DFID's strategy for improving health in developing countries (2)
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With some experience in seeing DFID support, whether it is helping or not helping, we feel that it is not money that is required. When existing infrastructures and facilities are not performing to the lowest level, adding more is helping very little. It is a common site in most PHC-based systems that the doctor will be absent, or busy in private practice; most pathology systems are non functional, existing buildings are not maintained at all. Who stays at these facilities? Nobody. Then, by providing some additional money, what will actually happen? Nothing has succeeded in making it possible for most paramedics and doctors to stay at these centers over night, or even 8 -9 hours/day.
Money is only part of the solution. The desire to work is disappearing in Government hospitals. Most doctors who were appointed in newly created rural centers have either left or are only going some days and drawing salaries. Surgical activities are already minimal. By adding advanced level systems would not help much. If there is no power how will many of the electric systems function? Computers at many centers are non usable. Manual data are being prepared. Our primary health data are totally false.
I have attended some DFID meetings at District level. It is nothing short of chaos. Everything is around how much is spent not about what is performing, who is performing and who is not and if not, why not?
sksingh
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S.K. Singh
mailto:sambhavgwr@hotmail.com