First survey exposes chinks in service delivery at HWCs

BOX—- Formed in 2019

* To ensure delivery of Comprehensive Primary Health Care services, the existing sub-centres covering a population of 3,000-5,000 were converted into Health and Wellness Centres (HWCs) in 2019.

*The Population Research Centre at the Centre for Research in Rural and Industrial Development, Chandigarh, assessed 20 HWCs in four districts — Kaithal, Yamunanagar, Ambala and Fatehabad – from January to March.

* The study found that in spite of spacious and modern physical infrastructure, HWCs lacked medical, paramedical and other manpower, which acted as a constraint in the execution of health care services and outreach activities.

Bhartesh Singh Thakur

Tribune News Service

Chandigarh, November 12

The first survey on Health and Wellness Centres (HWCs) in Haryana has pointed out gaps in the service delivery. While at some places, in the absence of Medical Officers (MOs), the pharmacists, staff nurses or Auxiliary Nurse Midwives (ANMs) were found prescribing medicines, there were centres where drug procurement and dispensing had become difficult in absence of pharmacists.

To ensure delivery of Comprehensive Primary Health Care (CPHC) services, the existing sub-centres covering a population of 3,000-5,000 were converted into Health and Wellness Centres (HWCs) in 2019, with the principle being ‘time to care to be no more than 30 minutes’. The Primary Health Centres (PHCs) in rural and urban areas were also converted to HWCs.

The Population Research Centre at the Centre for Research in Rural and Industrial Development (CRRID), Chandigarh, assessed 20 HWCs in four districts — Kaithal, Yamunanagar, Ambala and Fatehabad – from January to March. Prof Aswini Kumar Nanda and Associate Professor Rajesh Kumar Aggarwal of CRRID carried out the survey on the behalf of Ministry of Health and Family Welfare.

The study found that many HWCs are without a full-time MO. The part-time MOs were unable to meet the demands of patient load and community outreach programmes. There was an increasing demand among public for MOs at the facility for better diagnosis and treatment, the survey findings stated.

Also, it came out that in spite of the rising demand for diagnostic tests at the HWCs, most of them (Primary Health Centres /Urban Primary Health Centres) were without regular technicians. The arrangement of part-time technicians did not fully meet the day-to-day demand. At some places, with only one ANM, Mid-level Health Providers (MLHP) expressed the need for a helper to facilitate the services.

In spite of spacious and modern physical infrastructure, HWCs lacked medical, paramedical and other manpower, which acted as a constraint in the execution of health care services and outreach activities, said the findings.

“We have recently recruited a number of doctors so vacancies have been filled and we have sent the requisition for pharmacists and lab technicians. These posts will also be filled soon,” said Dr Suraj Bhan Kamboj, Director General Health Services (DGHS).

In Kaithal and Fatehabad districts, no Sub Health Centre (SHC) was upgraded to HWC. Only Primary Health Centres (PHCs) and Urban Primary Health Centres (UPHCs) were converted. So, there was no Mid-Level Health Providers (MLHP) in these districts.

The formation of Mahila Arogya Samiti for health awareness was not common in slums or slum-like settlements under the jurisdiction of most HWCs.

The non-availability of OPD slips meant to prescribe medicines was reported at Jaidhar SHC in Yamunanagar. There was no maintenance of building at Hafizpur SHC. Animals were seen roaming on the campus in the absence of a boundary wall. The poor road connectivity was also a factor in public approaching the facility in the district.

Also, poor road connectivity to the Sandhali HWC, Yamunanagar, impacted the follow-up of cases.

The quality of repair and upgrade work at Kaptan Majra HWC, Yamunanagar, seemed unsatisfactory to both staff and visiting patients. The 24-hour electricity provision got reduced to 18-hour during summers.

At the HWC in Kherati Khera in Fatehabad, the absence of an IT person made it difficult for the staff to download even a regular mail.

The shortfall in receipt of Iron-Folic Acid (IFA) tablets and Paracetamol syrup was reported from Fatehabad HWCs. The children were often prescribed tablets instead of Paracetamol syrup. All eight HWCs in Kaithal district were found without a MO.