08 March 2005	Tuesday	26 Muharram 1426

KARACHI, March 7: The Sindh government on Monday announced the first-ever provincial health policy that envisages 10 to 15 per cent reduction in seats at medical colleges , appointments of medico-legal officers on contract basis, and implementation on community-oriented medical education programme throughout the province.

The health policy was announced by Sindh Chief Minister's Adviser Faisal Malik while addressing a press conference here at Sindh Secretariat. Secretary Health Prof Naushad Sheikh, Additional Secretary Health Dr Shafqat Abbasi and Director-General Health Dr Hadi Bukhsh Jatoi were also present.

Establishment of a Public Health Academy; launching of a separate ambulance service to cope with natural calamities and emergencies; postings of Additional Police Surgeon and MLOs at district headquarters, taluka hospitals and rural health centres are some of the important aspects of the health policy.

Giving details of the policy, Adviser Health Faisal Malik said that Pakistan had been making efforts over the last two decades to bring the curriculum of its 57-year-old system of medical education more in line with the modern requirements of local medical system and the community needs.

He said that the Community-oriented Medical Education (COME) methodology, proposed by the World Health Organization, embodied a dynamic system exposing medical students to the national health problems with an emphasis on acquiring skills and relevant theory in an integrated manner.

As the first step, the project was being initiated in the Dow University of Health Science and later would be applied to other medical institutions in the province as well, he said, adding that the COME is a highly cost-effective programme.

Faisal Malik said that efforts would be initiated to reduce the number of medical seats gradually with a concomitant increase in the quality of education imparted in streamlining the process of continuing medical education (CME) so that medical graduates could keep themselves abreast of the latest developments in all disciplines of medicine and public health.

He said that every medical college would be required to adopt one district or taluka hospital or rural health centre in addition to the teaching hospital, affiliated to it. This would entail mandatory visits by faculty members and medical students to spend more time in rural settings, while helping to provide specialist services to the ailing population, he maintained.

He said that a compulsory rural service bond strategy would be introduced for new medical graduates, selected to fill up vacancies in rural areas. Referring to the Public Health Academy, he said that it would offer training to EDOs and doctors on other managerial posts.

He explained that district health managers would undergo compulsory in-service training at the academy, as EDOs were being criticized for lacking essential public health qualification and management skills.

Moreover, he said that effective linkages would be developed among the human resource development unit of the health department, the provincial health development centres, district health management centres and medical universities with a view to train district managers (EDOs and others) in public health disciplines.

The health adviser said that medical officers and health workers at district and taluka hospitals would be given hands-on training in anaesthesia and gynaecology/obstetrics to address the acute shortage of trained staff in various areas. Efforts would also be made to provide dialysis facilities at district headquarters hospitals, he added.

MEDICO-LEGAL SYSTEM: The provincial assembly would soon be adopting a law to bring about necessary improvement in the medico-legal system. Under the arrangement, a new cadre of MLOs would be introduced who would ensure implementation of the required modifications.

In addition, he said that medico-legal directorates would be established in Karachi, Hyderabad, Nawabshah, Sukkur, and Larkana respectively. Police Surgeon, Additional Police Surgeon and MLOs were said to be appointed at each of these medico-legal directorates.

There would be provision for additional police surgeon and MLOs at district headquarter hospitals, taluka hospitals and rural health centres, he said. It was further stated that MLOs would be appointed on contract basis for which the qualification would preferable by MPhil.

The adviser said that forensic science laboratories would be established at Police Surgeon offices in Karachi, Hyderabad, Nawabshah, Larkana and Sukkur, while pathology and forensic medicine departments at medical colleges would be utilized as forensic science laboratories. Standardized mortuaries would be established at all medico-legal centres equipped with digital cameras, portable x-ray and paraphernalia, he added.

SERVICE STRUCTURE: The health department will prepare service structure of major groups of health professionals who are awaiting career structure since long. These included doctors of general and specialist cadre, public health researchers, dentists, nurses and paramedics, medical laboratory technologists and technicians, pharmacists, physiotherapists and occupational therapists.

At present, more than 14,000 doctors; 2,000 nurses; 12,000 paramedics; 17,704 lady health workers and 705 lady health workers supervisors are serving in the provincial health department.

Under the health policy, the readjustment of posts from BPS-17 to BPS-20 would be made at provincial and district level for better and effective administrative health services.

All vacancies of WMOs, nurses, LHVs will be filled on priority basis. Promotion cases of BPS-17 to 20 will be expedited. Award and reward to good workers and punishment to delinquent, especially to absentees would be followed.

SPECIAL PACKAGE: As per approved decision of the Sindh cabinet, a special package for medical specialists serving in rural areas would also be materialized. Complimenting the same would be non-practicing allowance worth Rs1,000 to Rs4,000 for doctors and paramedics serving at rural health units.

USER CHARGES: Adviser Health Faisal Malik further said that the health department would apply "User Charges", where necessary in the teaching hospitals for sophisticated investigations.

He made it clear that care would be taken to ensure that the imposition of these charges might not in anyway hinder the access of poor patients to general health services with sufficient provision for destitute and marginalized segments of the population. The amount so generated would be reverted back to the health sector, he added.

The policy has been prepared by Dr Shafqat Hussain Abbasi, Dr G.N. Kazi and Dr M. Jamil Mughal, while Dr Kamil Rajpar, Dr Sajan Memon, Dr Nooruddin Qureshi, Dr Fateh M. Khan, Dr Shershah Syed and Dr Abdul Majid have also contributed to its preparation. -PPI