Government needs to invest more in the state-run dispensaries, the first unit in the healthcare infrastructure, to enable them to effectively cope with the basic medical needs of the people. The government investment in medicine, services, equipment and infrastructure is badly needed as public sector dispensaries studied by Free and Fair Election Network (FAFEN) in May 2011 showed a worrying lack of capacity in providing safe treatment to the patients.
For instance, sterilises are not available in almost two-third of the surveyed facilities while a quarter of those studied did not have syringes and cutters. Lack of basic equipment results in re-use of syringes and unsafe use of other equipment leaves the patients at risk of serious infections. Similarly, one-fifth of the dispensaries surveyed nation-wide are without medicines. Unavailability of medicines at dispensaries compromises the responsibility of healthcare system to provide free-of-cost medicines to the patients visiting primary healthcare facilities.
Besides equipment and services, many dispensaries lacked even basic infrastructure. Around two-fifth of dispensaries did not have waiting areas while nearly half (48%) did not have washrooms for patients. The buildings of one-third of the observed facilities are not in good conditions. The poor condition and operational capacity of many dispensaries, coupled with the fact that there is hardly any oversight by elected and public officials suggests that state-run dispensaries are suffering neglect. Only 36 oversight visits by elected and public officials have been recorded in 81 monitored dispensaries during past three months (February-April 2011).
Dispensaries do not have basic services also necessary for any state run facility, as more than half of the monitored dispensaries nation-wide lack arrangements for clean drinking water for patients. The lack of water for drinking is serious issue in summer months.
While there is hardly any issue of understaffing in monitored dispensaries, there is a serious issue of transparency in sharing the information. The staff of dispensaries either does not have or withhold the information about sanctioned and appointed staff in the facilities from FAFEN monitors. Information about doctors' appointments is withheld by more than half (41) of the monitored dispensaries. While 37 monitored facilities do not share information about female paramedical staff, those who share have 96% occupancy rate. While the majority of patients interviewed by FAFEN at monitored facilities, were satisfied with the services and behaviour of the staff, 29% of these complained that the overall behavior of the doctors was not good. Around 11% of the interviewed patients were dissatisfied with the behavior of the support staff. Nation-wide, 17% of patients who were interviewed said that they were not getting free medicines from the in-house pharmacy as per the doctor's prescription.
In February 2011-April 2011 quarter, government officials made six visits in connection with Polio Day-one each to the dispensaries in Sindh and Balochistan, and the rest to Punjab. Three surprise visits were also made-two in Punjab and one in KP; other regular visits were made to check medicine stocks and staff, attendance and medical records, as well as monitoring visits, general inspections and routine visits. Overall, elected representatives and government officials made 36 visits.
However, these included only one visit by an MPA, while none was made by any MNA anywhere in the country. It is possible that this lack of government oversight is responsible for the lack of equipment and services observed in the dispensaries. FAFEN Governance Monitors visited 81 dispensaries in 57 districts nation-wide - 38 in 25 districts in Punjab, 21 in 14 districts in KP, 18 in 15 districts in Sindh, three in as many districts in Balochistan and one in ICT.
Comments
Comments are closed.