Need of public health cadre in Uttarakhand. Demand for Public Health Cadre in Uttarakhand during the Swasthya Chintan Shivir of Ministry of Health & Family Welfare and Central Council of Health and Family Welfare

Dehradun

In the presence of the Union Health Minister, Union Minister of State for Health and Health Ministers of various states across the country, the demand for a public health cadre has come to the fore from Dehradun-based think tank SDC Foundation for the improvement of health services in the state of Uttarakhand.

A two-day Swasthya Chintan Shivir is being organized by the Ministry of Health & Family Welfare, Govt. of India and Central Council of Health and Family Welfare, the apex health advisory committee in Dehradun. Union Health Minister Dr. Mansukh Mandaviya along with the Union Minister of State for Health and health ministers of all the states of the country are in Dehradun to participate in the Shivir.

On the occasion of the Chintan Shivir, SDC Foundation has raised the issue of improving health services in Uttarakhand and has demanded to set up a public health cadre in the state.

Issuing a press note, Anoop Nautiyal, founder of SDC Foundation, has said that this is the right time when we should strongly raise the issue of improving health services in Uttarakhand, so that it reaches Chintan Shivir. He says that many health indicators have improved in Uttarakhand when compared to NFHS-4, but there is still a great need for improvement in many other areas. This reform can be possible by creating a public health cadre in the state.

As per Anoop Nautiyal, Uttarakhand has 436 specialists against the sanctioned posts of 1067, a shortfall of 59%. There is a severe shortage of clinical specialists in hospitals so posting them in administrative public health posts is gross injustice to the common people of Uttarakhand. If we look at the qualifications of personnel entrusted to run institutions like National Health Mission, Food and Drug Administration, State Health Societies and ESI very few have basic degrees of MD community medicine or Masters in Public Health as recommended by Government of India, and neither any serious effort has been taken thus far to correct these anomalies.

The state has 29 trained Public Health Specialists but none of them are posted as per their qualification. Even though financial support for establishing a dedicated Public Health Cadre has been provisioned by the Central government under the Health Ministry’s budget, the Uttarakhand government has not gathered enough resources to establish a Public Health Cadre.

States which have shown considerable improvement in health indicators like Tamil Nadu have always had a Public Health wing so much so some states even have a separate Director General in Public Health. It is also necessary to ensure that only properly trained officers are entrusted with the specialized tasks and medical professionals who have done short term mid career courses or courses with no validity should not be engaged through back door entry.

The health system in Uttarakhand is grappling with issues such as a lack of financial management, technical expertise, logistics management, and social determinants of health and leadership. Doctors with clinical qualifications and even with vast experience are unable to address all these challenges.

Anoop Nautiyal said that with a public health cadre in place, the state will have personnel who can apply the principles of public health management to deliver quality services. This will improve the efficiency and effectiveness of the health system in Uttarakhand. The poor and needy will benefit as this will reduce their out-of-pocket expenditure and dependence on private health care. This will also save resources of specialists and bureaucrats by deploying them in areas where their services are actually needed.

It is critical that Uttarakhand looks at the formation of a state task force to create a public health cadre under the Chief Secretary. Identification of posts of public health importance in all fields from disaster management, urban local bodies, food and drug administration and Atal Ayushmaan Yojanas is needed.

Among the existing specialists of public health it is important to post them as per qualifications and make decisions on what percentage of district level and state level positions need to be filled by public health specialists. Only doctors with a public health degree and experience should be considered for holding the important public health posts of CMO. Then only we can expect the comprehensive improvement of the healthcare system in Uttarakhand.