Rashmi Menon Bangalore, March 6, DHNS
An external evaluation report on the first phase of mobile health clinics in five taluks in Karnataka has found staff attrition based on caste.
The report indicated that at Kumta in Uttara Kannada district, one of the five taluks that came under evaluation, doctors and staff nurses were changed thrice on the basis of their caste, affecting the patient-staff relationship. The report compiled by the Institute of Health Management Research, Bangalore, which was done at the behest of the Karnataka Health Systems and Development Reforms Project (KHSDRP), was submitted recently.
The KHSDRP and the National Rural Health Mission are the funding and monitoring agencies for the project run on a public-private-partnership model. The first phase introduced mobile health clinics in Sagar (Shimoga), Tarikere (Chikmagalur), Chamarajnagar, Kollegal (Chamarjanagar) and Kumta (Uttara Kannada) taluks to ensure that medical services reach hilly, remote and backward regions of the State.
While the report acknowledged that the initiative had benefited people in these taluks, it also highlighted some of the concerns such as shortage of staff, scarcity of drugs, less time spent in each village, inadequate funds, lack of laboratory facility and poor information, education and communication (IEC).
Even supervisory visits to the mobile clinics in these five taluks were inadequate, the report stated and suggested a strict guideline for mandatory home visits in maternity and geriatric cases.
The report recommended that NGOs maintain their working hours in each village, and an increase in the budgetary allocation for not only drugs but also to reduce the attrition rate among staff. Using more IEC materials and GPRS tracking device to ensure accountability and transparency were also suggested.
While the project is in its fifth phase, with 95 mobile health clinics in 28 districts, the KHSDRP has already started acting on the recommendations.
Besides, communicable diseases, the clinics would focus on non-communicable diseases and ailments like arthritis, hypertension, diabetes and epilepsy. Funds are also going to be increased for procuring drugs for these diseases and laboratory investigation would add blood sugar test too. However, officials said that despite increasing the salary for MBBS consultants, NGOs were finding it difficult to recruit doctors.
“Since the report has pointed out that the monthly funds were not sufficient, we will scale up salary of staff, funds for labs and procurement of drugs,” said Dr G Y Nagaraj, joint director (PPP), KHSDRP.
The KHSDRP and the National Rural Health Mission are the funding and monitoring agencies for the project run on a public-private-partnership model. The first phase introduced mobile health clinics in Sagar (Shimoga), Tarikere (Chikmagalur), Chamarajnagar, Kollegal (Chamarjanagar) and Kumta (Uttara Kannada) taluks to ensure that medical services reach hilly, remote and backward regions of the State.
While the report acknowledged that the initiative had benefited people in these taluks, it also highlighted some of the concerns such as shortage of staff, scarcity of drugs, less time spent in each village, inadequate funds, lack of laboratory facility and poor information, education and communication (IEC).
Even supervisory visits to the mobile clinics in these five taluks were inadequate, the report stated and suggested a strict guideline for mandatory home visits in maternity and geriatric cases.
The report recommended that NGOs maintain their working hours in each village, and an increase in the budgetary allocation for not only drugs but also to reduce the attrition rate among staff. Using more IEC materials and GPRS tracking device to ensure accountability and transparency were also suggested.
While the project is in its fifth phase, with 95 mobile health clinics in 28 districts, the KHSDRP has already started acting on the recommendations.
Besides, communicable diseases, the clinics would focus on non-communicable diseases and ailments like arthritis, hypertension, diabetes and epilepsy. Funds are also going to be increased for procuring drugs for these diseases and laboratory investigation would add blood sugar test too. However, officials said that despite increasing the salary for MBBS consultants, NGOs were finding it difficult to recruit doctors.
“Since the report has pointed out that the monthly funds were not sufficient, we will scale up salary of staff, funds for labs and procurement of drugs,” said Dr G Y Nagaraj, joint director (PPP), KHSDRP.
Mobile clinics
In the first phase, mobile health clinics held in 3,317 camps (till April 2010) examined about 1.1 lakh people. Based in taluk hospitals, the vans visit villages on a rotation basis.
The clinics provide preventive, promotive, curative and referral health services. Each clinic comprises a doctor, pharmacist, two staff nurses and two group D staff.
In the first phase, mobile health clinics held in 3,317 camps (till April 2010) examined about 1.1 lakh people. Based in taluk hospitals, the vans visit villages on a rotation basis.
The clinics provide preventive, promotive, curative and referral health services. Each clinic comprises a doctor, pharmacist, two staff nurses and two group D staff.
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