NRHM big failure in Poonch district, monitoring goes for toss

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Jasleen Kour

National Rural Health Mission (NHRM) has seemingly been of little or no significance for people of Poonch since positions of doctors from regular side are vacant while as specialists have not been engaged.

According to a survey report of the state government, most of the positions of doctors from regular side are vacant and specialists have not been engaged under NRHM in the district which has severely affected the service delivery. Report has recommended that there is an urgent need to fill-up these regular positions on priority basis and the process for recruitment of specialists under NRHM need to be expedited.

Report has stressed that there is also a need to stop the practice of attachments of doctors and other para medical staff. Various components of Janani-Shishu Suraksha Karyakram (JSSK) have been implemented but the monitoring mechanism for its implementation is poor. Survey has said that there is a need to form a task force to monitor all activities being provided under JSSK to beneficiaries.

It is also recommended to make available various records pertaining to JSSK for public scrutiny. Availability of infrastructure at PHC and SC level is inadequate and there is a need to improve the infrastructure to meet the growing demand of patient care and service delivery. Toll Free number for availing transport facility under JSSK is not operational in the district.

Survey team has recommended that there is a need to make the number operational. There are some backlogs of Janani Suraksha Yojana (JSY) (both for beneficiaries and ASHAs). They have recommended for regularizing the payments under JSY (both to beneficiaries and ASHAs). They have also suggested for making changes in the payment mode (payee account cheque) as most of the beneficiaries face difficulties in opening the bank account for this purpose.

Medical Device Reporting was found as one of the neglected areas as the meetings in this regard does not take place on regular basis. They have recommended for holding such reviews on regular basis. They have said that prescription audit is not taking place in the district at any health facility and suggested that there is a need for audit of diagnostic tests or drugs prescribed by the doctors at all the higher health facilities.

Though officially the district has established NBSUs and NBCCs but due to lack of space, equipment, manpower such units are not functioning properly. Therefore, there is an urgent need to improve the working of NBSUs/NBCCs in the district. It is also recommended to provide trained staff to these NBSUs/NBCCs to make them functional. There is also need to establish the remaining NBCCs in the district.

Since immunization coverage is low in the district and in this regard more efforts are needed to improve the immunization in the district. There is also a need to increase number of immunizations days at all the levels and provision of all doses of immunization at each facility. All the health facilities complained of inadequate ambulances to meet the requirements under JSSK therefore, there is a need to provide more ambulances to the district to meet the growing demand under JSSK.

The family planning acceptance is low in the district as only 23 percent women are using any method of family planning therefore there is a need to put more efforts for improving the use of various methods of family planning in the district. Staff for various disease control programmes should be provided to district pooch for effective implementation, the team has said.

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