PESHAWAR: The Khyber Pakhtunkhwa government has allowed Sarhad Rural Support Programme to continue People Primary Healthcare Initiative programme and manage basic health units in 17 districts of the province for next 18 month.

The move has also poured cold water on the health department’s earlier directive in May, asking the district health officers (DHOs) to take over charge of basic health units (BHUs) from SRSP by June 30, 2016.

Health Minister Sharam Tarakai told Dawn that SRSP agreed to continue to manage 572 BHUs in 17 districts till June 2018 because the government system was weak. “Disengagement of SRSP will create healthcare problems,” he admitted.

The minister said that SRSP had been given three-year extension in 2015 but it refused to continue the project after December 2015 and wrote letters to health department, seeking disassociation from the health department.

Minister admits weakness of govt system to run health facilities effectively

“In this regard, there will be no notification from health department but SRSP will withdraw letters in which it has conveyed about disengagement from the government,” he said.

The minister said that government’s system was very slow due to which they faced a lot of issues regarding hiring of staff, purchase of drugs and equipment and repair and civil work while the partner organisations were able to make fast-tracked decisions and make thing happen in days instead of months if done under government’s rules.

He said that in five districts, the BHUs were managed by government where situation was unsatisfactory.

Sources said that disappointed at the response of SRSP, health department alerted district health officers (DHOs) to take over the BHUs in their respective districts. The DHOs expressed readiness to take back control of BHUs because they weren’t happy over the contract with SRSP, which managed all staff in the BHUs where it worked, they added.

The SRSP started work in few BHUs in 2002 and ultimately got control of most of the health units of the province which irked the DHOs, who despite top officers in the district had no powers in health units where PPHI was in practice. “All these BHUs have been outsourced to SRSP through memorandum of understanding,” sources said.

They said that the PTI government had claimed that it would contract out the BHUs through transparent manner and in line with Public Private Partnership Act, 2012. The health department had also advertised the outsourcing programme for which over 50 NGOs had applied, they said.

“The government also held meeting with SRSP wherein the former pledged to resolve all problems pointed out by the latter and in future there would be more flexibility in the contract,” said sources.

They said that under the PPHI project, SRSP received all funds and spent the same on the BHUs. There was no audit of the amount given to SRSP because the governments from time to time escaped its responsibility to strengthen health system at the district level, they added.

Currently, SRSP has employed about 2,000 people including doctors, administrative personnel, lady health visitors, paramedics and Class-IV employees.

Sources said that the decision left the DHOs high and dry, who were preparing to take control of the BHUs by June 30. The DHOs said that they managed civil hospitals, rural health centres and tehsil hospitals so they could run the BHUs effectively.

However, the DHOs have to wait for one and half years to be able to look after the BHUs as the government is not going to strengthen the district health system and find solace in finding solution to people health through private partners.

“The health department has also given assurance to SRSP that it would get smooth flow of funds in future as there had been numerous complaints about delay in release of funds and other official matters,” said sources.

Published in Dawn, June 29th, 2016