62% staff shortage, no nurses or labs
CHANDIGARH: It is a derelict building with a lock that hasn’t seen a key for a while. This is the primary health centre at Rurke Khurd village near Barnala, one of the many such centres that tell the tale of the broken health system in Punjab villages.
“Be it viral, gastro or even toothache, the villagers in this belt are forced to travel 10 to 20km all the way to Barnala or Bhadaur and shell out ₹250 for consultation alone,” fumes Pirmal Singh Dhaula, MLA from Bhadaur.
The recently released CAG report will vouch for the sickly state of rural healthcare in Punjab, which is short staffed by 62%. In some places, there is no staff at all. None of the 150 community health centres in the state have a nurse, for instance. These healthcare centres are also severely short of essentials like medicines and laboratory facilities.
Jagraon MLA Saravjit Kaur Manuke claims there isn’t a single well-oiled health centre in the 30-odd villages in her constituency. “There is no staff, the buildings are in ruins and the less said the better about diagnostic facilities. Visit a government dispensary in a village and chances are they will be hunting around for a thermometer.”
A performance audit of the State Health Society (SHS), mandated by the National Rural Health Mission (NRHM) to provide affordable healthcare facilities in villages, shows that it failed to meet its objectives during 2011-2016 due to manpower and infrastructural deficiencies.
The audit noted that 92% community health centres (CHC) were without ultrasound, 83% had no blood storage facilities, 80% didn’t have the prescribed drugs, 70% had no vehicles, 60% were without separate wards for men and women, while 40% had no standby gensets.
Although there were 4,065 auxiliary nursing midwives for the existing 2,950 sub-centres in the state, 138 such centres were functioning without ANMs indicating their injudicious deployment by the health department.
Many of the existing 427 PHCs were functioning without allopathic doctors (37 PHCs), pharmacists (94 PHCs), lady health visitors (99 PHCs), laboratory technicians (143 PHCs) and accountant-cum-data entry operators (397 PHCs) as of March 2016.
Only 15 posts of public health nurses (PHN) were sanctioned against the requirement of 150 nurses for the existing 150 CHCs as per the Indian Public Health Standards (IPHS). As of March 2016, there was no nurse in place in any of the community health centres. Besides, no post of dental surgeon, general duty medical officer, dental assistant, OT technician, ward boys or counsellor was sanctioned for any of the existing CHCs in the State, as prescribed under IPHS.
The Punjab countryside was also short of sub-centres (15%) and public health centres (26%), a deficiency that was brought to the notice of the Punjab government in the last audit (2010-2015) but failed to receive any remedial measures. Eleven to 21% of pregnant women could not be provided essential healthcare viz ante-natal check-ups, iron and folic acid tablets and tetanus toxoid immunisation. Eight to 22% of the women in villages continued to deliver babies at home. There was also a shortfall in achievement of targets in administering doses of Vitamin ‘A’ and family planning methods during 2011-16.
Though the State Health Society (SHS) was quite conscientious about commissioning annual facility surveys to find out the gaps at each health centre, it made no effort to draw a roadmap to plug these holes. The health department attributed the shortage of medical staff and paramedical staff to the general lack of interest among medical practitioners to serve in remote areas.