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Health Care

  • Troubled partnerships in healthcare sector

    Markets and partnerships can be effective only when there are strong and enforceable regulations, meaningful competition, and an informed consumer base. These are rare in rural India. With less than one per cent of the Gross Domestic Product (GDP) invested in public healthcare provision, India is currently one of the world's most privatised health economies. It is a country which is home to one-fifth of the world's diseases, where the regular level of malnourished children is higher than that of sub-Saharan Africa, and with higher rates of anaemia and maternal under-nourishment. The buzzwords inscribed into current government policy, includi ng the Eleventh Five Year Plan, are Public Private Partnerships (PPPs)

  • Cost and effectiveness analysis of immunization service delivery support in Andhra Pradesh, India

    The immunization service delivery support (ISDS) model was initiated in Andhra Pradesh, India, in November 2003 with the aim of strengthening immunization services through supportive supervision. The ISDS model involves a well-established supervision system built upon the existing health infrastructure. March 2008

  • Report of the high level group on services sector

    The rapid growth of India's exports of commercial services during the period 2000-2006, from US $ 16 billion to US $ 72.8 billion, and of India's share in world exports from 1.1 per cent to 2.7 per cent provides ample evidence of India's international competitiveness in the services sector as a whole. However, calculations of Revealed Comparative Advantage (RCA) show falling RCA in respect of travel (tourism) and transportation (of which shipping is the major component) and accelerating RCA in

  • Cockpit

    In early December 2007, the country prided itself on providing the world with a road map to check the highly pathogenic avian influenza virus H5NI. Containing the virus in Maharashtra in 2006 and in Manipur in 2007 gave health authorities sufficient caus

  • An unhealthy health scheme

    The healthcare and medical facilities provided under the Central Government Health Scheme suffer from several anomalies. While the right to healthcare and medical facilities should be seen as an integral part of the right to life, bureaucrats have ensured that hassle-free and quality healthcare at good private nursing homes and hospitals at Government's expense is available only to MPs, senior Government employees, pensioners and their families. The nursing home facilities in Government hospitals, too, are mostly cornered by the high and mighty. Medical specialists attached to CGHS dispensaries are unavailable on the weekdays that are slotted for their visit as they are away on 'VIP duties' for months. There exists a complex classification of CGHS beneficiaries. The parameters depend on the stage and scale of pay or pension, the position one holds or held in the Government, whether one is an employee or pensioner of some 'purely governmental department' or Central autonomous body. It is astounding that the pensioners among the beneficiaries of autonomous bodies are not treated at par with their counterparts who retired from the 'purely Government service' -- particularly in matters of grant of credit facilities. Even while the babus perpetuate and practice such blatant discrimination, or create provisions for it in the rulebooks, they are not held accountable for the miseries caused to the beneficiaries of the scheme who are some autonomous body's pensioner. In the evening of their lives, suffering from age-induced infirmities and debilitating diseases, they have to run around complying with absurd formalities, placating highly inflated egos of the babus concerned. They also have to get their department's permission before and after the treatment, incur all expenses on the spot in the first instance irrespective of the enormity of the amount of expenditure, make repeated trips to the hospital for getting the bills verified by the CGHS medical authorities then to the department from which they have retired. They are subjected to this unreasonable discrimination only for the sin of their having retired from an autonomous body. Is the life of a Class IV employee in any way less valuable than that of a senior class I officer? As the senior citizens of this country, all pensioners should be treated at par, particularly in the matter of healthcare and medical facilities.

  • Tottering Orissa health system gasps for breath

    The public health system in Orissa is on the brink of collapse. Most government hospitals in the state are running without doctors, para-medical staff, medicine and basic infrastructure. The outbreak of cholera in Koraput last year and the recent cases of anthrax-related deaths have already exposed the weak links in the health system. What's worse, at a time when the government is grappling with controversies like irregularities in the Rs 415-crore World Bank-aided Orissa Health Systems Development Project and the fake medicine scam, about 3,000 government doctors have threatened to quit their jobs. On February 18, government doctors across the state put in their papers en-masse demanding higher salary and more privileges. The doctors have given a time-frame of one month to the government to either consider their 18-point charter of demands or accept the resignation letters. Their demands include basic salary of Rs 12,000-Rs 16,500 per month at the entry level (subject to revision, as per recommendations of the Sixth Pay Commission), specialist allowance of 30% of the basic salary, in-service post-graduation study and housing accommodation for doctors from primary health centres to block headquarters and, above all, security to all doctors. The doctors demands are not illogical, say observers. With the population:doctor ratio touching a new low (roughly one doctor to 8,000 patients), the doctors in government hospitals have to bear the burden of a huge workload. Unable to meet the growing demand, these doctors end up facing public wrath. There have been many such incidents in various parts of the state. Moreover, these doctors see no reason why they should serve the government when higher salaries and better privileges await in the private sector. Amidst all this, it is the patients who have been suffering. Orissa is virtually running short of doctors, particularly allopathic, in recent years. There are 929 posts of doctors that have been lying vacant in various streams. Of these, 765 are for allopathic, 77 ayurvedic and 87 homeopathic doctors. The highest number of 31 vacancies in allopathy has been reported in Sundergarh district. Even though state health minister Sanatan Bisi has assured the people that the vacancies would be filled up, the fact is that adequate number of doctors are not available in the state. The few doctors who pass out from the three government medical colleges migrate to other states in search of higher compensation, promotional avenues, professional security and social status. There are 150 seats each in the three medical colleges and hospitals in the state, while in private medical colleges there are 300 seats. In a desperate bid, the state government is now considering enhancing the entry age limit of doctors for government jobs from 32 years to 45. It also proposes to raise the retirement age of government doctors from the present 60 to 62. Meanwhile, the state government has empowered the chief district medical officers to appoint on contract those MBBS pass-outs who have failed to make it in the Orissa Public Service examinations and have crossed the age limit. Retired doctors can also be appointed on contract basis till 68 years of age. An incentive of Rs 4,000 a month has been announced, besides salary, for doctors posted at the district and sub-divisional headquarters of KBK, Boudh and Gajapati districts. Doctors on rural stint in these districts get an incentive of Rs 8,000 a month. Contractual doctors in KBK, Gajapati and Boudh districts get Rs 18,000 a month while in the rest of the districts, the salary amounts to Rs 12,000 a month. "There is requirement of an additional 5,000 doctors in the state. From where will such a huge number of doctors come'? says Madhusudan Mishra, president of Orissa Medical Service Association (OMSA). He suggests that the state government should take immediate steps to retain existing doctors and provide them all the facilities. "The doctors demands will be taken up for consideration soon after the on-going Budget session is over', health minister Bisi said.

  • Punjab people deserve better health care (letter)

    AJ. Philip's survey of primary health centres in Punjab (Feb 4, 5 and 6) has brought out the pathetic neglect of the basic healthcare. The Bhor Committee (1943) has laid down the three-tier health setup for the country with the primary health centre as the pivot for providing preventive and curative services at the grassroots level. District hospitals and specialised higher medical institutions were to provide the secondary and tertiary care service. Instead of strengthening the PHCs and district hospitals with adequate staff, equipment and drugs, the government continues to hoodwink the public by announcing new schemes which hardly make any impact. People, especially the poor, continue to be denied the basic healthcare as enshrined in the Constitution. No doubt, Punjab is lagging behind in social service indices, of which health services is an important segment compared with many other states. Having closely observed the working of PHCs in Punjab, Madhya Pradesh and Maharashtra, I feel that the system is best for the country if appropriate steps are taken to strengthen it and plug the loopholes in its working. Instead of wasting financial and human resources in unproductive activities like realty development, it would be better to improve the existing peripheral health services to provide succour to the suffering rural folks of the state. Brig H. S. SANDHU (retd), Panchkula

  • Free healthcare service for farmers at city hospital

    For the first time in the country, a four-bed special unit was opened at Japan Bangladesh Friendship Hospital (JBFH) in the city yesterday with a view to providing healthcare service to the poor and marginalised farmers at free of cost. The unit titled 'Jibon Kheya' was opened under the joint initiative of JBFH and Hridoy-e Mati O Manush, a popular agriculture-based documentary programme of Channel i, as part of their joint healthcare programme for the farmers. Agriculture Adviser Dr CS Karim inaugurated the unit on the second floor of the hospital. Prior to inauguration, a meeting was held at the reception room of JBFH. Speaking at the meting, the adviser said JBFH and Hridoy-e Mati O Manush have taken a noble initiative on a noble day. He said about 1.5 crore farmers of the country through their labour and merit are producing food for 15 crore people but they often do not get deserved price. "If anyone is called a national hero it is our farmers who continue their struggle in an ailing state,' he said, adding, if the farmers get sick while working on the field it will affect food production and food security. CS Karim said a specialised unit for the farmers should be opened in all the hospitals of the country for providing basic healthcare service to them. Shykh Seraj, director of both the programme and Channel i, said, "I am waiting for that day when the four-bed unit will become a 400-bed hospital.' He said they have already completed their farmers' healthcare programme in five districts and during the visit they noticed that most of the farmers are unaware of the primary healthcare service. Seraj said integrated efforts by all a must to build such a specialised hospital for the farmers. He said Hridoy-e Mati O Manush stepped into fifth year yesterday and it has become a voice of the farmers. Dr Junaid Shafiq, chairman of JBFH, said they started their farmers' healthcare programme last year and during this time they realised that primary healthcare service is not enough for them. "Later, we thought to open a unit for the farmers where they would get all the healthcare services including admission, test, medicine and surgery at free of cost,' he added. "Farmers are the main driving forces of the country and we (doctors) are prepared to serve them always,' he said, hopping that the hospital will become a specialised hospital for the farmers. Faridur Reza Sagor, managing director of Channel I, and Dr Sarder A Naim, managing director of JBFH, also spoke on the occasion. Later, the adviser visited the unit and talked to three patients who are now receiving treatment there. Talking to The Daily Star, one of the patients Rafiqul Islam, a farmer from Shibpur of Narshingdi, said he has been receiving treatment at free of cost. Abdul Halim, husband of Shefali Begum who is also receiving treatment there, said, "I never thought that my wife could receive such treatment.'

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