Jaipur, July 29, 2010
’36 per cent absenteeism was found in doctors and on an average 27 per cent of it was observed in 5 categories of health providers’ Says a study conducted by CUTS International in Tonk district of Rajasthan in partnership with Transparency and Accountability Programme (TAP) of the Results for Development (R4D) based in Washington DC.
900 unannounced on-spot observations were made for 35 consecutive days except on Sunday by 150 monitors selected from the catchment of the PHCs. One of the reasons behind absenteeism can be the poor infrastructure facilities for which interesting correlation was found. Other than that absence of medicines and other medical facilities at the centre and also poor implementation of community monitoring, which are integral part of NRHM, were found poor.
Along with the participatory absenteeism tracking, CUTS utilized Citizen Report Card for 902 people to know their perception about the status of health service delivery in the district. In this project titled ‘Ensuring service delivery through community monitoring of health services in 30 health centers in Tonk district of Rajasthan’ CUTS kept civic engagement and community monitoring aspect of National Rural Health Mission (NRHM) as a central point
- 69 % of respondents say that they either get no medicines or only few medicines
- 47 % reports that they don’t know about VHSC and only 54 % says that they have never met any VHSC member.
- 82 % of the people reported that they do not know any existing grievance redress mechanism.
- 44 % of the respondents found not to be satisfied with health service delivery.
- 32 % of respondents says that they have not received any cash assistance under JSY
- 37 % says that 24-hour delivery facility is absent at their PHC
- 34 % says that no one has visited their home to know their health status
- 24 % of JSY beneficiaries were not given iron tablets and 25 % were not done any lab test
To understand their viewpoint, the service providers were also interviewed and found that 69 percent of them want to change their PHC. At the same time, 12.5 percent of the respondents were found to be dissatisfied with their jobs and 25 percent of the respondents say that they don’t get leave on demand. 41 percent of the service providers say there is shortage of staff and 12 percent of the respondents reported somebody having left a job recently.
With the purpose of presenting the findings and the recommendations to the key policy makers at the state level and to a wider audience, as part of the evidence based advocacy, CUTS organized the State Level Dissemination cum Advocacy Meeting in Jaipur (at Hotel Jaipur Palace, Sahakar Marg, Tonk Road, on.
George Cheriyan, Dirctor, CUTS international said that absence of governance and accountability is the major obstacle in the process of service delivery and presented the objective and overview of the project. Om Prakash Arya, Project Coordinator, presented the key finding.
Rao Rajendra Singh, MLA, Rajasthan, Ms. Shyama Nagarajan, Health Specialist and Incharge of Rajasthan Health System Development Project, Shiv Chandra Mathur, Executive Director, Rajasthan Health System Resource Centre, representatives from various civil society organizations in Rajasthan, Representatives of Media and PRI and various other stakeholder groups attended the meeting and shared their experiences and responses to the presentations.
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