Kannada, Kannadiga, Kannadigaru, Karnataka,

Kannadigarella ondaagi Kannadavannu ulisona, kalisona and belesona

Campaign for the Revitalization of Primary Health Centres (2006 onwards)

Campaign for the Revitalization of Primary Health Centres (2006 onwards) Print
This campaign was undertaken by the Janaarogya Andolana – Karnataka (People’s Health Movement – Karnataka) to address crucial issue of state withdrawal from health services and the situation of Primary Health Centres (PHCs) which were being rendered dysfunctional all across the state. There are about 1600 primary health centres in the state spread across 27 districts.Though India was a signatory to the Alma Ata Declaration of 1978 which declared the progressive mechanism of the state to ensure Health for All by 2000’, in the post-reforms era, the state fund allocation was reduced to a dismal 0.9% of the GDP in India! In a socio-political atmosphere where there is unregulated privatization of medical practice allowed on the one hand, and state is steadily withdrawing from health services, especially the primary health care, on the other, access to Primary Health Care is becoming increasingly difficult for the vulnerable communities and the poor in general. Besides, as the government itself is pushing the agenda for the privatization of primary health centres in the name of public-private partnership, people’s right to health is being increasingly denied. In this context, JAA-K took the initiative of mobilising people towards the issue of revitalizing PHCs. The important milestones in this process were as follows:

a) Dialogue with the State:

April 7th being the People’s Health Day, JAA-K decided to hold a dialogue with the State on the eve of this day, viz. 6th April, 2006. The meeting was held Ashirvad, Bangalore from 2.30 – 4.30. Nearly 100 delegates representing various organisations and various districts presented their findings on the study conducted in sample PHCs. The Deputy Health secretary and Dr. Vijaylaxmi, the chief health officer of BMP attended the sessions. Nearly 100 delegates from various districts attended the dialogue with the state. Dr. Vasundhara chaired the sessions. Presentations were made from the districts of Raichur, Kolar, Kanakpura (Bangalore Rural), Tumkur, Bangalore Urban on the state of Primary Health Care and the conditions of the availability of services at the Primary Health Centres. These presentations were based on the surveys of PHCs done in these districts. The common emerging issues were,
§ Non availability and irregularity of the Professional staff such as Medical officers, Nurses and Lab technicians and Pharmacist (Irregularity/regular absenteeism and private practice during work hours)
§ Large number of vacancies of medical staff in PHCs;
§ Unavailability of adequate amount of appropriate drugs/essential drugs in PHCs;
§ Anti-people and unfriendly attitude of the PHC staff towards the poor patients;
§ Corruption and blatant demand for money for all services and turning away of people due to the poor patients’ incapacity to pay.

The responses of deputy health secretary and the chief health officer were not adequate and their attitude of putting everything back on people left the people disappointed. Hence the group decided to meet again to choke out the future strategies.

b) State level brainstorming meeting on Right to Primary Health Care

A state level brainstorming meeting of organisations/ networks interested in strengthening primary health care was organised on April 25th 2006 at Vishranti Nilayam, Bangalore. About 25 people from various organisations across 10 districts attended the meeting. The meeting was called to ensure that a truly vibrant people’s movement emerged and that the movement worked towards ensuring access to primary health care.

Dr. Gopal Dabade shared about Jagruthi’s work in Khanapur taluk of Belgaum district. He said that 350 SHG’s had been started in 22 villages. Low sex ratio was one of the problems in the district. Eight months back in the PHC at Beedi village, the doctor sent back a lady who had brought her husband, because she did not have money. She began begging to meet her medical needs. The SHG federation members discussed the issue and SHG members of neighbouring villages decided to protest in front of the PHC. The decision was conveyed to the DHO, who came to the village immediately, transferred the doctor, brought medicine supplies and revamped the PHC. Jagruthi along with the people decided to turn the day of action into a day of awareness, since their demands had been met, and they invited the same DHO to spread awareness. Later, a film on the ‘action at the PHC and the awareness campaign on primary health care’ in Belgaum was screened.

Other Participants from Kolar, Bidar, Raichur shared about their experiences about the situation of PHCs in their respective districts. The common emerging issues were corruption, prescriptions to be bought from outside, lack of cleanliness, lack of staff, etc. She said that people were selling land and livestock to access medical care in private hospitals because of pathetic state of affairs in Government health centres. She said that lack of awareness led to people being exploited.

All the participants expressed the need for more training in health related issues. The need for training materials in Kannada was also expressed. The information about

The participants then shared about their expectations from the meeting, which included the following:

§ Training to NGOs and activists
§ More training and reading material in Kannada
§ Plan for one year – collectively and individually
§ To work collectively on making PHCs functional
§ Take a stand and not step backwards
§ Collect information / documentation
§ We must bring back info in the next meeting
§ Information to Government about our work
§ Prioritisation of action
§ Resources (human, money and materials)
§ Campaign materials
§ Information about Primary Health Care

A brief action plan (with time frame) was discussed which included expanding the group in each district, meeting of large group, trainings (4th – 5th month) and a PHC survey.

c) State level Strategy Planning Meeting on Right to Primary Health Care (RPHC)

A state level Right to Primary Health Care (RPHC) strategy planning meeting was held at Ashirvad, Bangalore on Sunday, June 25, 2006 on the theme “Revitalising PHCs”. The meeting focussed on strategy planning for the revitalisation of Primary Health Centres within the framework of right to health care. About 18 representatives from 8 districts attended the meeting.

The issues that were discussed were,

1. Campaign priority
a. Information dissemination about Primary Health Care to NGOs and communities.
b. Information dissemination regarding health and primary health care activities of the Government to NGOs and communities.
c. PHC survey
d. Documentation of cases of denial of health care.
e. Letter campaign.
f. Block/ district level public hearings.
g. PHC Action (Dharnas, Discussions, PHC level public hearings, etc.)

2. Information required from the Government

a. Structure of health system, staffing pattern and staff responsibilities.
b. State health budget (district-wise and programme wise).
c. Budget allocated to Panchayati Raj Institutions for health.
d. Recommendations of the task force on health.
e. Details of health programmes of the government (including health insurance schemes).

CHC as a resource centre agreed to be the contact for the campaign and also to provide necessary logistical support with information and coordination.

d) Weekly core meetings

Regular weekly core meetings of the core members in the Right to Primary Health Care Campaign (Prasanna, Kshama, Saras, Chander, Naveen and Premdas) took place at CHC mostly on Wednesdays discussing the week by week progress of the programme and the details of the follow up that was required. .

e) Right to Information (RTI) training

A training on the topic ‘Using Right to Information in the Right to Health Care Campaign’ was conducted from 9.30 a.m. to 2.30 p.m. on 25th July 2006 at Christian Medical Association of India (CMAI). It was attended by about 30 people from various organisations. Mr. Cyriac Anand from Sakshi trust conducted the training on the know-how of Right to Information Act.

Issues raised in the RTI training workshop for PHCs were (1) macro data at the state level, health budget and its distribution district-wise, vacant positions of staff, health programmes, procurement of drugs etc. (2) micro data: Staff, functions and responsibilities, facilities such as infrastructure, medical and other services, budget and finances, medicines and availability, equipment, monitoring and inspection, documents

f) State level meeting on Right to Health Care Campaign

A state level meeting on Right to Health Care Campaign was held at CMAI office on Cunningham Road, Bangalore on 25th August, 2006. Various organisations including GMO, Kolar and NJMO Raichur, participated in the same. The main issues of the meeting were report of district meeting, address data base, core group meeting on Wednesdays, budget preparation (for human resource and campaign material), right to information act to be use as a tool for the campaign, background information prepared so far and translated. The meeting ended with the discussion on multiple strategies for the consolidation of the campaign, to form a survey format as a tool for advocacy and to form district level committees for the promotion of the right to primary health care.

g) Revitalising Primary Health Care (RPHC) Planning meeting

The Revitalising Primary Health Care (RPHC) Planning meeting was held at CHC on 4th January 2007 from 10.am to .3.30 pm. The participants included representatives from 5 districts and different networks. The agenda of the meeting was sharing of district processes, planning for state-wide action on February 1, 2007, state level action to address health issues, strategies to be adopted and division of responsibilities for different districts. The participants narrated their experiences regarding health systems in various districts. It was decided that a state level action would be held to raise issues of health care all across Karnataka state. Lathi campaigns; targeting family and welfare department; constant advocacy and approaching elected representatives such as MLAs and MPs were discussed as strategies to be adopted in the future. CHC took responsibility to financially support Chitradurga, Tumkur and Mysore districts. Oblesh was to be the contact person. Premdas was involved in the preparation of a pamphlet ‘Right to Health’ in Kannada which was distributed in all the districts.

h) State-wide Public Action on Revitalising Primary Health Care (RPHC)

On February 1, 2007, action took place across 13 districts in the state where memorandums were submitted to the District Health Officers (DHO) and the Chief Executive Officers (CEO) of Zilla Panchayats regarding the state of health systems in their districts. People in large numbers gathered and held a dialogue with the CEO and DHO of their districts. Press Conferences, rallies and submission of memorandum were the common factors across all these districts. The action was well covered and reported in all major vernacular newspapers and local televisions.

In Chamarajnagar, JAA-K members had a dialogue with the District Health Officer (DHO) for 3 hours and various people presented testimonies in front of the DHO. Kolar too had a series of meetings with the Chief Executive Officer (CEO) of the Zilla Panchayat (ZP) and were evolving series of actions for improvement of services. There was some visible change in some of the PHCs. About 50 women of various SHGs in Gadag District took out a rally and presented memorandums to the district administration. In Koppal district, JAA-K members conducted a press conference before 1st February and had all the newspapers highlighting the plight of the PHCs in their district. JAA-K members in Raichur district had collected data from 50% of the PHCs and had presented the consolidated data to the district authorities. As a follow up of this, the Chief Executive Officer (CEO) of the Zilla Panchayat (ZP) agreed to tackle the infrastructure related issues of the PHCs in this year’s action plan. There were also a series of actions by Jagruti and other JAA-K related organizations in Belgaum District which resulted in some visible changes at the PHC level.

CHC in collaboration with Obalesh of the Human Rights Forum for Dalit Liberation (HRFDL) supported action directly in three districts namely Mysore, Chitradurga, and Tumkur were covered.

In Mysore, over 170 people from 4 taluks – H.D.Kote, Nanjangud, Hunsur and Mysore participated in the action. Over 100 of the participants were women. The issues covered in Mysore related to access to drugs, functioning of the primary health centre and social determinants. Media persons from different Kannada publications like Prajavani, Vijaya Karnataka and K.P. Andolana covered the event.

In Chitradurga, 110 people participated in the action. Of these, 93 participants were women. Organisations who participated included HRFDL, Dalit World, SPIN network, Sadhana Samasthe, and so on. The issues covered in Chitradurga related to availability of health personnel, availability and access to drugs and with regard to functioning of the primary health centre. Media persons from different Kannada publications like Prajavani, Vijaya Karnataka and Praja Pragathi covered the event.

In Tumkur, 118 people participated in the action. Of these, 78 participants were women. Organisations who participated included Matanga Women’s Association, MMO, REDS, Jeevika, DJS and some other development organisations from Tumkur. As the result of the rally and meeting, a health action committee was formed in the district. Media persons from different Kannada publications like Prajavani, Samyukta Karnataka, Vijaya Karnataka and Praja Pragathi covered the event.

Last Updated ( Tuesday, 29 May 2007 )

October 22, 2007 - Posted by | Primary Healthcare Centers - PHC's

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