Staff resent Health Department stance

KOCHI: The public health staff in the state are up in arms against the Health Department for what they term as biased exclusion and a threat to the decentralised structure of the state’s health services. The issue involves the exclusion of health supervisors (HS) and lady health supervisors (LHS) from the district-level review meetings.As per the government order 132/204/H&FWD dated 23 June 2004, on the fifth working day of every month a meeting must be convened by the district medical officer with various medical officers and public health staff. The agenda of the meeting includes the review of various health programmes, field activities, assessment of work, co-ordination of activities and most importantly preparing a plan for the month.But for the last four months, the LHSs and HSs have been excluded from these meetings. “The LHSs and the HSs head the public health staff at the block level. Their exclusion from the district-level review meetings will affect the effective functioning of the public health system. Moreover, it is in these meetings that the block-level programmes for the month are scheduled. The decisions taken in these meetings are then passed on to the coordinators at the next levels on specified dates in the succeeding days. So this exclusion affects the whole structure of the public health system,” said chairman of the Kerala Public Health Staff Action Council, M M Ashraf.According to the Directorate of Health Services, the district-level review meetings have been compensated with additional meetings. “In the old system, we used to find it difficult to accommodate the doctors at various levels. We also have separate meeting for the LHSs/HSs. So this will not affect the health system”, Dr P K Jameela, director of health services, said.But the pubic health staff dismiss the claims of the director. “The additional meetings have no prescribed minutes or agenda. There are no fixed dates to hold the meetings. In January no meeting was held, in December it was held at the end of the month. How could we make plans for the whole month with a meeting held at the end of the month? Besides, this is a blatant violation of the terms of the government order. The order was prepared on the basis of a detailed study by a European Commission-supported Sector Investment Programme. It is highly inappropriate to change such an order and disrupt the structure at the grassroots level,” said Ashraf.Each LHS/HS caters to a population of 1 lakh to 1.5 lakh people under them as per the survey in 2004. This is apart from 40 to 60 grassroots-level workers and their first-level supervisors. The LHSs and HSs also play a pivotal role in programmes like the National Anti-malaria Programme and the Revised National Tuberculosis Control Programme. Prevention and control of communicable diseases at the block-level, coordination of junior public health nurses and health inspectors are some of the other functions under the purview of the health supervisors.