Government priorities misplaced all health centers – The New Indian Express | Tech Reddy

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NEW DELHI: For Sunita Yadav, an auxiliary nurse-midwife (ANM), who runs a primary health sub-centre in Balpura near Jakhrana in Alwar, Rajasthan, it’s a struggle every day for a strange reason. She is supposed to distribute basic medicines to patients, administer vaccines to children and check pregnant women for problems such as high blood pressure and anemia. But his constant concern is to make sure that the children at the center do not swallow drugs that are on a table in the room. The sub-health center starts from a primary school that doubles as an anganwadi center for pre-schoolers.

Bishan Parmar, a farmer who came to the center to ask for medicine for the common cold, is not happy either. “For so many days, the ANM has said that there is no Cetrizina. This sub-center barely meets the needs it promises,” he says grumpily. Barkha Gupta, medical officer at the Jakhrana health center who is responsible for overseeing six sub-centres in the block, says that while the supply of medicine has improved in recent years, only three or four patients visit each day.

“Even pregnant women who go to the sub-centres are often disappointed that there is only a partially trained ANM who sees them,” she says. “Most sub-centres do not have their own buildings and are run by anganwadi centres, where even keeping medicines safely is a major concern.” When asked if the Union government’s ambitious plan to upgrade 1.5 lakh sub-centres, which act as smaller units of healthcare delivery machinery, into wellness centers seems realistic, Gupta just smiles.

First in the national health policy last year and then in the Union Budget this year, the Center promised that wellness centers across the country will be developed to provide comprehensive health care with a bouquet of services 12. “The role of the doctor and specialist will be expanded from making a diagnosis and a treatment plan to ensuring compliance with medications for chronic diseases and follow-up care provided close to home,” said a senior official in the Ministry of Health and Family Welfare.

But no one knows where the magic wand will come from that will transform sub-centres like the one in Balpura. The district-level household survey (2015-16) showed that 22 percent of India’s sub-health centers do not even have ANMs and about 56 percent never have all listed medicines or vaccines . Several other surveys in the states have shown that less than 25 percent sub-centers are able to provide at full capacity.

“This plan seems extremely problematic to me from the word go,” said Jashodhara Dasgupta, public health expert and coordinator of the NGO Sahyog. “When the sub-centres were not able to provide the two basic services – immunization and maternal care – due to lack of staffers and resources, how were they proposed to provide other facilities? Where are the doctors and where is the money?”

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