RURAL HEALTH SERVICES IN HARYANA

 

Rural Health Services in Haryana

In the era of globalisation, health is one of the human rights everywhere including Haryana- a prosperous state of Indian economy. Health which refers to the state of complete physical , mental , social and spiritual well-being and not merely an absence of the disease ; received prominent place in the construction of Human Development Index since 1990

Along with that there are social determinents also like safe drinking water, balanced diet, no air pollution,

 

World Health organisations pointed out the dependency of health  on the availability of better health infrastructure in terms of health Institutions , medical staff in medical Institutions and doctor patient ratio , doctor nurse ratio etc.

Therefore provision of health infrastructure ,health services and related health issues are one of the prime areas of concern .

Here is the attempt to go into details of Haryana Rural Health Services .

      There should be one sub health centre on 5000 population .

There needs to be one Primary Health Centre (PHC) for 30,000 population.

It is recommended that there should be one Community Health Centre(CHC) on

80000 hilly area and plain area 1,20000 population.

(As per data by Rural Health Statistics 2019-2020)

The condition of rural health services in Haryana is very miserable as per the above parameters of the Govt. of India are taken in to consideration.

  There are 3 points which are being  taken note of as follows.

 

1. The condition of Haryana Health Services which should have been as per the required norms set by Govt. of India as per rural population of Haryana 1.65 crores in Census 2011.

2. The condition of Haryana Health Services as per projected April 2021 rural population of Haryana 181 crores in 2021.

3.The actual condition of Haryana Health Services  infrastructure and staffing as per the available data of Mar/Jun 2020.

When Haryana Rural Health Services  Infrastructure Position is being analysed in detail a very miserable situation comes out

1.Sub Health Centre :-

*Required Sub Health Centres with respect to Rural Population of Haryana 1.65 crores in Census 2011 should be 3301

Where as required  sub health centres with respect to Projected Rural Population of Haryana 1.81 crores in 2021 should be 3609. But

the Current /Actual Position of Sub Health Centres in Mar/Jun 2020 is 2667 . Shortfall is very obvious.

2. Primary Health Centre :-

*Required Primary Health Centres with respect to Rural Population of Haryana 1.65 crores in Census 2011 should be 550 and Required  Primary Health Centres with respect to Projected Rural Population of Haryana 1.81 crores in 2021 should be 606, whereas Current /Actual Position of Primary Health Centres in Mar/Jun 2020 is 532. We are lacking in the required numbers .

 

3. Community Health Centre :-

Required Community Health Centres with respect to Rural Population of Haryana 1.65 crores in Census 2011 should be 137

and Required  Community Health Centres with respect to Projected Rural Population of Haryana 1.81 crores in 2021 should be 151, but Current /Actual Position of Community Health Centres in Mar/Jun2020 is 119. Need more CHCs as per requirement.

      If we go through the data of rural health services in Haryana , as per 2011 rural population of Haryana norms , we do not find required infrastructure upto the mark.

*We have deficiency of 634 Sub Health Centres, 18 Primary Health Centres and 18 Community Health Centres.*

    Similarly if we consider the Haryana projected  rural population  of April,2021, then it is still more miserable.

*Then we have deficiency of 942 Sub Health Centres, 74 Primary Health Centres and 32 Community Health Centres*

The staff which is required in these is also not as per required norms.

Haryana Rural Health Services Staff Position is also not up to the required needs. The details are as follows.

1) Specialists in CHCs:

It is recommended that there should following specialists  in each CHC:-

one each General Surgeon,Physician,Obstetrician &

Gynaecologist , Paediatrucian,Orthopedic surgeon 1

Orthopedics surgeon 1

Anaethetist-1

*Required specialists with respect to Rural Population of Haryana 1.65 crores in census 2011 should be  822

And Required specialists with respect to Projected Rural Population of Haryana 1.81 crores in 2021 should be 906

***Current /Actual Position of specialists in Mar/Jun 2020 is 27

There are only 27 specialists in position whereas we need 906 specialists with respect to Projected Rural Population of Haryana 1. 81 crores . So there is shortfall of  879 specialists.

2)  Medical officers in PHC :

We have at present 491 Medical officers for 532 Primary Health Centres where as we need 1212 Medical officers with respect to Projected Population of Haryana 1.81 crores in 2021. There is shortfall of 721 Medical officers .

 

3) Nursing staff at PHC and CHC:

* Required nurses at PHC and CHC with respect to Rural Population of Haryana 1.65 crores in census 2011 should be 2333

**Required nurses at PHC and CHC with respect to Projected Population of Haryana 1.81 crores  should be 2571

***Current /Actual Position of staff nurses in Mar/Jun 2020 is 2193

So in  required  phcs and chcs as per 2011 population , we have shortfall of  140 nurses.

Also there will be shortfall of 378 nurses with respect to projected Rural Population  of Haryana 1.81 crores in 2021.

4) Radiographers at CHC

At  present in 119 CHCs,

there are 38 radiographers where as we need 119. There is a shortfall of 81 radiographers. As per  2011 population there should be 137 CHCs , then shortfall would be of 99 radiographers.

As per April,2021 projected population, there should be 151 chc's , then there should have been 151 radiographers . But position at present is  that

radiographers are 38. So we will need 113 radiographers more in that case .

5) Pharmacist at PHC and CHC

There are at present 405 pharmacists in position. As per 2011 population, the need of pharmacists is 824, there by shortfall of 419. As per projected population in April, 2021, we need 908 pharmacists. Shortfall comes out to be of 503 pharmacists .

 

6) Lab technicians at PHC and CHC

There are at present 400 lab technicians in position.

As per 2011 rural population, the need of lab technicians  is 824, there by shortfall of 424.

As per projected rural haryana population in April, 2021, we need 908 lab technicians. Shortfall comes out  to be of 508 lab technicians .

 

 

   Seeing these conditions of Haryana Rural Health Services,

Jan Swasthya Abhiyan Haryana suggests and demands new creation of required posts and filling of vacant posts .

Dr R.S.Dahiya

State core committee member

Jan Swasthaya Abhiyan Haryana

1. The health services infrastructure should be immediately updated to face probable third wave of Covid pandemic or otherwise to provide quality health care facilities to citizens of Haryana

2. Allocate immediately more funds for health services infrastructure  strengthening.

3. Guarantee comprehensive , accessible, quality health services for all,Covid and non Covid patients.

4. Along with this there should be proper and immediate training of health work force on line or otherwise for covid 19 norms and post covid 19 situations.

5. At the same time the government should work on the social determinants of health which include

A) Promotion of food security by universalisation and expansion of the public distribution system.

B) Safe drinking water for all C) Sanitation facilities

D) Full employment to all

E) Education for all

F) Decent and adequate housing.

G)The gender dimensions of health should also be addressed adequately.

6. Guarantee comprehensive , accessible, quality health services for all women for all their health needs which includes but is not limited to maternal care.

7. Create more posts for the entire range of health personnel  in the public health system as per latest population requirements .

8. Regularise contractual employees and provide ASHAs ANMs and all levels of public health system staff with adequate skills, salaries and decent working conditions.

            Extreme inequality in access to health care services and the poor living conditions of people are responsible for the poor conditions of health in India and Haryana as well. 

       While people who can pay are able to receive world class treatment facilities , for most people in the state a major illness in the family plunges the family in to extreme poverty and destitution .

     The corona pandemic also shows this rich poor gap in the management of covid cases who need hospitalisation. The Govt should see remedies for these inequalities also.

  It is sincere effort of JAN SAWASTHAYA ABHIYAN HARYANA to make the people aware about these issues  so that people make Health as people's agenda and struggle for it collectively and request the Haryana Govt. to take immediate remedial measures.

With regards.

Dr R.S.Dahiya

Retired Sr Professor Surgery,

PGIMS, Rohtak. Haryana

 

(Data Source :Rural Health Statistics 2019-20)

And

http://haryanahealth.nic.in/Documents/CHC.pdf

Documents/PHCsubcenter.pdf

http://haryanahealth.nic.in/infrastructure.htm/

Mission https://ejalshakti.gov.in

 

Seeing these conditions of Haryana Health Services,

Jan Swasthya Abhiyan Haryana suggests and demands :

1. The health services infrastructure should be immediately updated to face probable third wave of Covid pandemic or otherwise to provide quality health care facilities to citizens of Haryana

2. Allocate immediately more funds for health services infrastructure  strengthening.

3. Guarantee comprehensive , accessible, quality health services for all,Covid and non Covid patients.

4. Along with this there should be proper and immediate training of health work force on line or otherwise for covid 19 norms and post covid 19 situations.

5. At the same time the government should work on the social determinants of health which include

A) Promotion of food security by universalisation and expansion of the public distribution system.

B) Safe drinking water for all C) Sanitation facilities

D) Full employment to all

E) Education for all

F) Decent and adequate housing.

G)The gender dimensions of health should also be addressed adequately.

6. Guarantee comprehensive , accessible, quality health services for all women for all their health needs which includes but is not limited to maternal care.

7. Create more posts for the entire range of health personnel  in the public health system as per latest population requirements .

8. Regularise contractual employees and provide ASHAs ANMs and all levels of public health system staff with adequate skills, salaries and decent working conditions.

            Extreme inequality in access to health care services and the poor living conditions of people are responsible for the poor conditions of health in India and Haryana as well. 

       While people who can pay are able to receive world class treatment facilities , for most people in the state a major illness in the family plunges the family in to extreme poverty and destitution .

     The corona pandemic also shows this rich poor gap in the management of covid cases who need hospitalisation. The Govt should see remedies for these inequalities also.

  It is sincere effort of JAN SAWASTHAYA ABHIYAN HARYANA to make the people aware about these issues  so that people make Health as people's agenda and struggle for it collectively and request the Haryana Govt. to take immediate remedial measures.

With regards.

Dr R.S.Dahiya

Retired Sr Professor Surgery,

PGIMS, Rohtak. Haryana