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| NRHM 9 year old in J&K, Ladakh still faces healthcare blues | | HR missing in facilities | | Syed Junaid Hashmi
JAMMU, Aug 30: Despite National Rural Health Mission (NRHM) completing 9 years in Jammu and Kashmir, Ladakh division continues to face healthcare blues.
There is irrational setting up of physical infrastructure under NRHM. Community Health Center (CHC) in Drass and Special New Born Care Unit (SNCU) has been set-up in Kargil. Those who planned these two institutions have done it without proper application of mind since the two institutes have been set-up at these places without the availability of the necessary Human Resource (HR) component.
The available staff in entire Ladakh division working under NRHM has not been imparted training for Mother and Child Tracking System (MCTS) for the reasons better known to the planners sitting in air-conditioned rooms in Srinagar and Jammu respectively. Financial management capacity of the medicare facilities for utilisation of untied funds is poor in entire Ladakh region.
These comments have been made by the Integrated Monitoring Team (IMT) of Union Health and Family Welfare Ministry which visited Leh District and Kargil in Ladakh division. The team headed by Assistant Commissioner in Maternal Health in the Union Health and Family Welfare Ministry Dr. Manisha Malhotra included Senior Consultant in NHSRC Padam Khanna, Regional Director (RD) Dr. Abhishek, Consultant in Maternal Health Dr. Pushkar Kumar, Consultants in NRHM namely Divya Shree and Dr. Nitasha Manpreet Kaur.
Team had been assigned task of monitoring status of implementation of Reproductive Child Health (RCH) Programme-II/ NRHM strategies in Ladakh division through interaction with district and state officials and field visits to facilities in the district including sub-centres, PHCs, CHCs, other sub-district level facilities and the district hospital to understand best practices, gaps in implementation, constraints and support that can be rendered by the Ministry of Health and Family Welfare.
The team found out that utilization of funds was low in almost all the facilities visited by them. On being asked, the team was told that it was due to short working span as in winters the place gets cut off due to heavy snow and the working conditions are harsh; secondly, the disastrous cloud burst necessitated reconstruction in a big way in some areas of Leh.
Team also noted with concern the irrational classification of areas due to application of the old SRO Classification of the state for "Inaccessibility" (as per State Rules) had resulted in medical officers (MOs) posted in facilities of less inaccessible areas drawing incentives (e.g. in Block Nubra of Leh District), while others posted in more inaccessible areas were not getting any (e.g. Block Nyoma and Tangste).
The team in its report has recommended that there is an urgent need for the state to revise the classification of areas as per inaccessibility. It also found out that sanitation was an issue in every facility visited due to lack of water supply and provision of sanitary latrines. There was also dire need for staff quarters while the few available were in poor condition and not liveable.
Team also found out that capacity building was an issue, as most of the medical and para-medical staff had not undergone various skill based trainings. Pointing towards urgent need of creating head-offices of NRHM in Ladakh division, the team has said that due to comparative inaccessibility, information from Srinagar district for deputing the trainees often reaches late.
The team further found out that out of pocket expenditures on transport were incurred by most people except pregnant women and children from 0-6 years. It also came to know about underutilisation of contractual AYUSH doctors. The team has reported these shortcomings to the Union Health and Family Welfare ministry which is set to take up the issue with Jammu and Kashmir government. |
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