How PPP model changed the face of public health care in Aruchal Pradesh

Anpum (Aruchal Pradesh), April 24: Until a couple of years ago pregncy was uvoidable for women in this tiny village of Aruchal Pradesh. Uvailability of contraceptives in the defunct Public Health Centres not only led to unwanted pregncies but also lack of spacing and materl morbidity, filly resulting in unhealthy children, with bleak chance of survival.

Thirty year-old Christi Perme (me changed) never wanted to have four children, keeping in mind her family’s economic status. But she ended up becoming pregnt four times in the first six years of her marriage as neither she nor her husband could avail of any type of contraceptives, for which they still have to travel miles through hilly terrain, without the surety of returning the same day in case a downpour damages the muddy roads passing through deep forests.

Such a situation prevailed some six-seven years ago, but now the tribal women in this village either undergo tubectomy or use any other type of contraceptives to block their chances of pregncy.

This was made possible after the government decided to hand over the public health centres to NGOs under the Public Private Partnership (PPP), which proved to be a boon for the state, which has one of the highest Total Fertility Rate in the country with a population of mere 1.4 million.

“It will be wrong to say that we had no idea about contraceptives. In fact it was the uvailability of any type of contraceptives here which led to unwanted pregncies among our women. Now we do not become pregnt if we do not want to. Availability of contraceptives in the PHCs has helped us plan proper spacing in the births of our children,” Dome Dini, a ANM (Auxiliary Nurse Midwife) with Anpum PHC now run by Karu Trust, told IANS.

Karu Trust, an NGO, has been tasked to mage 11 PHCs by the Aruchal Pradesh Government, all in remote areas which takes days to reach from the state capital.

According to the villagers, PHCs which used to be in a dilapidated condition and could not provide medical services even to people suffering from common cold, after being operated by Karu Trust, are able to provide all basic medical care including family planning. Institutiol deliveries have increased by 30 percent and home deliveries have come down to a great extent.

Under then PPP model, Karu Trust is given Rs.30 lakh annually by the government to mage each PHC in Aruchal Pradesh. The PHCs now have IT-based essential supply chain magement system for drugs and vaccines, reproductive and child health programmes for tribals, and delivery of generic drugs along with dental care facilities.

In the initial years Karu Trust also received funds from Population Foundation of India to strengthen its medical care facilities in the PHCs.

“There is no doubt that Karu Trust is doing a marvellous job. In fact by witnessing the work of the NGO and the satisfaction of the people in the remote areas, I want to give the work of more PHCs to Karu Trust, so that we can ensure our people in the remote areas do not die due to lack of medical care,” P.N. Thungan, Mission Director tiol Health Mission, told IANS.

Unlike earlier, now Karu Trust posts medical staff in PHCs as per the Indian Public Health Standards (IPHS). The staff of the PHC and sub-centres reside 24X7 inside the respective campus.

“There is a drastic change in the medical services provided by the PHCs after they have been given to the NGOs to mage. It was difficult to mage the PHCs in the remote areas with limited manpower and the difficult terrain of Aruchal; so in such a situation handing over work to NGOs was the best we could do,” Raja Dodum, nodal officer for tiol Urban Health Mission, told IANS. (IANS)