Health Policy Issues and Health Programmes in ... - Amazon S3

Implementation of National Health Programmes in UttaranchalThe state has inadequate specialized manpower. Three districts do not have any eye surgeons.Against a sanctioned allotment of 33 eye surgeons, only 27 are in position. Of these, 17 havealready completed training in intraocular lens (IOL) implantation, three are undergoing training,and the remaining have been nominated for training. In addition to these, there are 109positions for ophthalmic assistants, with 23 vacancies. Ophthalmic assistants are crucial becausethey serve as the link between the programme and the community. The positions for two staffnurses are also vacant.The District Blindness Control Society (DBCS) conducts eye operations in hospitals and basecamps. In rural areas, eye-screening camps are arranged on fixed dates both in government andnon-governmental set-ups. Area-wise responsibility has been assigned to the district eyesurgeons and agencies to hold eye camps and perform cataract operations. In eye camps,cataract operations are routinely performed and, after proper follow-up, spectacles are providedfree. As part of the national programme, the district also carries out school eye-screening campsfor children aged between 5 and 15 years. These children are examined for refractive error andspectacles are provided free. It is estimated that 6%–7% of children aged between 11 and 15years have refractive error. To circumvent the shortage of staff, teachers are receiving eye-caretraining. In the year 2001/02, the state target of conducting 31,056 operations had anachievement rate of 88.6% with 27,516 conducted, including 17,298 IOL implantations.As part of a World Bank Project, 9 operation theatres, 6 eye wards, 60 eye beds, and 3 dark roomshave been provided to the districts. This, too, is insufficient. The list of equipment andinstruments required has been submitted to GoI and the state is still awaiting the supplies.Shortcomingsl Shortage of manpower at hospitals and other levelsl Lack of equipment and instrumentsl No dark room facilities at the primary health centre (PHC) levell No refresher training given for PHC medical officers, ophthalmic assistants, or staff nursesl No mobile facilitiesl Lack of a transport systeml Poor outreachl Poor community participation.40Solutionsl Adoption of an integrated approachl Addition of contractual appointmentsl Centres equipped by the GoI, as per the list providedl Involvement of NGOs, Panchayati Raj institutions (PRIs), anganwadi workers (AWWs),teachers, traditional birth attendants (TBAs), and Mahila Swasthya Sangh (MSS) forincreasing awareness and outreachl Better monitoring and supervision at the PHC levell Refresher training for existing staff membersl Promotion of information, education and communication (IEC) activities.