This document presents the key results of a recent research on the health care system of the Indian Sundarbans conducted by Institute of Health Management Research (IIHMR) in West Bengal, India based on a research grant awarded by the Department for International Development (DFID), United Kingdom to an International Research Programme Consortium (RPC) in which IIHMR is a partner. The consortium, titled as Future Health Systems: Innovations for Equity (FHS), will carry out innovative research programmes in six countries. The three basic themes of FHS can be summarized as follows:
- How can the poor be protected from the impoverishing impact of health-related shocks?
- What innovations with public and private health sector can work for the poor?
- How can policy and research processes be used to meet the needs of the poor?
IIHMR has identified West Bengal as the major focus state for implementing the research programme in India. More specifically, it proposes to explore the potential of the strategy of decentralization of health care services, as manifested in a series of initiatives recently being spearheaded by the Department of Health and Family Welfare (DoHFW) in the state to improve the effectiveness of the health system, in protecting interests of poor people.
The present document is based on a series of studies carried out during the earlier part of the year 2009 in the Indian part of the Sundarbans – a cluster of islands with extreme geo-climatic challenges and spread over 19 blocks in West Bengal. The principal driving force behind the initiative was the keen interest of the government as well as of a few local non-government agencies to curve out a special plan to improve the health care delivery system of the area. All stakeholders concur alike that the area, due to its extreme geographical barriers and abject poverty, requires a long-term innovative plan to provide basic health care services to its people.
Evidently, the routine services provided by the existing health care structures are not adequate to reach every corner of the islands with an affordable solution to people’s health problems. The unique location of the Sundarbans in the geographical and human development map of the state makes it imperative that there is a separate health plan that would be aligned to the overall master development plan of the area.
This document is expected to serve two purposes: (1) based on recent evidences it attempts to highlight the need for a special attention to the Sundarbans’ health service delivery system, and (2) it presents a broad framework of a health plan especially targeted to improve the system and make it work more for the poor and vulnerable groups of population in the islands. Given that fact that the Sundarbans represent a typical fragile and hard-to-reach pocket within a state, the initiative may also be considered as a learning platform for other similar fragile states in India and in other developing countries.
We hope that the findings and the planning framework presented in this document will be discussed and used by the Department of Health & FW, Government of West Bengal and other key stakeholders to finally draw a detailed master health plan for the Sundarbans.