Covering Deprivation, Government, Health

Government’s ‘Delivery’ issues

Hunsur: Field workers such as the auxiliary nursing midwives (ANM) are limping from village to village in Hunsur taluk, covering its 296 villages; there are only 47 ANMs against a sanctioned strength of 76.

“Policy makers must understand that vacancies result in decreased reach of the health department and the reduction in coverage affects health awareness activities and services indirectly. Plus, the community here needs continuous assessments. ANMs and Asha workers bring field reports to the Taluk Health Officer’s table. Fewer field workers means fewer assessment reports,” said Rajeshwari H M, Block Health and Education Officer, Hunsur.

A new Measles and Rubella (MR) vaccine campaign is set to begin on Feb 7. A Junior Health Inspector is worried that there will be no supply at the PHC just as it happened when pregnant women who had queued up in front of a health camp at an Anganwadi were sent away since their tablets and injections were yet to arrive. Sometimes these pregnant women were also made to wait for hours as there was a shortage of staff to conduct blood tests and distribute nutritional supplies.

“At Nerlukuppe, there are two positions that are vacant at the PHC. At Doddahejjuru, there are two sub-centres that are empty. There areas are provided services through camps and deputations,” said MB Juby, Junior Health Assistant, Hunsur Hobli PHC.

Sitamma, mother of a pregnant woman sitting in the check-up room at an Anganwadi, revealed that when Meenakshi, a nurse who use used to check her daughter, quit two months ago, a complaint was made at the local PHC since no midwife or nurse was available. She then took her daughter to a former government doctor who had opened a private clinic in her area.

“If they say there are no nurses, what do I do? If they are not there when the time comes for my daughter to deliver, I have to take her to Mysore,” she said.

Government’s Delivery Issues

“Government funds, allotments, and policies are always a problem,” said BHEO Rajeshwari.

Under the National Rural Health Mission’s Janani Suraksha Yojana, pregnant women with a Below Poverty Line (BPL) card were to receive Rs.1000 in their 3rd to 6th month pregnancy, essentially, to procure locally available nutritious food.

“Pregnant women haven’t received the money for the last three years,” she said.

Under the State Prasuti Aarayke scheme, all tests at the Government Hospital are free for pregnant women and they also receive free ration. It is given to the pregnant woman but other members in the house consume it.

Use a SIM without a Phone?

Under the Mother and Child Tracking System (MCTS) and digitisation drive, field workers were given a free SIM. The data-entry system was modernised and hosted online. The field worker had to open the App, and enter the information. Earlier, entries were made in a ledger that was carried in the field kit.

Only a free SIM was given but not a smartphone. With meagre salaries, field workers couldn’t afford a quality smartphone.

Soon, the data-entry system reverted to its earlier process of field workers coming back to the PHC to enter the data manually.

“Technology was supposed to cut down the time between request and delivery but it has remained the same,” said BHEO Rajeshwari.

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