A ray of hope: NRHM model for BOHS in India

Introduction
Health care for rural areas is a formidable challenge in India. Lack of infrastructure, funds, awareness, stakeholder apathy; all contribute to problems in delivery of primary health care. The situation has uncanny resemblance with state of BOHS in unorganized sector in the country and elsewhere. Just as effective primary health care delivery can bring in a sea change in quality of life; adequate BOHS in unorganized sector has potential to benefit workers as well as the economy in general. NRHM in India is a success story as far as primary health care goes. The approach basically was a shift from state controlled to state sponsored movement with full community involvement. This study aims at drawing parallel between PHC & BOHS and explores possibility of adopting similar model for BOHS.

Methods
Genesis and implementation of National Rural Health Mission (NRHM), was studied in details. Approach adopted, road maps, course corrections & results achieved were captured from various articles, presentations and publications.

Results
It was found that health situation in rural India had lot of similarities with occupational health status in unorganized sector. Remote areas, inadequate infrastructure, stakeholder apathy, lack of awareness and resource crunch were common to both.
As can be seen from facts and figures quoted in the study; with involvement of communities and support rather than active government intervention, NRHM slowly but surely changed the health care scenario in rural India.

Discussion
With stakeholder involvement as the approach, NRHM has made a significant impact on rural healthcare. It is possible to employ a similar model for BOHS in unorganized sector. Creating a cadre of grass-root workers who are familiar with occupational health issues (just like ASHA in NRHM), can go a long way in improving occupational health for unorganized sectors. With state support, this model can bring about transformation in OH status.