ISLAMABAD, June 6, 2011: Almost half of the 80 monitored Basic Health Units (BHUs) in April 2011 by FAFEN did not have specially trained staff to treat TB patients. There was also a noticeable shortage of staff to run disease control programs currently being implemented by the ministry of health. These include the Malaria Control Program (MCP) and the Control of Diarrheal Diseases (CDD) program.
FAFEN Governance Monitors visited 80 basic health units across Pakistan during April 2011 – 33 BHUs in 22 districts of Punjab, 25 in 18 districts of KP, 15 in 11 districts of Sindh and seven in as many districts of Balochistan.
With the exception of facilities monitored in Punjab, where 73% BHUs had TB staff, in all other regions, at least 60% BHUs lacked TB staff. Similarly, 39% of the monitored BHUs nationwide did not have staff to run the CDD program and 35% did not have staff to run MCP.
In Balochistan, 57% of the monitored BHUs did not have staff to offer basic vaccination facilities under the expanded program on immunization (EPI). This is especially worrying since many serious diseases are covered under the EPI. However, in all other regions, at least 90% facilities in each had the required staff.
The monitored BHUs also showed lacks in maternity care. Forty six percent of the monitored facilities did not have the standard minimum of two maternity beds on the premises. In addition, labor rooms were missing in 40% of the monitored BHUs and 20% were lacking in delivery kits. Female staff was present to attend to patients in 86% of the monitored BHUs, however, 57% of BHUs in Balochistan were lacking in this regard.
With regard to essential equipment, more than half of the monitored BHUs nationwide did not have a working oxygen tent, 31% did not have sterilizers and 17% lacked syringe cutters. Nationwide, 69% of monitored BHUs lacked wheelchairs and half did not have stretchers. Lacks in these areas had also been noted in BHUs monitored in April 2010, and negligible improvements were observed during the current monitoring. All these are very basic items that all health facilities should have.
The lack of wheelchairs and stretchers means that there is no provision for conducting patients into the BHU, even if they are injured or otherwise incapable of walking. Similarly, administering injections to patients is part of routine work for BHU staff, and the absence of syringe cutters is reflective of lack of concern with regard to reuse of syringes which often leads to transmission of diseases.
General facilities for patients were also lacking in April 2011. Nationwide, 36% of the monitored BHUs lacked arrangements for clean drinking water for patients. Over a quarter of the monitored BHUs nationwide lacked washrooms with running water for patients. Similarly, a properly shaded waiting area for patients was missing in 21% of monitored BHUs nationwide. On a positive note, the numbers of BHUs with clean drinking water and washrooms with running water for patients increased by seven and nine percentage points respectively in 2011 compared to data gathered in April 2010.
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