Many Prescribed Drugs Unavailable in BHUs

  • Doctors and staff without accommodation in more than a quarter of BHUs
  • Maternal health neglected in 30% BHUs
  • A report Based on Monitoring of 110 Basic Health Units¬†across Pakistan in July 2011

An overwhelming majority of patients visiting Basic Health Units (BHUs) monitored by FAFEN during July 2011, complained regarding availability of free of cost prescribed medicines (prescription drugs) at in-house pharmacies.

In comparison with FAFEN’s monitoring reports on BHUs since April 2010, the availability and issuance of free of cost medicines has improved by at least five percentage points. However, the huge number of patients’ complaints in July 2011 suggests that despite the improvement, patients’ needs for medicines are not adequately met at these primary healthcare facilities.

FAFEN Governance Monitors noted that 85% of 110 BHUs monitored in July 2011 had stocks of medicine and 89% were issuing free of cost medicines to patients. However, 86% of 90 patients interviewed by FAFEN Governance Monitors at the premises of the BHUs complained that not all prescribed medicines were available and that they had to purchase some from the market.

A similar number of BHUs (110) were monitored in April 2010 and July 2011. Although only two BHUs were common to both monitoring periods, more than half of the facilities monitored in both periods were situated in same districts. Since April 2010, a respective increase of nine and five percentage points has been observed with regard to stocks and availability of free medicines. In light of these findings, it is important to investigate why such a large number of patients are complaining about not being issued all the prescribed medicines free of cost.

In general, the BHUs monitored in July 2011 were observed to have several infrastructural issues. Lacks were noted with regard to basic amenities, essential equipment, maternal health, staff to run disease control programs, etc. Essential equipment was lacking in a majority of BHUs; 65% lacked wheelchairs, 49% stretchers, 37% working oxygen tents, 22% sterilizers and 12% did not have syringe cutters. Apart from this, basic amenities like clean drinking water, washrooms with running water and properly shaded waiting areas were not present in more than 15% of the monitored BHUs.

Mini laboratories were lacking in 80% of the BHUs monitored nationwide, including the BHU in Islamabad Capital Territory (ICT), one out of two in FATA, 90% in Punjab and at least 60% in other regions.

In addition to the above, 31% of the 110 BHUs monitored nationwide did not have residential houses for doctors on the premises. These included 86% BHUs in Balochistan, 31% each in Sindh and Punjab and 18% in Khyber Pakhtunkhwa (KP). Residential houses for other staff were also absent in 26% of the BHUs monitored nationwide. It is necessary for doctors as well as other staff to be provided with residential quarters on the premises so that they are within easy reach and access of the hospitals and patients receive timely treatment. It is also important to minimize time loss by providing subsidized and/or free accommodation in areas doctors and other staff members are not familiar with.

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