First survey of Haryana’s health and wellness centres exposes gaps in service delivery

Bhartesh Singh Thakur

Tribune News Service

Chandigarh, November 12

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

To ensure delivery of the Comprehensive Primary Health Care (CPHC) services, existing sub-centres covering a population of three to five thousand were converted into Health and Wellness Centres (HWCs) in 2019, with the principle being “time to care” to be no more than 30 minutes. Primary Health Centres in rural and urban areas were also converted to HWCs.

The Population Research Centre (PRC) at the Centre for Research in Rural and Industrial Development (CRRID), Chandigarh, carried out the assessment of 20 HWCs in four districts of the state-Kaithal, Yamunanagar, Ambala and Fatehabad during the period of January to March.

Prof Aswini Kumar Nanda and Associate Prof Rajesh Kumar Aggarwal of CRRID carried out the survey on the behalf of the Ministry of Health and Family Welfare.

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

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 laboratory technicians. The arrangement of part-time laboratory technicians did not fully meet the day-to-day demand of visiting clients. At some places, with only one ANM, Mid-level Health Provider (MLHP) expressed a desire for a helper to facilitate the services.

In spite of spacious and modern physical infrastructure, HWCs lack medical, paramedical and other manpower which acts as a constraint on the health care services and outreach activities under their jurisdiction, the findings read.

“We have recently recruited a number of doctors so vacancies have been filled and for pharmacists and lab technicians. We have sent the requisitions. They 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 into HWCs. So, there was no Mid-Level Health Provider (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 for prescribing medicines reported at Jaidhar SHC in Yamunanagar. There was no maintenance of building at Hafizpur SHC. Animals used to come inside the building area in the absence of a boundary wall. The poor road connectivity was also a factor in public approaching the facility in the district.

Poor road connectivity to the Sandhali HWC (Yamunanagar) impacted the follow-up of cases.

The quality of repair and upgradation work at Kaptan Majra HWC (Yamunanagar) seemed unsatisfactory to both staff and visiting clients. The 24-hour electricity provision got reduced to 18-hour during the hot summer days.

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

The shortfall in receipt of iron-folic acid (IFA) tablets and the paracetamol syrup at the HWCs reported from Fatehabad. The children are often prescribed tablets instead of paracetamol syrup.

All eight PHCs that were HWCs were found without a MO in the Kaithal district.

The one at Shakti Nagar in Kaithal district was located in an old private building. It was reported that the dogs kept by the owner often create a problem for the visitors as reported by some OPD clients.