Launched in January 2018, the Aspirational Districts Programme (ADP) of the government of India aims to uplift and transform the districts that have shown relatively lesser progress in achieving key social outcomes.

Encouraging the spirit of competitive and cooperative federalism, the programme ranks the selected 115 districts on the basis of a composite index of 49 key performance indicators.

The indicators comprise key sectors such as health & nutrition, education, agriculture & water resources, financial inclusion & skill development, and basic infrastructure.

Dhenkanal is one of 10 aspirational districts of Odisha. Constituted of two ex-princely states of Dhenkanal and Hindol, the district is home to around 12 lakh people (Census 2011) and is two hours away, by road, from the bustling capital city, Bhubaneswar.

As far as the ADP ranking is concerned, Dhenkanal has tremendously improved its rank from 91st position in September 2018 to 24th position in September 2019 as seen in the ADP dashboard.

However, at the same time, Dhenkanal is still grappling with the problem of low child sex ratio in different pockets of the district and low percentage of pregnant women receiving four or more of the antenatal care (ANC) components as well as being tested for haemoglobin four or more times.

During my field visits and while interacting with the district officials, I noticed that many programmes/initiatives of the district had the word ‘Kalpana’ (‘imagination/creativity’ in Hindi) in its name.

On voicing out this observation, I was told that these programmes were named after Kalpana Dash, the first Odia mountaineer to scale Mount Everest, who was from Dhenkanal.

She passed away in May 2019 while descending Mount Everest after having scaled it once again.

One such initiative named after her is the ‘Kalpana programme’ which aims to identify high-risk pregnant women and give them adequate care, improve the sex ratio, identify severe acute malnourished children, etc.

It was found that pregnant women at some blocks were skipping radiology tests due to the issue of distance, accessibility, etc.

Hence, steps were taken by the district administration to ensure mandatory Ultrasound Sonography (USG) testing of all pregnant women by scheduling mass USG test dates across the sub-district hospitals under the Kalpana programme.

By bringing all pregnant women together at the hospitals, it was also envisaged that this would encourage more discussions regarding their lifestyle, food habits and they could also learn from one another’s experiences as well.

The Kalpana programme has also been instrumental in improving the sex ratio from 852 in March 2018 to 972 in August 2019 as per the ADP dashboard.

This can be seen as a result of mass community awareness programmes across Dhenkanal advocating the message of ‘gender equality’ in order to change the predominant societal mindset of preference for a male child.

Established in the district headquarters hospital, Dhenkanal, in January 2019, the ‘Kalpana Poshan Kendra’ also derives its name from Kalpana Dash and is based on the concept of establishing nutritional rehabilitation centres run under the umbrella programme of the National Health Mission.

It is an initiative to reduce under-five mortality rate due to Severe Acute Malnutrition (SAM) and provide physical and psychological growth of children recovering from SAM.

The Kalpana Poshan Kendra helps in recovering the lost weight of the children through intensive feeding of therapeutic food (rich in micronutrients) supplementation.

Capacity building of primary caregivers in preparing home-made nutritious food from locally available ingredients and counselling of mothers on family planning, etc., also take place here.

This initiative has certainly contributed to considerably reducing the percentage of underweight children under the age of 6 years in the district from 6.89 per cent in March 2018 to 0.52 per cent in August 2019, as per the ADP dashboard.

However, there are some serious challenges that Dhenkanal must tackle on its road to improvement, such as that of inadequate medical personnel in the district like paediatric specialists, anaesthetists, etc.

Steps must be taken to strengthen primary health care in the district and quality training must be provided to community healthcare workers to improve access to front line health care.

The lack of adequate health infrastructure in the district as per the population also needs to be addressed. Presently, there are 167 health sub-centres in Dhenkanal, out of which 42 are without even a building.

Basic life-saving equipment and medicines need to be available in all health facilities to help take timely action in order to save a patient’s life.

The programmes initiated by the district administration of Dhenkanal are positive steps to reduce maternal and infant deaths, improve the sex ratio and reduce malnutrition among the children.

At the same time, I feel that the district is promoting a much larger message of behavioural change, gender equality, women empowerment and the importance of a healthy balanced life through these initiatives.

These messages will motivate and inspire many more ‘Kalpanas’ from Dhenkanal to thrive and believe that every mountain top is within their reach.

Manshi Singh

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