All's not well with primary health care
By Express News Service | Published: 01st October 2016 03:24 AM |
BENGALURU: Primary health centres (PHC) are the first line of defence against illness in any city. Also, this is the only hope for the poor who can’t afford to go to private clinics, let alone hospitals.
Of the 198 wards in the city, at least 65 have no public health facility. Each ward should ideally have at least one PHC but that is not the case. With a population of more than a crore, there should be a PHC for every 50,000 people. Health facilities in the city are neither equally distributed nor sufficient in number, health experts point out.
The primary health care requirements of the population are taken care of by two authorities in the city — Bruhat Bengaluru Mahanagara Palike (BBMP) and the District Health Office (DHO), Bengaluru Urban. While health units in 135 wards are administered by BBMP, those in the remaining 63 wards are run by the DHO Bengaluru Urban.
In 2007, when Bangalore Mahanagara Palike (BMP) expanded to become BBMP, 110 villages, seven City Municipal Councils (CMC) and one Town Municipal Council (TMC) were brought under it and made into five zones — Bommanahalli, Mahadevapura, Yelahanka, Rajarajeshwari Nagar and Dasarahalli zones. While the revenue and engineering departments in these five zones are taken care by BBMP, health comes under the DHO, Bengaluru Urban.
The health facilities in these five zones are few and far in between. They are insufficient and inequitably distributed. These zones on the fringes have no semblance of a public health infrastructure and have been completely neglected, experts say.
Dr H Sudarshan, Head of Karuna Trust, which runs the Vivekananda Girijana Kalyana Kendra, said, “These five zones were formerly rural areas. Now they come under the DHO. Since they do not come under the BBMP, health facilities do not reach the people here. There is no coordination between BBMP and the health department.”
The BBMP has six referral hospitals, 27 maternity homes and 120 primary health centres. In all, there are only 146 health facilities in 198 wards. The DHO has 38 health facilities for 63 wards (10 new PHCs are coming up) and BBMP runs 108 health facilities in 135 wards.
BBMP’s City Programme Management Officer Dr Balasundar said, “In 1970, the population was 30 lakh and we had 100 health centers. Now the population is more than one crore and we should have at least 200 health centres, but we have only 146. For 2016-17, `74 crore has been approved under National Urban Health Mission. All these health centres are approximately 30 years old. About `10 lakh each has been approved for renovation of 56 health centres in 2015-16 and another 62 centres will be renovated in 2016-17 with additional `10 lakh. It may include small repairs, painting or electrical work.”
Dr Nirmala Buggi, chief health officer, clinical, said, “Some core wards have three PHCs and that is because population is not uniform across wards. Slum population is more in some wards, lesser in others.”
In Bengaluru, all secondary and tertiary healthcare facilities are concentrated in the core 135 wards of BBMP that was previously the BMP. As a result, people from far-flung areas have to travel to the centre of the city. These facilities are decades old and new ones haven’t come up in a long time.