JRD Tata Oration Seven

JRD Tata Oration Seven



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JRD Tata
Founder Chairman
Population Foundation of India
Guly 29, 1904 - November 29, 1993)

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7th JRD Tata
Memorial Oration
ROLEOF PANCHAYATS
IN POPULATIOSNTABILISATION
POLICIESANDPROGRAMMES
SHRI DIGVIJAY SINGH
Chief Minister, Madhya Pradesh
DECEj\\rBER 4. 2001
POPULATION
i
1.f1.'1.
FOUNDATION
OF INDIA

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PREFACE
The State of Madhya Pradesh has recorded during the
past ten years remarkable achievements in rise in literacy,
reductions in fertility and extent of democratic
decentralization. The Government of Madhya Pradesh, being
seized of the urgent need to arrest the high rates of
population growth in the State, has taken a conscious decision
to achieve replacement level of fertility by the year 2011 and
the involveme~t of Panchayati Raj Institutions to this
ambitious goal. This is a complex and difficult task calling for
an integrated approach, effective decentralization of various
programmes and coordination at every level that contribute to
reduction in the fertility levels of the population. It is very
fortunate that Madhya Pradesh has a committed and dynamic
political and bureaucratic leadership. It has formulated a
comprehensive State level Population Policy in the year 2001,
in which not only the desired demographic goals of the State
but also the strategies for reaching the same have been spelt
out.
Madhya Pradesh became the first State to enact a new
Panchayati Raj Adhiniyam in 1993 in conformity with the
provisions of the Constitutional Amendment. The three-levels
of Panchayat administration-district, block and village level are
involved in the Reproductive and Child Health programmes:
the Zila Panchayats manage and control all public health
institutions outside the urban hospitals, including medical
officers and staff, and all assets and supplies. The Janpad
Panchayats (block level panchayats) review and supervise the
Primary Health Centres and sub-centres. The Panchayati Raj
Institutions are also responsible for closely related social
(i)

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programmes suc:h as education, and efforts to improve the
status of women.
Madhya Pradesh can achieve the replacement level of
fertility by 2011, however daunting the task may seem,
provided each village takes upon itself the task of avoiding all
unwanted pregnancies - and this can happen only when each
gram panchayat resolves to do so with the involvement of
Gram Sabhas; when each Janpad Panchayat decides to
improve the delivery of Reproductive and Child Health
services; when every Zila Panchayat sets population
stabilisation high on its agenda; and finally, when the health
apparatus of the State enables Panchayats to own the
population programmes. Non-Governmental Organisations in
the State need to work with the State-government well on
strengthening the Panchayati Raj Institutions.
During the past five years, Population Foundation of
India has also been making serious efforts to strengthen the
programmes and projects implemented by the Panchayati Raj
Institutions and Non-Governmental Organisations in the
country towards population stabilisation and RCH services
through various approaches including training the members
of Panchayati Raj Institutions in various aspects of RCH and
family planning. Training of panchayat members is an
important and vital aspect for their empowerment and
appropriate action in the population field. Recently, the
Foundation has also undertaken projects on Empowerment
of Community on Health and Social Development Issues
through Mass Media: Radio and Television, in the major
States of India. The main aim of implementing these
programmes is to create awareness among rural people and
empower Panchayati Raj Institutions on the issues of RCH,
gender inequality, family planning methods, communicable
diseases and its prevention, water and sanitation, food and
nutrition and literacy and education etc.
(ii)

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As a pan of its advocacy programme, Population
Foundation of India instituted in 1990 "Encounter with
Population Crisis" lecture series inviting important
International and Indian celebrities to deliver lectures once in
a year to focus on critical issuesrelated to population and to
carry the debate forward.
Since 1995,the lecture series was re-christened as "JRD
Tata Memorial Oration" in memory of the founder of the
Foundation. The first of these lectures was given by
Mr Ramakrishna Hegde, followed by Mr Chandra Shekhar,
Dr Najma Heptulla, Mr I K Gujral, Dr Nafis Sadik and
Mr K C Pant.
This year we have invited Shri Digvijay Singh, Chief
Minister of Madhya Pradesh to deliver the Seventh JRD Tata
Memorial Oration on "Role of Panchayats in Population
Stabilisation Policies and Programmes". Shri Digvijay Singh
has played a key role in Madhya Pradesh's population
stabilisation programmes and strengthening of Panchayati Raj
Institutions. He argues convincingly that effective democratic
decentralisation and involvement of Panchayati Raj
Institutions in the development of reproductive and child
health programmes including family planning are the only
routes for sustainable development and rapid demographic
transItIon.
I am sure, this Seventh JRD Tata Memorial Oration will
stimulate the Government and Non-Governmental
Organisations to work together through a coordinated
approach to strengthen Panchayati Raj Institutions and
through these institutions achieve the goals of National
Population Policy.
New Delhi
December4, 2001
Dr K Srinivasan
ExecutiveDirector
(iii)

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7thJRD TATAMEMORIAL ORATION
Speech by
DR BHARAT RAM, CHAIRMAN, PFI
Hon. Shri Digvijay Singhji, Chief
Minister of Madhya Pradesh and
distinguished friends -
It is my privilege to welcome
all of you, especially Shri Digvijay
Singhji, for being with us today at
the Seventh JRD Tata Memorial
Oration. It is indeed kind of
Digvijay Singhji to have accepted
our request to deliver this lecture.
JRD Tata, in whose memory
we all have assembled here today, was a man deeply
committed to national growth and development. We all know
about his great contributions to the industrial growth of
India and to civil aviation, but his concern and contribution
on social issues, such as poverty, unemployment and ever
growing population are no less important. Mr Tata was a
colossus among the Indians who enriched the national life
in the 20th century in many ways. During his long and
chequered life, Mr Tata had promoted and fostered several
causes he was associated with is truly legion. He along with
some industrialists like me felt in the late sixties that
governmental inputs and efforts in the area of population
stabilisation have to be stimulated, supported and

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strengthened by non-governmental efforts and that is why
we started the Popubtion Foundation of India in 1970.
As a part of its advocacy programme, the Foundation
instituted in 1990 'Encounter with Population Crisis' lecture
series. The inaugural lecture was given by Dr Norman E
Borlaug, Nobel Laureate and Father of the Green Revolution,
followed by Dr M S Swaminathan, Dr Ashok Mitra, Dr
Abid Hussain and Mr Vasant Sathe.
In the Silver Jubilee Year of the Foundation, 1995, the
'Encounter with Population Crisis' the annual lecture series
was rechristened as ' JRD Tata Memorial Oration' in memory
of the founder of the Foundation.
This year we have the honour and privilege of having
with us Shri Digvijay Singh, Chief Minister of Madhya
Pradesh to deliver the Seventh JRD Tata Memorial Oration
on "Role of Panchayats in Population Stabilisation Policies
and Programmes".
I would like to say a few words about him and the
wonderful work that he is doing in Madhya Pradesh.
Born in the royal family of a principality in Madhya
Pradesh, Shri Digvijay Singh is an engineering graduate with
interest in Cricket and Tennis. Joining politics at the age of
24, he became the Chief Minister of Madhya Pradesh in
December 1993. He is the longest serving Chief Minister in
the history of the State. This is a great tribute in Indian
Politics.
The focus of Shri Digvijay Singh's vision is his firm
belief in the abilities and potential of the common people.
People are not the problem, they are the solution is the
cornerstone of his philosophy of development. Extensive
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decentralisation of powers, democratisation of society at the
grassroots and reservation for women in different walks of
public life are some of his notable contributions as Chief
Minister. The 'Digvijay Singh mantra' is participation of
people in governance for sustainable socio-economic
development.
Madhya Pradesh was recently given an award for
registering highest increase in female literacy in the country.
The State Government's community based Education
Guarantee Scheme and the Padhna Badhna Andolan have
reached out to poor and marginalised people living in remote
areas. About 30 lakhs people were made literate in one year
under the Padhna Badhna Andolan that was launched in
1999. 26,000 primary schools were created on the demand
of local communities within 18 months under the Education
Guarantee Scheme. These schemes have given access to basic
education to over 10 lakhs children belonging to tribals,
dalits and other underprivileged sections of the society. No
wonder the Scheme won for Madhya Pradesh the gold award
of Commonwealth Association for Public Administration
and Management at Kuala Lumpur in 1998.
In order to decentralise the health services through Gram
Sabhas, the State has started the Swasthya Jeevan Guarantee
Scheme which aims to post at least one trained Jana Swasthya
Rakshak and one trained Dai in each village by December
2002. The rural health care strategy starts from below, from
the community onwards and combines action and health
care with key determinants such as safe drinking water,
sanitation, nutrition and health education. Madhya Pradesh
will be the first State in the country to provide such a
comprehensive health care in 51,000 villages of the State.
The Jana Swasthya Rakshak will undergo a six-month
training in treatment of common diseases to work on the
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pattern of China's barefoot doctor. After undergoing this
training, these Rakshaks will ensure primary health care, sell
contraceptives and spread the birth control message. By
training one Dai in every village, government hopes to bring
down maternal and infant mortality rates which are higher
in Madhya Pradesh than most of the other states.
The Gram Swaraj, assured in the State, through an
amendment in the Panchayati Raj Act gives lot of powers to
the Gram Sabhas. Under the new law, each Gram Sabha is
supposed to have a village health committee of stockholders.
The Jana Swasthya Rakshak will act as the secretary of this
committee. The new strategy will enable the State
Government to create village level health plans which will
be aggregated as district health action plans, specifying
identified basic services and safe drinking water supply,
sanitation, nutrition, immunisation and provision of trained
dais and doctors.
Under the leadership of Shri Digvijay Singh, Madhya
Pradesh has bagged a number of international awards for
achievements in development. For using information
technology in rural areas for the direct benefit of the common
people, the Gyandoot project of the State was received the
Stockholm Challenge Award in 2000. For breathing a new
life in government run hospitals and health institutions
through people's participation, the State's Rogi Kalyan Samitl
{Patient's Welfare Society) initiative has won Global
Development Network Award.
In recognition of his efforts in conserving water and
soil, Shri Digvijay Singh was invited to participate in the
World Water Forum held at The Hague in March 2000. He
was invited to share his experiences on a panel on poverty
reduction strategies held as a part of Social Summit of the
UN General Assembly in Geneva in July 2000. In recognition
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of his innovative style of governance, he was invited to
participate in the World Economic Forum held in Davos,
Switzerland in January 2001.
Shri Digvijay Singh is among the handful of young
politicians in India who have a vision, political will and the
ability to face the challenges of the new century and to
shape a better future.
I welcome you all once again to this Tata Memorial
Oration by Shri Digvijay Singh.
I would now request Shri Digvijay Singh to address the
audience. Shri Digvijay Singh Ji-
.
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ROLE OF PANCHAYATS IN
POPULATION STABILISATION
POLICIES AND PROGRAMMES
December 4, 2001 at Bombay House, Mumbai
SHRI DIGVIJAY SINGH
Chief Minister of Madhya Pradesh
Dr Bharat Ram Ji, Dr K Srinivasan
Ji, Mrs Avabai Wadia Ji, Dr J J
Bhabha Ji, Ladies and Gentlemen,
I am extremely grateful to the
Population Foundation of India
and Dr Bharat Ram Ji for having
invited me to address and give my
views on "Role of Panchayats in
Population Stabilisation Policies
and Programmes" in one of the
most prestigious lecture series of this country dedicated to
the late Shri JRD Tata - The JRD Tata Memorial Oration.
This is also an opportunity to pay homage to the memory
of a great son of India, Shri JRD Tata. At the dawn of a
new century as we look back to the builders of India of the
Twentieth Century, Shri JRD Tata stands among the tallest
of them. His untiring efforts to build the industrial muscle
of India with which it could take on the world is a story that
inspires every Indian. This Population Foundation of India
is a testimony to his foresight that nation building must
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engage us all and that issues of national importance cannot
be left only to governments. It is gratifying to see that this
Foundation has done outstanding work in sensitizing public
opinion to the cause of population stabilisation.
We have entered a new century of hope. Many persistent
problems appear to us in a new light. We see new
opportunities that have not yet been tapped. The population
challenge is one such persistent problem that needs to be
reconfigured in terms of locating new solutions. It has been
seen as a problem of having too many people. It is time we
move to seeing people as an opportunity for collective
solution-building to the very same problem of population.
What can make this possible in the India of the Twenty-first
century is the increasing vitality of the Panchayati Raj system.
Panchayati Raj has created a new strategic architecture to
move people out of the "problem box" into the "solution
box". Panchayati Raj provides us unprecedented opportunities
to mediate with local communities. The challenge before the
nation is to effectively engage the energies of Panchayati Raj
institutions and the people to popularise and implement
actions that lead to a reduction in our population.
Before I go into the role that Panchayats can play in
population stabilisation, I would like to draw your attention
to the demographic transition that is happening in India,
especially in some of those States that were the "laggered"
States in this front. Madhya Pradesh along with Uttar Pradesh,
Bihar, Rajasthan and Orissa accounted for 45% of the total
population of the country after the 1991 Census. Now that
we have the results of the 200 1 Census, I am happy to share
with you that there are stirrings of change in Madhya Pradesh.
For the first time since the formation of our State, Madhya
Pradesh has recorded a reduction in its rate of growth of
population. While the national growth rate has reduced from
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23.82 to 21.34 during the decades 1981-1991 and 1991-2001,
the population growth in Madhya Pradesh has come down
from 27.24% to 24.34%. While in Bihar and Uttar Pradesh
the growth rates increased and in Rajasthan remained
stagnant, Madhya Pradesh has recorded this reduction in
growth rate. We believe, this happened largely due to the
impact of Panchayati Raj in our State. So to accelerate this
trend, we need to move firmly embed population stabilisation
strategies into the framework of decentralisation, especially
that of Panchayati Raj.
~
Time to move to District-focussed
planning within State-specific strategies
Reconceptualising the population challenge in this
framework of decentralisation can afford opportunities for
providing new impetus to current strategies. I am of the
opinion that it is time we stop thinking of our major
development challenges as "Indian" challenges at the national
level. They are not. They have all become challenges specific
to certain Indian States and locally within each State. If you
take a development challenge like nutrition, Kerala and Tamil
Nadu as well as Punjab and Himachal Pradesh have
substantially addressed this problem. In the area of literacy
and basic education most States in the South, the West and
the East except Orissa have moved to satisfactory levels. In
the area of population stabilisation, we now need to move
beyond even States and focus on "problem Districts" within
the States. We need now to evolve State-specific strategies
and within them District-specific action plans. In Madhya
Pradesh, out of 45 Districts there are 14 Districts that we
need to focus on as these Districts have not exhibited a
declining trend in population growth rate. We feel that we
are better able to do this because of the framework of
decentralisation and Panchayati Raj in our State.
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Population Stabilisation requires multi-sectoral action:
Panchayati Raj opportunity is that of multi-sectoral
action
The experience of all our work on population
stabilisation points out that only a multi-sectoral action plan
will be effective. There have to be action across sectors -
education, poverty reduction, nutrition, community and citizen
empowerment along action within the health sector in areas
like infant mortality reduction and provision of quality
services. The most important advantage population
stabilisation strategies gain will be from this multi-sectoral
mandate of Panchayati Raj institutions: Panchayats can
intervene in education, health, other areas of basic needs.
Most importantly by being able to mobilise community action
around these goals, they dissolve the supply-side and demand-
. side dichotomy that has characterised policies in the past.
Panchayats and Female Literacy: Evidence of Doing It
We have several examples to prove that by sharing the
tasks with Panchayati Raj institutions, development goals
become achievable. Dr Bharat Ram in his speech has
enumerated the achievements that we have made through
the decentralisation process. In Madhya Pradesh we created
a partnership with Panchayats to meet the challenge of
universal primary education through our Education Guarantee
Scheme. Here the Panchayats mobilised community demand,
identified a qualified local resident to be the Guruji and
provided the space to run the school. The Government
supported this with a grant to the community to run their
school, trained the Guruji and ensured all academic inputs.
Within 18 months of starting the Education Guarantee
Scheme on January 1,1997, we were able to provide a school
to every habitation in the State within one-km radius. A
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major development goal was accomplished in a simple manner
as 26,000 EGS Schools came up through Panchayat
partnership. The local residence of the Guruji saves the
school from the bane of teacher absenteeism. Panchayat
supervision creates accountability and our evidence is that
the academic attainments of children are better.
In the area of adult literacy, Madhya Pradesh attempted
a new strategy called the Padhna Badhna Andolan. Under
this, non-literate people could come together as a group and
choose any educated person in the community to make them
literate. Government gavethe learning material and conducted
the examination. The government also supported the scheme
by providing for a Gurudakshina at the rate of Rs 100 per
person made literate based on a State-wide examination.
Through a year-long campaign in the year 2000, we were
able to make 3 million people literate. Our strategy was
vindicated when the Census 2001 confirmed that Madhya
Pradesh registered an unprecedented increase of 20% in
literacy - from 44% to 64% - to catch up with national
average. Female literacy registered an increase of 23% - a
rate higher than that of the three preceding decades put
together, winning for us the country's Decadal Achievement
Award in female literacy.
I have cited these two examples only to show that an
overarching framework of decentralisation through Panchayati
Raj in our State made these possible. Our challenge of female
literacy continues and we intend to amplify our effort through
Panchayati Raj institutions.
Panchayat action on determinants of health: Swasthya
Jeevan Sewa Guarantee Yojana
Along with female literacy, the other major determining
factor in population stabilisation is infant mortality. Here
again we are attempting a new decentralised model of action
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in Madhya Pradesh. Learning from the Education Guarantee
Scheme, we have initiated something similar - a Health
Services Guarantee Scheme or a Swasthya Jeevan Sewa
Guarantee Yojana.
The objective is to develop an action programme that
addresses issues of health along with the determinants of
health like safe water supply, sanitation, nutrition and hygiene
education. These services would be provided within defined
time frames so that a rights-based approach to basic health
can evolve.
A community health activist in the form of a barefoot
doctor or what we call a Jan Swastya Rakshak will be trained
in each village. We intend to provide such a service in all our
51000 villages by December 2002. Similarly, all traditional
birth attendants (dai) will be trained so that maternal mortality
and infant mortality can be reduced. Along with improved
reproductive health related services, we hope such a
decentralised health action plan can considerably improve
rural health care delivery.
Panchayats can move ineffective vertical programmes
to effective horizontal programmes
Panchayati Raj institutions provide an opportunity to
move towards decentralised health care because they can
effect horizontal cuts in the highly vertical programmes that
we implement in the area of health. Most of these are disease
management programmes initiated by the Central
Government or donor agencies. These have resulted in
"comprehensive" health care being displaced by "selective"
health care. Through Panchayati Raj, we can reclaim a
comprehensive health care model that can lead to population
stabilisation. It offers the opportunity to create local-level
problem definition, develop plans based on local level
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priorities and implement and monitor programmes more
effectively.We have done in Madhya Pradesh a comprehensive
mapping of the health related indicators at the village level
and captured them in a Village Health Register to lead to a
Village Health Plan. These are then aggregated to create a
District Health Plan. We have shifted the focus of planning
to the Districts and at this level comprehensive planning can
be done for the health sector. Panchayati Raj Institutions
enable such decentralised planning on health and the
determinants of health, the absence of which, has been the
weakness in our population stabilisation policies so far. Simply
~
put, population stabilisaition policies have much greater
chances of success working through the intersectoral space
provided by Panchayati Raj institutions.
Panchayats can cataZyse community action
We have in Madhya Pradesh a very positive experience
of Panchayati Raj providing the facilitating environment for
direct action by the community. There are several such
examples, some of which I discussed in connection with the
education efforts in our State. Similar examples exist in the
natural resources management sector where we have had
unexpected success in mobilising communities for water
conservation and forest conservation. In the health sector,
the context of decentralisation through Panchayati Raj and
the culture of direct community action has also led to our
scheme for community management of our hospitals. We
now have Rogi Kalyan Samitis (patient Welfare Organizations)
managing our hospitals. They levy user fees (which exempt
the poor) and generate local resources that are deployed in
improving health care facilities. This public participation in
management and resource mobilisation can, in a certain sense,
be seen as a result of investment by the government in the
policy of decentralisation.
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Panchayats can create a frontline leadership
of women to act on population control
Women are not to be seen as the object of population
policies but as active agents of change. Panchayati Raj gives
the opportunity to organise a frontline team of women under
elected women representatives of Panchayats together with
grassroots functionaries like Anganwadi workers, village-level
teachers, health workers, traditional birth attendants and
women volunteers. The campaign against population growth
cannot be a campaign in the cities about what is happening
in the countryside. Panchayati Raj provides the opportunity
to mount this campaign led by women Panchayat leaders in
the villages.
Panchayats can mobilise religious and social
leadership to aid in population reduction campaigns
Some countries have effectively mobilised religious
leadership in campaigns to educate the people and promote
attitudes favouring small family and reduce population
growth. Panchayats can become effective mobilisers of social
and religious leadership of different denominations to lead
the campaign for population stabilisation, as religious dogma
is often cited as a deterrent in spreading the message of
population stabilisation.
Institutional change through Panchayati Raj
'in itself impacts positively on population reduction
There is now cross-country evidence to prove that
institutional change has a major impact on population
stabilisation. This happens because institutional change alters
the context in which reproductive health related decisions
get made. Panchayati Raj institutions lead to the
empowerment of women. Rajiv Gandhi's initiative to
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introduce the provision of one-third reservation for women
in Panchayati Raj institutions ushered in a silent revolution
in terms of women breaking out from the private space to
the public space. As women take greater control over their
environment, they also take greater control ov~r decisions
that affect their daily lives. This area needs to be mapped by
researchers and the very positive impact Panchayati Raj has
had in population stabilisation empirically established.
To conclude, in India we are now moving to a position
of seeing people as a strategic resource. Institutions like
Panchayats provide the opportunity to involve people at the
grassroots level for meeting national challenges. The national
challenge of population stabilisation needs to become a battle
that is waged at the grassroots level through Panchayats. For
this it is important to move from an understanding of
Panchayats as mere agents of the State or as the lowest tier
of a Government system to institutions of social change
which State and Central Governments cannot become. Many
of our current health programmes prescribe a "mobilisation"
role for Panchayats. They are meant to organise the demand
side to respond to Government programmes. The
responsibility of Panchayats in such a vision is that of a
"contractor" for social mobilisation. This is the wrong way
of relating to Panchayats. They are units of local government
who have been empowered to intervene in areas that can
affect population stabilisation - be it health, education,
nutrition, safe water supply, sanitation or poverty reduction.
They have to be conceived as co-planners, in fact as key
planners if population policies seek to benefit from the
energies and the resources that Panchayats can catalyse. Health
and population planners at the State and Central level must
make this shift in their mindset. Panchayats when genuinely
empowered can deepen our campaign for population
reduction. They will then initiate and lead the multi-sectoral
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action at the grassroots level that is a population planner's
dream. Our population challenge is a matter of people. We
must now make it matter to the people through Panchayats.
Thank you.
.
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Questions and Answers
Q. If power has to go to the grass roots, how has your
government brought about an attitudinal change in
your own bureaucracy to be able to achieve this?
A There are some black sheep in the bureaucratic and
political level. Once the political message goes through
firmly from the top, the bureaucracy falls in line. I have
had no problems so far as Madhya Pradesh is concerned
when we devolved power to the grassroots. Whenever
power is transferred, there is bound to be dissatisfaction.
Earlier, in the absence of elected bodies, most of the
administrative functions were being controlled by the
leaders and members of Parliament. The bureaucracy in
the absence of local bodies was handling all the schemes
and programmes. After the 73rdand 74thAmendments,
once the local bodies were empowered, there was some
bickering but by and large everybody fell in line.
Q. The moment women are empowered there is more
violence against them, like Sathins in Rajasthan.
How do you provide social security to the women at
the grassroots so that empowered women can do
their work under protection?
A There was bound to be some reaction when the socially
deprived and exploited class of women were empowered.
This also extends to the Dalit section. When reservations
were made for women and Dalits, people who had been
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continuously' elected suddenly found that their clout did
not work any longer because the seats were now reserved
for women, scheduled castes and scheduled tribes. This
created heart-burn to the extent that a Dalit Sarpanch in
Tikamgarh was not allowed to unfurl the national flag
on the 26thJanuary. We ensured that on the 15thAugust
she unfurled the national flag at the District headquarters
to give a firm message that this would not be tolerated.
Action was taken against all those who had prevented
her. This also built up her own image. The message in
Madhya Pradesh is that strong action will be taken against
those who exploit the Dalits and the women.
Q. How is your government protecting or preventing
the Panchayats from getting into corruption?
A As far as corruption is concerned, transparency in the
system and accountability, if brought forward in the
system, do by themselves reduce corruption. We have
made it mandatory in the Gram Sabhas that every penny
that goes to the Gram Panchayats will be deposited in
the Gram Kosh and the Gram Kosh will be operated by
the Gram Panchayat Sarpanch and the Treasurer of that
village Gram Sabha. Both will sign the cheque and only
then can money be withdrawn. Every Panchayat will
have to give details to the Gram Sabha as to what they
have done with the money.
Right to information is another area which helps in
controlling corruption. In this aspect we enacted a law
in 1996 in Madhya Pradesh which did not get the
Government of India's consent. Therefore through
administrative action we have made provision for any
citizen of the State to ask for any document through
the right to information. These are the two things that
can control corruption.
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Q. As people feel the acute need for water supply and
roads, health becomes a low priority and therefore
population stabilisation or family welfare related
issues eventually become the responsibility of
government officials rather than that of the
community.
A All the Panchayats now want to pay more attention to
infrastructure. This is where the money is. This is where
they can siphon off funds. That is why the social sector
- education and health - gets a back seat. 1 feel if you
institutionalize and empower the Gram Sabhas and give
them the legal authority at that level, it does make a
difference. For example, the legal authority to stop
payment of absentee teachers by the local community
has resulted in controlling the teacher absenteeism. What
is important is to see that the power now reaches the
grassroots. Even in the Panchayati Raj system, the
institution of Gram Panchayats and Sarpanch became
very strong and if the Sarpanch was good, the
performance was good. If he was bad, the performance
was bad. We have now transferred the power of Sarpanch
to the Gram Sabha by constituting different committees
for different sections. This will make the people more
aware of their rights and duties and shift the focus from
infrastructure to the social sector.
Q. How are you going to ensure that the community
health workers will not result into quacks? What
precautionary steps are you proposing that ultimately
it does not go out of hand?
A In Madhya Pradesh, we have involved the UNICEF and
our Health Department in evolving a course of integrated
medical system. We have also distributed the
grandmother's recipes for diseases as one of the books
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in the curriculum. They have to undergo a very rigorous
test after six months. The success rate has been 55% to
60%. They have been fairly active. We have also allowed
them to have a depot of a few drugs so that they can
keep the medicines available. In the absence of
decentralised health system or institutional health system'
in the villages the quacks are already there. The choice
now is to have a trained quack or an untrained quack.
It is better to have a trained quack than an untrained
one.
Q. What is the role that you have so far been able to
garner or you envisage for the partnership between
the business and civil society?
A. Two examples: Rogi Kalyan Samiti in Hospitals is an
example where we have a State - private partnership.
The donors are opted in the Rogi Kalyan Samiti and the
total management of each hospital, even primary health
centre hospital, civil hospital or medical college hospital
has been transferred to a registered body of which a
public representative is the Chairman. The Collector and
others are members of the Governing Board and the
Executive Committee. All donors are members of that
committee. In a Taluka level hospital, anybody donating
Rs 25,000 becomes a life member of the Samiti. Anyone
donating Rs two lakhs to a medical college becomes a
permanent member of the Governing Board. That is
how we have tried to involve the community in the Rogi
Kalyan Samiti.
We have offered space in the existing government
hospitals to private people to set up their machines like
CAT scan and MRI etc. Our experience has been that
there is a nexus between the technicians and the private
people. The government machines are usually not
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working, either their parts are missing or they do not
have the film ete. The private facilities just outside the
hospitals are doing roaring business and the technicians
get a cut. We have offered space to private people to set
up these machines at their cost with their technicians.
The bidding is on the basis of lowest figures on services
to be rendered. We have already set up these centres in
a number of hospitals. The cost for MRI or CAT scan
is almost 30 to 40% of what the person is paying in the
market. We have also an in-built scheme as an incentive
to technicians in government hospitals. What the
technician was getting from the private people outside
the hospital, he is getting the same incentive from the
money that we are collecting through the Rogi Kalyan
Samiti.
In the computer literacy programme, from class nine
upwards we have offered space in government schools
and government colleges for private people to set up
their computers through competitive bidding. The rates
are almost 25 to 30% of what is prevalent in the open
market. This is how we have been able to have State-
private partnership in the fields of health and education.
We have also done similar partnerships in Public Works
Department (PWD) and agriculture extension. We have
asked fertilizer and pesticide companies who have interest
in the growth and productivity, to take up agriculture
extension in different blocks and different districts in
Madhya Pradesh.
As far as NGOs are concerned, I have my own opinion.
They have mushroomed all over the country and it is
difficult to differentiate between the real and the unreal.
We do encourage NGO participation in education and
health sectors as demonstration projects.
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Q. Madhya Pradesh has done well in adult literacy. How
will those becoming literate through this programme
continue the process?
A. As far as continuing education is concerned, we have a
programme where the Padhna Badhna Samitis have a
continuing education in-built in the system. The adult
literacy programme as given by the Government of India
was too officer-centric. We had supervisors and
inspectors. We were spending more money on the
supervisors and inspectors rather than the people who
were actually teaching. It was not very successful.
We remodeled the whole thing and Government of India
has accepted more or less our model of adult literacy
programme where the illiterates create a self help group
and the groups appoint their own Guruji. For example,
, we have a programme called the - Gram Sampark
Abhiyan, where one week in a year the government goes
to every village and monitors the programmes and the
implementation. It was distovered that in a remote tribal
village in Mandala which do not have any school in the
vicinity of 15 km radius, we found a class 7 educated
girl who had made 17 women literate. We called all of
them. The Chief Secretary and my Secretary were with
me. We made these women write their names and read
newspapers. Each one of them did exceedingly well.
These Gurujis have now become initiators of the self-
help groups.
.
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"Achievement of demographic .objectives is
entirely dependent on a whole set of
societal responses and policy initiatives
which go well beyond contraception"
- JRD Tata
~!f~'~
POPULATION FOUNDATION OF INDIA
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