With overburdened staff in the grass-root level, government schemes, which form the tenets of the healthcare system, totter in its reach to the people.
While 64 out of the 444 posts for female Junior Health Assistants (JHA) - formerly called Auxiliary Nurses and Midwives - remain unoccupied in the district, a staggering 165 posts out of 228 JHA (Male) posts are vacant. These grassroot workers form the crucial link between doctors or government officials and the community.
With there being massive vacancies in other, higher-level posts - there are only 24 specialists in the district, compared to the 42 posts sanctioned; 13 vacancies in general doctors, four dentist posts vacant, and around 45 per cent of lab technician posts not filled up - the healthcare system in the district remains in a perpetual level of stress.
According to statistics obtained from the district health department, among the lagging schemes attributed to the shortage is the documentation of pregnant women (79 percent achievement in the last fiscal year between April 2012 and March 2013), dengue, DPT, polio, measles vaccinations (hovering between 85 and 87 per cent achievement of the targets), testing of persons under the AIDS prevention programme (79 percent for general public, 72 percent for pregnant women).
A JHA (female) is, ideally, supposed to handle 3,000 persons in rural areas and 5,000 in Urban areas, said a health department official. However, in places urban areas such as Ullal, a worker handles over 11,000 people.
“Even in rural places like Boliyar (in Mangalore taluk), four sub-centres are manned by only one female worker,” said a Mangalore Taluk Health official.
A female health worker primarily looks after Maternal and Child Health, which involves documentation of pregnant women, deliveries, administering vaccinations, monitoring anganwadi and school children; implementing National Rural Health Mission schemes; identifying beneficiaries for subsidy schemes such as Vajpayee Arogyashree; record keeping and calculating finances for all schemes.
The male worker is engaged in surveillance and control of vector-borne diseases, AIDS control, conducting malaria and tuberculosis programmes, fever surveys, door-to-door awareness campaigns among others.
“Obviously the schemes get affected. Though it is specified that a worker should visit an area once a week, it is impossible. Spreading awareness about communicable diseases, or proper documentation of maternity, infant health is affected,” said Jayaram Poojary, district president of the Karnataka State Senior and Junior Health Assistants Association.
Contract from private hospitals
In a recent meeting, newly-appointed Health Minister U.T. Khader had suggested getting support staff from private institutions on contract basis to deal with the shortage. While the Department has not formally received any such order, many officials believe this cannot be a solution, as the 1.5 years of training for JHA cadre has not been replicated by private institutions.