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PESHAWAR: The Khyber Pakhtunkhwa health department is planning to extend the contract of the People’s Primary Healthcare Initiative (PPHI), a private organisation owned by senior leader of the ruling PTI Jahangir Khan Tareen, to run 571 basic health units in the province.

Sources told Dawn on Saturday that the PPHI, which had been operating basic health units through the Sarhad Rural Support Programme since 2007, would soon get extension in its contract for continued operations in 17 districts of the province.

The organisation was launched in all provinces during military ruler Pervez Musharraf’s rule when Tareen was a federal minister.

Its objective was to develop primary level health facilities and benefit patients at grassroots level.

PTI leader Jahangir Tareen owns private organisation

It faces criticism for using the provincial government’s funds and staff without accountability. The PPHI began work in seven districts of Khyber Pakhtunkhwa but its scope later expanded to 17 districts, mostly in calamity-prone areas.

It has over 500 medical officers.

“The summary aiming to extend the contract of the PPHI till January 2016 is being processed at the government level. The organisation will get one year more due to its better performance in ensuring presence of staff, and availability of medicines and equipment at primary level,” secretary health Mushtaq Jadoon told Dawn.

He said the department was also extending contract of Merlin, another organisation doing the same job in the province, for another year.

“We have 89 per cent patient coverage in PPHI-covered area,” he said.

However, sources said extension of the PPHI’s contract had caused unrest among the staff of the health department.

They said the PPHI received one-time grant from the health department for which it was not held accountable.

The sources claimed the organisation spent the money wherever it wanted and that there was no audit of its expenses.

Doctors and other staff in PPHI areas work under the PPHI instead of the respective district health officers.

The PPHI also operates similar projects in Sindh and Punjab but in KP, the health department faces resistance to extension of the programme in the past due to the complaints of regular staff of the health department posted to BHUs.

According to sources, the PPHI is now totally dependent on provincial funds as the federal government stopped grant-in-aid for it after the enforcement of 18th Constitutional Amendment.

It receives funds but there’s government audit or third party validation of the funds provided by the provincial government.

The programme started in 2000 has been modeled after a World Bank’s report prepared in light of WHO Health Model, seeks a shift from curative to preventive and promotive care. It initially started as the President’s Primary Health Care initiative before its present nomenclature manages the administrative and financial matters of the basic health units to improve staff’s attendance and ensure minimum health package to population at the first level primary health facility.

The pilot project was carried out in Rahim Yar Khan in Punjab from where it was replicated in other provinces after its success at the grassroots level.

Doctors say the PPHI had appointed district support managers on the designated districts who managed the health facilities despite no medical knowledge.

In some areas, the programme has worked to the improve patients’ care through availability of doctors and support staff.

Maintenance and repair work in the health units under the PPHI has improved.

“Availability of lady health workers and women doctors has strengthened laboratory services and ultrasound for female patients. The services provided by the PPHI are more effective,” said Mushtaq Jadoon, who had headed the PPHI when it began working in the province.

He said in many districts, the organisation had clubbed together the services of three to five BHUs, which served together all patients.

Jadoon said it was impossible for the health department to appoint doctors on immediate basis but private organisations could do it.

“We have three medical officers for 11 BHUs in Hangu but the process of recruitment is lengthy,” he said.

Jadoon said reputable audit firms had given the third party validation of the programme.

The assistance given by the PPHI is commendable, secretary said.

Published in Dawn, July 5th, 2015

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