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As a result of the
influx of refugees from Bangladesh, there was considerable strain on the
health infrastructure of Kolkata and its surroundings. The KMDA was called
upon to augment the health resources of the State Government.
The Kolkata Urban Development Programme - III (CUDP-III) adopted a strategy
to provide health delivery services at the door steps of the beneficiaries
through a cadre of community based Honorary Health Workers (HHWs).
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The objectives of the CUDP-III health programme included:
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Provision of preventive measures
to cover a target population of about 2 million slum-dwellers throughout
KMA
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Use of local HHWs working at the
slum level to promote hygiene
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Maximum cost efficiency by
utilizing the existing resources
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Community participation by
engaging local people in planning, implementation and monitoring of the
health programmes, etc.
The project aimed at establishment of
more Health Administrative Units (HAU), outpatient clinics, procurement of
ambulances, etc.
Kolkata
Urban Development Programme - III (CUDP-III) & Its Health
Parameters
It
was realized during implementation of the Kolkata Urban Development
Programme - II, that the urban poor had little access to the
available health facilities. Slum-dwellers were vulnerable to
various ailments owing to neglect of personal hygiene. A sample
survey, conducted in 1983 to assess the knowledge, attitude and
behaviour of the beneficiaries towards health infrastructure created
under CUDP - II, indicated that the project failed to obtain proper
community response due to inadequate domicilliary contacts.
The CUDP-III adopted a slightly modified strategy to provide health
delivery services at the doorsteps of the beneficiaries through a
cadre of community based Honorary Health Workers (HHWs). The
objectives of the CUDP-III health programme included :
-
Expansion of the
preventive oriented activities developed so far to cover a
target population of about 2 million slum-dwellers throughout
Kolkata Metropolitan Area;
-
Use of local, part-time
Honorary Health Workers (HHWs) working at the slum level to
promote and teach proper health hygiene techniques;
-
Maximum cost efficiency by
utilizing the existing resources, e.g., buildings, equipment and
personnel;
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Community participation by
utilizing the local people in planning, implementation and
monitoring of the health programme through establishment of
popular committees at each level of health care system.
This project envisaged
establishment of one Health Administrative Unit (HAU) for 6 to 8
sub-centres, each of which would cater to 5000 beneficiaries. Each
sub-centre shall have 5 HHWs, with each having to cover 1000
beneficiaries or 200 families. One HHW will represent one block.
While the preventive health care and other related services shall be
administered through the network of HAU- Sub-Centre-Block, curative
health care shall be administered through Extended Specialized Out
Patient Department (ESOPD) at different locations. ESOPDs will refer
the complicated cases to hospitals. The project also provides for
establishing creche, procurement of ambulances, etc. Until March
1998, about 16 lakh beneficiaries have been covered, involving a
total investment of Rs 1610 lakh. The project, however, is now being
implemented as a spillover of CUDP-III health programme that had
officially closed in March 1992.
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