Nagaland sees increase in Primary Health Centres; more doctors required

Our Reporter
Dimapur, Nov. 8 (EMN): The Rural Health Statistics 2019-20 released by the Ministry of Health and Family Welfare (MoHFW) has revealed that the number of Primary Health Centres (PHCs) in Nagaland increased from 87 in 2005 to 137 as on March 31, 2020.

According to the report, there were 394 Sub Centres (SCs), 87 PHCs and 21 Community Health Centres (CHCs) in Nagaland in 2005. However, SCs increased to 415 and PHCs to 137 while CHCs remained unchanged at 21.

Regarding to building position for Sub Centres in rural areas in the state (2020), a total of 313 were functioning in government buildings, three in rented buildings and 79 in rent-free panchayat or voluntary society buildings.

The building position for PHCs in the state showed that out of the 130 functioning PHCs, 123 were functioning in government building, nil in rented building and seven in rent-free panchayat or voluntary society buildings. Meanwhile, all the 21 CHCs in the state were functioning in government buildings as in 2020.

As per the rural health statistic 2020, the required number of female health worker/ANM at Sub Centres and PHCs in rural areas of Nagaland in 2005 was 481, sanctioned number was 342, while 342 were in position and the shortfall was 139.

However, in 2020, the number of sanctioned post increased drastically. The required number of workers was 525 but 747 were sanctioned, and a total of 900 workers were in position. There was no shortfall of workers, according to the report.

The statistics of doctors required at the PHC in Nagaland in 2005 was 87, out of which only 53 were sanctioned, resulting in a shortfall of 34. In 2020, the requirement was 130, while the sanctioned number was 113 and 120 were in position. There was a shortfall of 10 doctors.

The total number of specialists (surgeons, obstetrician and GY, physicians and paediatricians) required at CHCs in Nagaland rural area in 2005 and 2020, as per the statistics provided, was 84. In 2005 the sanctioned number was nil and specialists in position was nil.

However, two were sanctioned in 2020 and nine specialists were in position, translating to a shortfall of 75.

Out of the 21 required radiographers in 2005, 11 were sanctioned all of them were in position but there was a shortfall of 10. In 2020 the requirement was 21, out of which three were sanctioned and an equal number in position, while the shortfall was 18.

Significant nationwide increase

The Ministry of Health and Family Welfare said in its Rural Health Statistics 2019-20 that as on March 31, 2020, there were 155404 Sub Centres, 24918 PHCs and 5183 CHCs functioning in rural areas of the country.

There was an increase of 9378 SCs from the year 2005 with a significant increase observed in Rajasthan (2968) and the number of PHCs rose by 1682.

According to the MoHFW, a Sub Centre is the most peripheral and first contact point between the primary health care system and the community. It assigns tasks relating to interpersonal communication in order to bring about behavioural change and provide services in different programmes like maternal and child health, family welfare, nutrition, immunization, diarrhoea control and communicable diseases as well as non communicable diseases.

Each Sub Centre is required to be manned by at least one auxiliary nurse midwife (ANM) / female health worker and one male health worker for details of staffing pattern. Under NRHM, there is a provision for one additional second ANM on contract basis. One Lady Health Visitor (LHV) is entrusted with the task of supervision of six Sub Centres. The government of India bears the salary of ANM and LHV, while the salary of the Male Health Worker is borne by the state governments.

The PHCs are established and maintained by the state governments under the Minimum Needs Programme (MNP)/ Basic Minimum Services (BMS) Programme.

As per minimum requirement, a PHC should be manned by a medical officer supported by 14 paramedical and other staff. Under NRHM, there is a provision for two additional staff nurses at PHCs on contract basis. It acts as a referral unit for six Sub Centres and should have 4-6 beds for patients.

Community Health Centres (CHCs) are established and maintained by the state government under MNP/BMS programme.

As per minimum norms, a CHC is required to be manned by four medical specialists i.e. Surgeon, Physician, Obstetrician/Gynaecologist and Paediatrician supported by 21 paramedical and other staff. It should have 30 in-door beds with one OT, X-ray, labour room and laboratory facilities.

It also should serve as a referral centre for 4 PHCs and provide facilities for obstetric care and specialist consultations.