PHA-Exchange> DFID's strategy for improving health (2)

[claudio at hcmc.netnam.vn]

 from "S.K.Singh" <sambhavgwr at hotmail.com> -----
  
With some experience in seeing DFID support,  whether it is helping or not 
helping, we feel that it is not money that is required. When existing 
infrastructures and facilities are not performing to the lowest level, 
adding more is helping very little. It is a common site in most PHC-based 
systems that the doctor will be absent, or busy in private practice; most 
pathology systems are non functional, existing buildings are not maintained 
at all. Who stays at these facilities? Nobody. Then, by providing some 
additional money, what will actually happen? Nothing has succeeded in making 
it possible for most paramedics and doctors to stay at these centers over 
night, or even 8 -9 hours/day.
Money is only part of the solution. The desire to work is disappearing in 
Government hospitals. Most doctors who were appointed in newly created rural 
centers have either left or are only going  some days and drawing salaries. 
Surgical activities are already minimal. By adding advanced level systems 
would not help much. If there is no power how will many of the electric 
systems function? 
Computers at many centers are non usable. Manual data are being prepared. Our 
primary health data are totally false.
I have attended some DFID meetings at District level. It is nothing short of 
chaos. Everything is around how much is spent not about what is performing, 
who is performing and who is not and if not, why not?
sksingh


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