Pharmacies at BHUs: patients complain of non-availability of prescribed medicines

An overwhelming majority of patients visiting 110 Basic Health Units (BHUs) across Pakistan in July 2011 complained about non-availability of prescribed medicines at in-house pharmacies. This was revealed in the Free and Fair Election Network (FAFEN) monitoring report released here on Thursday.
FAFEN Governance Monitors noted that 85 percent of the monitored BHUs had stocks of medicines and 89 percent were issuing them free of cost to patients. But 86 percent of 90 patients interviewed at the premises of BHUs complained that not all prescribed medicines were available and that they had to purchase some from the market. The report said compared to monitoring reports on BHUs since April 2010, the stocks and availability and issuance of free of cost medicines have improved. However, the huge number of patients' complaints in July 2011 that despite the improvement, patients' needs for medicines are not adequately met at these primary healthcare facilities.
About infrastructural issues, the report said in July 2011 the monitored BHUs lacked basic amenities, essential equipment, maternal health facilities, and staff to run disease control programmes. It said 65 percent lacked wheelchairs, 49 percent stretchers, 37 percent working oxygen tents, 22 percent sterilises and 12 percent did not have syringe cutters. "Basic amenities like clean drinking water, washrooms with running water and properly shaded waiting areas were not present in more than 15 percent of the monitored BHUs."
It said mini laboratories were lacking in 80 percent of the BHUs, including the one in Islamabad Capital Territory (ICT), one out of two in FATA, 90 percent in Punjab and at least 60 percent in other regions. Additionally 31 percent and 26 percent of the 110 BHUs did not have residential houses for doctors and other staff on the premises. The report called for providing doctors and other staff residences so that they are easily available and patients receive timely treatment.
It is also important to minimise time loss by providing subsidised and/or free accommodation to doctors and other staff members. The report said maternal health was also in a state of neglect. Maternity beds were not present in 39 percent of the monitored BHUs, while 30 percent lacked labour rooms.
More than 70 percent BHUs in Balochistan and Khyber Pakhtunkhwa lacked labour rooms, as did a quarter in Sindh and 8 percent in Punjab. Maternity beds were not present in 68 percent BHUs in Khyber Pakhtunkhwa, 57 percent in Balochistan, 31 percent in Punjab and 19 percent in Sindh. Delivery kits were not present in 16 percent of the monitored BHUs nationwid.
BHUs also lacked staff to treat TB patients and to run the Control of Diarrheal Diseases (CDD) and Malaria Control Programme (MCP). As many as 40 out of 110 BHUs did not have staff to treat TB patients. The report said nation-wide 92 percent of the monitored BHUs did not have generators for power backup, terming it a worrying aspect given the frequent power outages in the country. "These included all BHUs monitored in ICT, FATA and Balochistan, 95 percent each in Punjab and Khyber Pakhtunkhwa and 69 percent in Sindh.
FAFEN monitors visited 110 BHUs in 66 districts in July 2011. Sixty two BHUs were visited in 31 districts in Punjab, 22 in 15 districts in Khyber Pakhtunkhwa, 16 in 10 districts in Sindh, seven in as many districts in Balochistan, two in as many agencies in FATA and one in ICT.