8 Kiphire 2 0 1.4 13.9 Longleng 1.5 0 0.4 6 Nagaland 15.0 2.4 4.4 22.3
Sharp district wise disparities The data shows huge district wise disparities in child and maternal care. For instance, if one looks at the percentage of mothers with at least four antenatal care visits (healthcare by professionals during pregnancy for last birth in five years before the survey), while top performing districts like Mokokchung and Kohima have 35.8% and 30.5% respectively, it is as low as 2% and 1.5 % in Kiphire and Longleng respectively, as per the NFHS-4. In case of full antenatal care (at least four antenatal visits, at least one 51.2 21.0 30.3 24.3 tetanus toxoid (TT) injection and India iron folic acid tablets or syrup taken *At least four antenatal visits, at least one tetanus toxoid (TT) injection and iron folic acid tablets or for 100 or more days), while almost all syrup taken for 100 or more days for last birth in the 5 years before the survey) the districts have low averages, 4 districts shows zero visits, while in two child iMMunizations and VitaMin a suppleMentation Children Children Children others, it was below 1%. Children Children Children receiving receiving a receiving The percentage for postnatal care age 12-23 who are who are 3 doses of vitamin A measles months fully stunted underweight of mothers from health professionals Hepatitis dose in last vaccine immunized* (height-for- (weight-forwithin 2 days of delivery also ranges B vaccine 6 months (%) ** (%) age) (%) ^ age) (%) ^ from as high as 36.9% in Mokokchung (%) # (%) ** to 4.8% in Mon. Immunization – 5 districts below state’s level; all below national average In case of full immunization (denoted by a BCG, measles, and 3 doses each of polio and DPT for Children aged 12-23 months), all the districts average below India’s 62% while five districts are below the State level of 35.7%. However, district wise difference ranges from as high as 60.5% in Kohima to as low as 10.8% in Longleng. In case of children receiving three doses of Hepatitis B vaccine, the differences were 71.1% and 25.1%.
What disparities? While the NFHS-4 data shows sharp disparities, how does one explain the outcome? There is no clear explanation, however, an analysis of the district wise health units provided in the Nagaland Economic Survey 2006-17 and ctabulating the same with 2011 census could provide some answers. In Dimapur and Kohima, for instance as per the Survey, a single government health unit is serving, on Mokokchung 51.9 66.8 58.3 75.8 19.8 5.8 an average, 6210 and 4542 persons Kohima 60.5 71.1 37.1 71.2 24.7 15.2 respectively. In Longleng this figure Peren 49.1 54.7 51.7 51.7 29.8 10.3 Dimapur 33.7 43.7 36.0 47.3 20.9 14.8 came to 4207, followed by Mon at Tuensang 44.9 56.0 23.1 58.8 36.4 21.0 3475, Peren at 3400, Wokha at 3080, Kiphire 36.0 38.9 21.1 50.2 41.1 25.6 and Kiphire at 2551. Beside geographical distances Phek 34.7 46.4 19.1 47.3 27.8 12.8 Wokha 22.1 38.3 29.9 54.1 18.7 11.6 from the core, if we look at the access Zunheboto 24.7 32.0 20.4 48.2 31.1 13.7 to health care in worst performing Mon 19.9 29.8 13.6 31.1 35.6 24.6 districts like Longleng, Kiphire, and Longleng 10.8 25.1 12.8 37.9 26.1 17.1 Mon, almost 100% of the health care Nagaland 35.7 45.6 27.1 50.4 28.6 16.8 access is through the Government. NFHS data showed that for almost India 62.0 62.8 60.2 81.1 38.4 35.7 all provision for immunization and oth*(BCG, measles, and 3 doses each of polio and DPT) #(9-59 months) **(12-23 months) ^Below 5 years Table compiled from “National Family Health Survey – 4,” Ministry of Health and Family er health care requirements, the public is dependent on the government. Only Welfare, Government of India, 2017.
Dimapurdistricthadaround28%provision by private providers. While the per unit density of healthcare for Dimapur and Kohima is relatively high, health provisions in these districts are amply augmented by private entities. Such augmentations, however, are almost nil in low performing districts thereby leading to possible poor outcome.
Government critical to solve Nagaland’s Health Paradox While Nagaland is below national average in most variables that contribute to infant mortality, the death rates are much lower than the former. Again, if one compares the average spending on health sector expenditure in Nagaland with other states, the health outcome does not commensurate with the expenditure. Thus, heath care remains a paradox in Nagaland. For instance, spending a whopping Rs. 395 crore in, Nagaland State is sixth among Indian States on the list of per capita health expenditure (Rs 1707) and fifth on Health Expenditure as a percentage of Gross State Domestic Product (2.23%) in 2013-14 according to latest ‘National Health Profile 2016’ published by Central Bureau of Health Intelligence (CBHI). By all accounts, with such expenses, it is expected that the State would score highly in both qualitative and quantitative delivery of healthcare to its citizens. However, misplaced priorities as well as acute regional disparities seem to be pulling its health indicators down needing an urgent and critical course correction.
Augmentation of water supply to Kohima ready for commissioning Dimapur DC notifies schools Our Correspondent Kohima | April 6
The augmentation of water supply to Kohima town (Zarü project) under the Urban Ministry is almost ready to be commissioned. Minister for Public Health Engineering Department (PHED), Chotisuh Sazo along with top officials from PHED today made a field visit to the project and took stock of Oi hey, stop, hey, hey stop the work progress. right there I said stop. You The project was taken dropped your Dada daba! up by PHE department since 2012 and on completion is expected to provide an additional supply of 3 million litres per day to the capital. Sazo said the project will be inaugurated by this month by Chief Minister, Dr Shurhozelie Liezietsu. Our Correspondent Against the total reKohima | April 6 quirement of 11 million 909 cases of power theft litres per day for Kohima were detected and penalties imposed to the tune of Rs. 11.3 lakhs during the period 201415. This was stated in the annual administrative report 2016-17 of DIMAPUR, APRIL 6 the Power Department (MExN): The Nagaland tabled in the just con- RMSA Teachers’ Association cluded state assembly (NRMSATA) today served a 7 session by Minister of day ultimatum to the EducaPower, C. Kipili Sang- tion Department (RMSA) for tam. The report stated release of 5 months worth of that the department pending salaries. had initiated the Anti A press note from the Power Theft Mobile NRMSATA stated that deSquad (APTMS) in the spite enough reminders of year 2013-14 and had their grievances at all given proven to be useful in opportunities and platprevention of power form, there has been no theft. Meanwhile, Na- positive response and outgaland villages and come towards the fate of households electrifica- RMSA teachers even after a tion has achieved a lot long patient wait. The assowith implementation ciation said that “it was unof the centrally spon- acceptable when we are ofsored scheme: Deen ten being dragged into the Dayal Upadhya Yojana, pool of pitiable conditions the report claimed. It and to live without salary informed that 81 un- for over 5 months.” electrified villages along “We did all that was huwith 2 Sansad Aadarsh manly to us and therefore, Gram Yojana villages we had good faith that the have been electrified, department must have which will enable elec- heard our grievances being tricity access to 4743 ru- addressed, but only to realral households. ize of beating the dust at the
909 power theft cases detected in 2014-15
For children receiving vitamin A dose in last 6 months, 6 districts are below the State average of 27.1% while it was highest in Mokokchung at 58.3%. Consequently, with lower nutritional intake, in five districts, children below 5 years who were considered ‘stunted’ - suffering from growth retardation as a result of poor diet or recurrent infections – are above the state level (28.6%) with Kiphire showing the highest incidence at 41.1%. In case of underweight child below 5 years, four districts - Tuensang, Longleng, Mon and Kiphire have higher rate than the State level of 16.8%.
PHED Minister, Chotisuh Sazo and others during a field visit to the augmentation of water supply to Kohima town (Zarü project) on April 6. (Morung Photo)
town, only 1.5 million litres per day is received at present. Advocating the need to provide sufficient safe drinking water to the public, the Minister was hopeful that the commissioning
of this project would solve the water scarcity problem in the city. He also felt that online payment system in water supply will also improve the revenue collection of the department.
PHED Secretary, Dr Maongwati Aier said the department is also focusing on rainwater harvesting in the state capital. PHED Chief Engineer, Er Kevisekho Kruse said the project will target areas in the capital where water supply is less. WSSO (PHED) Director, Er K Ghushito Sumi; PHED Additional Chief Engineer, Er Yhusinlo Tep and several other officers including Mima village leaders were also present. It may be recalled that PHED was bifurcated from the erstwhile PWD and became a fully fledged Department in 1974. As per the Rules of Executive Business, the PHED is responsible for providing safe and potable drinking water supply, safe disposal of solid and liquid waste and environmental hygiene.
DIMAPUR, APRIL 6 (MExN): The Deputy Commissioner, Dimapur has issued an order informing that in pursuance of the NBSE notification dated March 16, 2017, all schools under Dimapur district have been directed to implement the said notification and see to it that school bags of children do not exceed 10% of the weight of the child. The DC said that in other words, the bags of the school children
should not be disproportionately heavy, detrimental to the body of the child. The order meanwhile observed that many school buses and vehicles do not have protective bars on the windows, making it unsafe for children. It directed all schools to put windows bars in vehicles carrying school children with immediate effect. Strict action will be taken for non compliance of this order, it cautioned.
Develop better understanding of depression: Gov
DIMAPUR, APRIL 6 (MExN): Nagaland State Governor, PB Acharya today called upon the people of the state to work towards developing a better understanding of depression and its related effects. In a statement to mark World Health Day, which falls on April 7, the Governor said: “better understanding of depression will help reduce the stigma associated with the illness, and lead to more people seeking help.” “Depression can be treated. If you think you have depression, seek help. Talking with people you trust can be a first step towards recovery from depression” he added.
The Governor said that depression is an illness that can happen to people of all ages, from all walks of life, in all countries. It causes mental anguish and affects people’s ability to carry out everyday tasks, with sometimes devastating consequences for relationship with family and friend. He said that at worst, depression can lead to self inflected injuries and suicide. However, fortunately depression can be prevented and treated, which usually involves either talking therapy or antidepressant medication or a combination of these. The theme for the World Health Day 2017 is ‘Depression: Let’s Talk,’ with aims to mobilize action on depression.
NRMSATA serves 7 day ultimatum 400 Cr loan agreement signed for Nagaland Forest Management Project and increased production and soil fertility, and to proDELHI, APRIL for release of 5 months worth salary NEW of fuel wood, fruits and mote agroforestry to bring 6 (MExN): The Japan In-
C M Y K
end of the day when we are bogged down on this same old issue,” it added. It meanwhile reminded that during the ULB imbroglio, “when the employees of the state were delayed a month of their salary, the State Government doused the fire with rapidity, producing assuring statements and genuinely expressing their regrets with wholesomeness by introducing immediate corrective measures.” On the excuse of non release of funds from the central ministry, it questioned if the central ministry is so disorganized in their functioning that it persistently leaves their work pending, inconveniencing the innumerous departments that falls under them. Failing to comply with the ultimatum, it further cautioned, will invite the association to take its own course of action.
ternational Cooperation Agency (JICA) signed an agreement with the Government of India to provide an Official Development Assistance (ODA) Loan of approximately Rs 400 crore for the Nagaland Forest Management Project. A press note from the JICA informed that the ODA loan’s conditions are very concessional, i.e. 0.3% interest rate for project activities and 0.01% for consulting services interest rate and 40 years of repayment period (including 10 years of grace period). The JICA-assisted Project aims to improve forest ecosystem and support income generation by rehabilitation of Jhum Cultivation (traditional slash and burn practice) area and provision of livelihood support, thereby contributing to sustainable forest and environmental conservation and livelihood
(L-R) Takema Sakamoto, Chief Representative, JICA India with S Selvakumar, Joint Secretary , Department of Economic Affairs (DEA) at the Loan Agreement Signing Ceremony.
improvement in the target villages in the state of Nagaland. The agreement was signed between Takema Sakamoto, Chief Representative, JICA India Office and S Selvakumar, Joint Secretary, Department of Economic Affairs, the Ministry of Finance. Speaking on the occasion, Takema Sakamoto
said: “JICA recognizes the significance of livelihood improvement and poverty alleviation in forestry areas, and the Project shall contribute towards ecological rehabilitation of Jhum cultivation areas and poverty alleviation in the state of Nagaland. It is envisaged that by implementing the Project, better nutrient recycling within forestry soil
Non-Timer Forest Products (NTFP) would decrease people’s dependency on Jhum Cultivation and improve their livelihood.” The project comprises Forestry Interventions and Biodiversity Conservation, Livelihood Improvement and Community Development and Institutional Strengthening, targeting 185 villages in 22 forest ranges in 11 divisions, covering approximately 80,000 ha for forestry intervention. In Nagaland state, between 2013 and 2015, forest cover decreased by 78 km2 and one of the reasons is Jhum Cultivation, a form of traditional shifting cultivation, in which approximately 60% of the population is engaged and approximately 60% of food demand is met from. During the project, five models will be applied to the areas of Jhum cultivation to improve tree density
additional income sources to the people who are engaged in Jhum Cultivation and reduce the extent of dependency of the people on Jhum Cultivation. The Executing Agency for the Project is Department of Environment, Forest and Climate Change, Government of Nagaland. The JICA was established as an independent administrative institution under the Government of Japan. It aims to contribute to the promotion of international cooperation, as a sole Japanese governmental agency in charge of ODA implementation. JICA is the world’s largest bilateral donor agency and works as a bridge between Japan and emerging countries, and provides assistance in forms of loan, grant and technical cooperation so that the emerging countries can strengthen their capabilities.