March 17, 2008	Monday	Rabi-ul-Awwal 8, 1429

KARACHI, March 16: With the financial year entering into the last quarter, healthcare observers have yet to see any visible progress in the urban health centres project conceptualised as filter clinics for secondary and tertiary hospitals by the federal government in June last year.

Under the project, financed by the federal government, 900 health centres were supposed to be set up at union council level in Karachi and six other districts of the country, including Islamabad, Lahore, Faisalabad, Peshawar, Quetta and Rawalpindi.

In Karachi, the promised clinics were supposed to be set up in 178 union councils and made functional during the first quarter of this fiscal year. However, nine months have passed without any visible progress toward the setting up of healthcare facilities.

At the launching of the programme in June last at Islamabad, nazims and senior health officials of various districts were told that the proposed healthcare centres would ultimately reduce the primary care patients’ load on secondary and tertiary hospitals.

Under the president’s initiative for urban primary health care system, the federal government was supposed to bear the expenses of these health facilities for three years after which their operational expenses were to be transferred to the respective district governments.

Each health centre was to function as out-patient centre with a referral facility having a medical doctor, a nurse or a dispenser, a lady health visitor and a sweeper-cum-guard. All the posts were to be filled on a contract basis after inviting applications from qualified candidates through advertisements in national dailies.

“Though we were told that health ministry wanted to make the clinics functional at the earliest, the measures taken so far negate any such claim,” said an official.

Sources said that mapping of sites, allocation of premises for the urban clinics, appointment of staff and provision of relevant facilities were yet to be undertaken. Till date neither any substantial correspondence has been made to select and hire buildings for clinics nor have funds been released to the district governments for this purpose.

Unless the government selects buildings and signs rental agreements with their owners it is very difficult to map out the proposed clinics, an official said, adding that the relevant correspondence had created doubts that the project had been virtually put on the back burner.

It has been learnt that the government will allocate Rs40,000 to Rs50,000 a month for the rent of clinics and the payment of salaries to the staff.

Sources in the city government health department said that authorities were considering the Rs10,000 allocation a month for medicines as a meagre amount that might prove fruitless. Officials suggested that instead of separating the allocations meant for premises rent and medicines, the federal government should earmark a lump sum amount under a joint head so that the amount save from the rent could be used for the procurement of medicines.

Interestingly, the Sindh government has recommended to the federal government the name of an official for his appointment as focal person of Sindh health department on the subject though the clinics are supposed to be selected, run and supervised by district governments. The appointment of a focal person against a handsome salary is being considered as an additional financial burden on the project.

Observers say that the government should not go for hiring all clinic places from the private sector but try to utilise the unattended health facility structures at its disposal first which can help save public exchequers and time as well.