ESTATE
HEALTH & URBAN HEALTH
The Vision of the
programme is to ensure a Healthy and productive plantation population
The General objective of the programme is to reduce the disparity that
exists between the plantation sector and the other sectors of the country in the
provision of Basic health care services.
To achieve this objective the strategies
adopted are
1.
To provide quality health care services delivery as in other
parts of the country .
2.
To mobilize the resources available equitably to maintain in
the service provision.
3.
To empower the plantation population to take decisions to
improve their quality of life.
Curative Care Services
It was decided to take over 50
hospitals but so far only 21 were taken over.
Health ministry of Central province
had decided to take over 3 more hospital namely West Hall, Ragala and Protof,
and Health Ministry of Uva had decided to take over Warwick, Udaweriya and
Unugolla and due to the shortage of funds in the Community development ministry,
the New Construction and repair work is delayed for 2004. Out of these 21
Hospitals which were taken over 5 institutions doesn’t have any ambulances to
transport patients on any emergency and because of this three hospitals are
functioning only with OPD in Kegalle district even though the necessary
buildings are available.
Public Health services
The
Preventive Health Care Provision in the estate sector was not considered as part
of the responsibility of the Medical Officers of Health in the resent past
though it had been their responsibility before the establishment of the SPC and
JEDB. When the rest of the country under took to re-demarcate the health areas,
the PHII ranges and the Family Health Workers Areas, this exercise was not
carried out for the estate sector though on paper the population covered by the
MOOH included the plantation sector too. With the concurrence of the provincial
authorities cabinet approval was sought for creation of new MOH areas to serve
the estate population. The approval is given for four new MOH areas in Central
Province and two new MOH areas in Uva province with the necessary cadre, 06
Divisional Medical officers of health, 09 Medical Officers of Health, 28 PHII
and 110 PHMM.
At present wherever possible the
MOOH in most of these areas are extending a planned MCH care to the estate
sector. This activity is very much handicapped because of the embargo on
vehicles for the provincial health authority though additional MOOH are being
appointed to these areas. They also carry out School Health Activities on an
organised planned manner.
Out of the 39 PHII trained for the
estate sector, only 13 were appointed in the Central, Uva, and Sabaragamuva
provinces and the rest were sent to North and east provinces due lack of cadre
provision at that time.
Partnership Building
A committee on Estate Health is
formed at the central level and had only one meeting.
Provincial steering committee
meetings on Estate Health were held in the Uva , Sabragamuwa and Central
Provinces to streamline the taking over of the Estate Hospitals. The members of
the committee were multisectoral involving all the stakeholders. The meetings
were chaired by the Chief secretary / Provincial ministers/ or Provincial
secretaries of health.
There were 7 meetings held in Uva
province while Central and Sabaragamuva had 4 and 5 respectively.
Out come and Impact
Provision of quality primary care
and preventive care is achieved to a certain extent but it is rather very early
to make any comment on this.
Other issues
There is a delay in functioning of
these estate hospitals already taken over, effectively as hospitals.
These hospitals that are being ear
marked for taking over had not been maintained for some years by the trust or by
the companies.
The MBBS Medical Officers duty
hours and the hospital OPD functioning hours clashes with the working hours of
estate workers where the estate management expect the workers to seek treatment
before or after the working hours and not during the working hours of hospital.
In some hospitals the 24 admission
facility is not available and they are functioning as CD or CD and MH and the
wards were not utilized due to lack of ambulances and telephone.
All the assets belonging to the
hospitals such as Quarters are not handed over.
Some of the provinces feel that
this is an additional burden as they are not in a position to run the hospitals
they already have in hand.
Some of the newly appointed medical
officers are highly motivated and they like the places they are serving and like
to continue in the same institutions even after 4 years.
The Director appointed to
coordinate the implementation Estate Health sector has no additional staff to
help in her activities not even a graduate trainee.
The work involves extensive
travelling in very bad roads and extreme climatic conditions but the director is
not provided with a suitable vehicle to effectively carry out the planned work
and achieve targets.