A survey of district hospitals in Punjab by the Centre for Research in Rural and Industrial Development (CRRID) has found widespread shortcoming in their functioning which range from a crippling lack of facilities to pestering patients for ‘shagun/badhai’ on the birth of a child.
The centre has submitted reports on eight district hospitals run by the Punjab government for the period 2015-16 after being assigned a study by the Ministry of Health and Family Welfare, Government of India, to tabulate the benefits and shortcoming under the National Rural Health Mission (NRHM). Professor Ashiwni Kumar Nanda, Professor at the Population Research Centre (PRC) at CRRID and Rajesh Kumar Aggarwal, Assistant Professor have authored the reports on the hospitals in Pathankot, Ferozepur, SAS Nagar, Bathinda, Fazilka, Amritsar, Moga and Faridkot.
The reports mention that there are shortage of doctors at several levels, which includes specialists at the district hospitals, community health centres as well as duty medical officers at primary health centres. Shortage of manpower plagues almost every district where the survey has been carried out. In Ferozepur, the study team found that there is no Assistant Civil Surgeon, District Family Welfare Officer (DFWO) and District Immunisation Officer (DIO). The district hospital is without a paediatrician, and Dermatologist while the community health centre at Guru Harsahai has no specialist available.
In Pathankot, there is shortage of administrative manpower like superintendents, clerks, persons maintaining records of births and deaths and drivers. A health centre in Kaunterpur was found without electricity connection. “Earlier, electricity was drawn from water works facility inside campus but that is not being allowed now,” the report says adding that there is no drinking water facility available too.
The surveyors have also found that there is a practice of operation theatre attendants and other staff of the hospital demanding ‘badhai/shagun’ from patients after the delivery of a child. “The amount could range anything between Rs. 300-Rs. 500 or even more depending upon the sex of the baby, but, as per patients, nobody was being spared on this account,” the report states about Pathankot district.
The report goes on to say that the Asha workers were also found to be taking ‘badhai/shagun’ and that they threaten that in the absence of the gratification they will refer the delivery cases to private hospitals where better monetary incentives are available to them.
In Fazilka, the team found that there was no radiologist at the district hospital and all patients, including pregnant women, have to pay out of their own pocket to get scans done from outside hospital. The report states that in the government facility in Abohar, where a radiologist is available, the staff scan a pregnant woman free of cost only in the last month of pregnancy and at all other times she has to pay for the facility.
Non-functioning toilets, no heater in wards even at peak of winters and non-operational 24×7 primary health centres were also detected by the team. Several primary health centres in the districts surveyed were found to be without medical officers and in some instances the attendance of the staff was found to be tardy.
Acute shortage of all medicines including injections, tablets, cotton, bandage, ORS packet and antispetics also found. The study also found that non-availability of space and mosquito infestation at one health centre resulted in all cases of deliveries being discharged on next day of delivery without spending stipulated 72 hours of stay at the facility.