Despite National Health Mission guidelines mandating one government dispensary per 15,000 people, there is just one government dispensary per 64,468 population in Mumbai, the latest report by NGO Praja Foundation shows.
An analysis of patients getting treated in government out-patient-departments showed that only 24 per cent visit a municipal dispensary for primary healthcare, while the rest prefer going to municipal hospitals.
The findings indicate the need for strengthening primary healthcare in the jurisdiction of the Brihanmumbai Municipal Corporation (BMC).
Currently, there is a 19 per cent vacancy in dispensaries across Mumbai. With just 74 medical and para-medical government staff per lakh population, Mumbai remains far away from Sustainable Development Goals of 2030, which mandate 550 medical and para-medical staff per lakh population.
“The concept of mohalla clinics in Delhi is innovative. The government has infrastructure in Mumbai, it only needs to rope in specialists to consult at these dispensaries,” said Milind Mhaske, project director at Praja.
According to Dr Mangesh Pednekar, director at Healis-Sekhsaria Institute of Public health, public dispensaries should be open throughout the day till 10 pm to ensure accessibility.
Of the 20,187 people surveyed by Praja, it was found that 73 per cent had no medical insurance. Mhaske said only 27 per cent of the surveyed people knew that a government health insurance scheme existed. With no insurance, on an average, these households spent 10 per cent of their annual income on healthcare.
“Mumbai residents spent Rs 27,795 crore on health in a year. The government is moving from providing services to an insurance model. There is a need to increase dispensaries, allocate more doctors and more budget,” added Mhaske.
TB data discrepancy
The white paper on health released by Praja Foundation shows that on an average, 26 people die due to diabetes every day in Mumbai.
According to RTI data from 2017, at least 9,525 people died directly or indirectly due to diabetes. At least 8,058 deaths were due to heart attacks in 2017.
But a huge disparity remains between government data on deaths due to tuberculosis (TB) and total deaths collated by the NGO through RTI. The Revised National Tuberculosis Control Programme (RNTCP) recorded 803 deaths due to TB in 2017 across Mumbai, but RTI data of death certificates showed 5,449 people succumbed to TB in 2017.
While Praja has stressed that the government needs to do better data management to get accurate figures, the BMC’s TB control officer, Dr Daksha Shah, said they have been training private doctors on identifying cause of death properly.
“In the past few years, RNTCP data shows there is reduction in deaths due to TB. The RNTCP is only maintaining deaths of patients in government set-ups, so there is a large difference between both data,” said Shah.