A public-private partnership helps revive healthcare access for people in Nagaland
For the first time since 2007, last month, the District Hospital at Mon – one of Nagaland's most backward districts – witnessed major activity. A successful caesarean operation on a woman had helped deliver a healthy baby.
This was possible only after the hospital tied up with Medicine Sans Frontiers (MSF), an international organisation that helps provide healthcare to people in difficult conditions or deprived communities across the world. The MSF took over the hospital in July 2010 when it was on the verge of collapse due to lack of infrastructure, manpower and financial resources.
Between 2010 and now, the face of the hospital has undergone a sea change. It is buzzing with activity, and sports a proper out-patient department, in-patient facilities and regular supply of drugs. “Uninterrupted electricity and water supply are issues that need to be sorted out urgently as these are hurdles in maintaining a cold chain and starting blood storage facilities, a must for any functional hospital,” says Andrea Ciocca, Field Coordinator, MSF.
Trained staff and doctors – though still less than the required numbers – are available in the hospital that has been in existence since 1965. A new OPD building was built from money provided by the Prime Minister's Special Project Funds in 2009. The number of patients has also gone up substantially and each patient is given a card which has all his/her health details. “The hospital manages it waste scientifically through its own resources and now the system is being replicated in many other hospitals,” Mr Ciocca says.
The management of the hospital in now with the MSF but it is the Hospital Management Committee, chaired by the District Magistrate that takes all important decisions. Members of the community are also in the committee to ensure their participation in the running of the hospital.
The revived hospital has come as a boon to the local people, particularly women who had to travel to as far as Dibrugarh in Assam for difficult a delivery which, in itself, was a grave risk to the mother and child considering the road conditions. People now don't have to ignore or travel to far off places for minor ailments. “Our contract is until July 2013 but we are hopeful it will be extended and by the time we leave, the hospital would be self- sustaining.”
Another private-public partnership which is proving to be successful is the primary health centre (PHC) at Longpang in Tuensang district where the church contributes generously for running a canteen and the people themselves chip in to ensure its financial sustainability. The farmers in the region have been trained by NABARD in banana and citrus plantation. This gives them a regular income, a small component of which is used for running the PHC.
The funds have helped the PHC here to pay additional wages to accredited social health activists (ASHAs) for motivating and bringing women for institutional deliveries which continues to be a major issue here as is the shortfall in the availability of contraceptives due to distance and difficult terrain. With some innovations, the facility here has a HIV ward which is known as Special Ward to avoid discrimination and stigmatisation of HIV infected people, particularly women who are biologically more prone to HV infection and have a higher chance of contracting opportunistic infection.
The local church here has also partnered with the hospital to tackle HIV related issues. Such an active role has not been taken by any church even in the so-called progressive districts, the villagers point out.
Another area that the facility deals with is mental health. These are lifestyle-related stresses and those caused by HIV stigma or due to lack of proper nutrition.
Under the National Rural Health Mission (NRHM), the State government has also reached an agreement with the Nagaland police to make healthcare facilities available to the civilian population in all 16 police hospitals, says Kika Longkumer, Deputy Director, NRHM.