October 25, 2008	Saturday	Shawwal 25, 1429

THATTA, Oct 24: Lack of coordination, supervision and implementation have so far kept the benefits of the People’s Primary Healthcare Initiative (PPHI) from trickling down to masses and managed to bring little visible improvements in the health sector of the district.

The system is being supervised by a district support manager who uses help of two assistants but none of them is a technical person in healthcare delivery system.

The PPHI has hired one female medical officer for five Basic Health Units (BHUs), one male medical officer for two BHUs, one woman medical officer (WMO) for only one day at a BHU in a week and lady health visitors at a meagre amount of Rs6,500 per month. The female doctors have on travel 50 to 150 kilometres in private taxis to reach their places of work in remote areas, which are far off the route of public transport.

Many WMOs who had been selected had later refused to join after learning that there was no facility for transport. The seats vacated by them were then filled by those who were on the waiting list. The male medical officers have been assigned two BHUs each to work on alternate days.

All the appointments have been made purely on contract basis and wages offered are considerably low. The appointees have to arrange their own conveyance to reach the BHUs in far-off places without getting any travelling allowance or conveyance charges.The district health department has not formally handed over government assets, furniture, fixture, instruments and equipment available at the BHUs to the PPHI staff.

The PPHI is a three-year program and that too can be cancelled at any moment if desired by the district government concerned. On the one hand it has relieved the district health authorities of the responsibility for looking after the BHUs while on the other non-technical persons at the PPHI lack ability to sense gravity of problems faced by the staff, particularly females.

There are reports from different centres that syrups have been provided in pound bags, a practice which has been banned since 2002, while quality of medicines have improved under the PPHI.

The PPHI has brought about some improvements in the system. It has fully taken over supply mechanism of logistics and drugs required at the BHUs.

Not only they supply drugs on monthly basis but they are supplying them with more frequency during the month in case of need.

The PPHI plans to provide V-wireless sets to each BHU to ensure round the clock communication, and glucometer to each WMO for conducting free blood glucose estimation of patients.

A source in the provincial health department said on request of anonymity that although a huge budget had been released to run the PPHI system a majority of EDOs of health had suggested in their reports abolition of the program on grounds that it had obstructed the district health programmes of preventions as well as quality control of medicines.

The district has 84 health facilities and the PPHI has been given Rs45 million to run 50 BHUs of the district to cater to the needs of 1.4 million people of the district.

In another development, provincial minister for cooperatives Abdul Jalil Memon recommended addressing genuine problems being faced by the WMOs when he was approached by the Thatta DCO Laeeq Memon.

The DCO convened a meeting with the district support officer and the newly-appointed WMOs and recommended some changes in the BHUs but the PPHI did not follow it.