Dr. M. Najeeb Durrani, Epidemiologist, Member Global Outbreak Alert and Response Network (GOARN), Add District Health Officer, Islamabad
To execute the Health Services in the rural area there has been a dire need to fulfill the gap created by the deficient human resource (HR) component in Islamabad Capital Territory (ICT). As in the absence of sufficient HR, the Health delivery System has been weak and could not meet the basic healthcare delivery standards. Secondly the population of Islamabad was 0.3 Million in 1981 when the District Islamabad was created, but now it has grown to 1.493 Million (Rural: 510,998, Urban: 9, 82,893).
Over the years, the rural population has been increased tremendously due to infrastructure development, urbanization, settlements of labor working in Islamabad hailing from KPK, Punjab and Northern areas and settlements of retired government servants in the rural areas, besides development of public housing societies and haphazard dwellings has marred the communication, transport and provision of health care services a challenging job for the concerned authorities thus making it extremely difficult to carry out health functions and tasks. As a result, the work load has been increased excessively in RHCs/BHUs under the control of Health Department ICT, while the staff requirements/manpower or strength of the ICT Department could not grow in the same proportion to the required strength due to persistent ban on recruitment and existing posts getting vacant due to the retirement/ resignation or death of officials.
Meeting on Prime Minister’s directive to discuss and implement the needed reforms
In this regard to improve the service delivery and strengthen the existing health care delivery system in ICT, a meeting was held in the Prime Minister House on 27th June 2016 under the chairmanship of Secretary to the Prime Minister Mr Fawad Hassan attended by all the senior Authorities from Islamabad Administration, Metropolitan Corporation, CDA, CADD, PIMS, FGSH. The Following were decided in respect to the Health Department ICT:
The meeting was aimed to improve and Strengthen Health care delivery system in ICT through the existing infrastructures of the Health Department and up-gradation of four government health facilities in the Islamabad Capital Territory rural into MNCH centers with the assistance of PIMS, and proper functioning of the Basic Health Units of the Health Departments by placement of post Graduate Doctors from FG Ploy Clinic.
The Following were decided in respect to the Health Department ICT:
- Requisition for the Doctors on vacant posts to be sent to FPSC for recruitment while in the meantime Doctors may be selected for contract appointment through advertisement.
- Three RHCs and one BHUs Shah Allah Ditta to be strengthened and upgraded into MNCH services.
- As a stop gap arrangement doctors (post graduate students) and assisting Nursing staff to be posted from PIMS on turn by turn rotation basis in these facilities for a specific period enabling them to orientate themselves about provision of community health care as per following arrangements.
- For the quality management of the Health Care Facilities and ensuring punctuality for the provision of quality and timely care, transport facility will be provided to all the health facilities visiting doctors, as per decision a case has been taken up for 18 Suzuki Cultus. As a response a case has been prepared at an amount of Rs 21,042,000/- to be procured be with assistance of Prime Minister Secretariat.
- Doctors to be given promotion as per rules available and in place in the Punjab Government regarding their service structure thus thereby enabling them to enjoy a better service structure for timely promotion.
- Regarding creation of posts, the directive is to make efforts for the establishment of new posts for the establishment of a Health Directorate.
- Government of Punjab will be requested for Dengue Control and other preventive controls.
- Accordingly compliance has been made after reaching mutual understanding between the concerned authorities/stake holders as a stop gap arrangement till such time that the ICT Health Department develops its own human resource and necessary infrastructure.
- Regarding provision of missing equipment and machinery for the provision of quality MCH services, the list had been prepared in consultation with doctors from federal hospital and other experts an estimated list worth around 37 Million that is being shared with the PM House Secretariat for the provision of financial assistance.
- As per directive the Public Health staff that had already been placed at the disposal of the Mayer Office from the Health Department and the Civil Defense Department may now be placed at the disposal of Commissioner Office Rawalpindi for training and putting up epidemic response to the suspected Dengue Outbreak in the forth-coming season in rural areas of Islamabad adjoining Rawalpindi District.
- The Doctors from PIMS have joined the Health Department while arrangements are being made to appoint doctors from FG Poly Clinic in Basic Health Units after completing survey of all the Basic Health Units (BHUs) by the FG poly Clinic Senior Staff. This office has already received a list of Doctors from FG poly Clinic that was to be posted at BHUs.
This plan for the strengthening of the Health Care Delivery System would surely bring a great change in the long run and it would not only improve the health status of the general public in the rural areas of Islamabad but would also remove grievances of the Doctors by providing them their timely promotion. The above mentioned steps would also compensate for the gaps in the provision of quality health care delivery through the Rural Health Centers (RHCs) and Basic Health Units (BHUs) in ICT Rural.