State-run basic health units (BHUs) in the twin cities of Islamabad and Rawalpindi are unable to provide free of cost prescribed medicines at in-house pharmacies to patients. An overwhelming majority of patients visiting BHUs during the month of July 2011 complained about the unavailability of free-of-cost prescribed medicines at in-house pharmacies.
According to monthly statistics revealed by FAFEN Governance Monitors, an Islamabad-based NGO, 85 percent of the monitored BHUs had stocks of medicines, while 89 percent were issuing free-of-cost medicines to the patients. However, 86 percent of the 90 patients interviewed at various BHUs complained that not all prescribed medicines were available and had to be purchased from the market.
Compared to monitoring reports on BHUs since April last year, the stocks, and availability and issuance of free-of-cost medicines has improved by at least nine and five percentage points, respectively, the report said. However, a large number of patients’ complaints in July this year suggested that patients’ needs for medicines were not being adequately met at these primary healthcare facilities, despite the improvement.
About infrastructural issues, the report said in July this year, the monitored BHUs lacked basic amenities, essential equipment, maternal health facilities, and the staff to run disease control programmes. It said 65 percent lacked wheelchairs, 49 percent did not have stretchers, 37 percent lacked working oxygen tents, 22 percent did not have sterilisers and 12 percent did not have syringe cutters.
“Basic amenities like clean drinking water, washrooms with running water and properly shaded waiting areas were not available in more than 15 percent of the monitored BHUs.” The report said 80 percent of the BHUs did not have mini-laboratories, including the one in Islamabad Capital Territory (ICT), one out of two in FATA, 90 percent in Punjab and at least 60 percent in other regions. Additionally, 31 percent and 26 percent of the 110 BHUs did not have residential houses on premises for doctors and other staff.
The report called for providing staff residence on premises so that doctors were readily available and patients received timely treatment. The report said maternal health was also in a state of neglect. Thirty-nine percent of the monitored BHUs did not have maternity beds, while 30 percent lacked labour rooms. More than 70 percent of the BHUs in Balochistan and Khyber Pakhtunkhwa lacked labour rooms, as did a quarter in Sindh and eight percent in Punjab. Around 68 percent of the BHUs in Khyber Pakhtunkhwa, 57 percent in Balochistan, 31 percent in Punjab and 19 percent in Sindh did not have maternity beds.
Delivery kits were also not available in 16 percent of the monitored BHUs nationwide. BHUs also lacked staff to treat TB patients and to run the Control of Diarrheal Diseases (CDD) and Malaria Control Programme (MCP). As many as 40 out of the 110 BHUs did not have staff to treat TB patients. The report said 92 percent of the monitored BHUs nationwide did not have generators for power backup, terming it a worrying aspect given the frequent power outages in the country.
“These included all BHUs monitored in ICT, FATA and Balochistan, 95 percent each in Punjab and Khyber Pakhtunkhwa and 69 percent in Sindh. FAFEN monitors visited 110 BHUs in 66 districts in July 2011. Sixty-two BHUs were visited in 31 districts in Punjab, 22 in 15 districts in Khyber Pakhtunkhwa, 16 in 10 districts in Sindh, seven in as many districts in Balochistan, two in as many agencies in FATA and one in ICT.
