Pinangwa: Paving way for future

Access to primary health care facilities is projected as a basic social right (UN 2001). But even today, access to healthcare is hindered by geographic, social and cost barriers because of which several parts of the country still lack basic infrastructure and do not provide even the basic health facilities to the resident population.

With only 17 Primary Health Centers (PHCs) and 5 Community Health Centers (CHCs) catering to a million people, district Mewat in Haryana is a grim reminder of the neglect and apathy towards healthcare services, even while the state records boast of creating adequate health infrastructure across all districts.

The public healthcare system in rural areas consists of a three tier system, with CHCs at the apex providing specialist services at the block level, having 4 PHCs supporting it, further extended through 6 Sub Centers, which are the most peripheral point of contact at the grassroots serving a stipulated population. Out of the 5 PHCs established in the year 1960 in Mewat, only 2 PHCs got upgraded to CHC level in 1968, even though the population criterion for upgrading the centers stood applicable for balance three as well. The move was beyond justification as the people in Nagina, Taoru and Pinangwa blocks, where PHCs were not upgraded to CHCs, had no access to healthcare that they were entitled to, until an empowered group took courage to question the same.

People had already lost hope and accepted status quo when Sehgal Foundation launched a program on “Good Governance”, and trained rural people to demand their entitlements and take proper recourse if those were denied. The fact that the PHCs in question were entitled to become CHCs a decade prior to the intervention of the group so motivated them that they filed an application under the Right to Information Act (RTI) on 15th December 2009. Information on health personnel deputed under various health centers in Mewat, their establishment year, and the year in which each of them were upgraded was sought.

In the reply from DGHS, the reasons cited for the non-upgrade of Nagina, Taoru and Pinangwa PHCs were unacceptable. The plea put forth by the authorities was the proximity of these PHCs to the General Hospital, which was non existent in Pinangwa’s case, said the group members. Getting CHC status for the Pinangwa PHC (catering to 44 villages with a population of 64,700) became a mission for the group, which was trained for good governance through the clinical methodology, placing emphasis on learning by doing.

Non responsive governance, lack of community leadership and a callous attitude of the health department added to the miserable failure of our initial efforts to get Pinangwa PHC upgraded into a CHC. But we didn’t bow down, Rajuddin, the groups’ leader said. Not having even an inkling of the wave the initiative had started, the response to the RTI application was published by Dainik Bhaskar, one of the Hindi national dailies. According to the newspaper report, 63 PHCs in Haryana had been upgraded to CHCs, and all these PHCs were established after the 3 PHCs in Mewat. The report doubled the group’s efforts as they decided to follow up on the case even more aggressively.

Pursuing further, Rajuddin also wrote to the Governor, the chairman of Mewat Development Agency and Financial Commissioner and Principal Secretary, Health Department, Chandigarh about the issue. Considering the merit and need in the area, the decision to upgrade the PHC at Pinangwa was notified in the Mewat Development Agency (MDA) meeting on June 20, 2010. The upgrade means a lot to the community, as additional health services would come their way, said Rajuddin.This shows the victory of many of us over a handful we, who expressed their inability to sanction the CHC status at least in the current financial year.

“Our aim is to replicate this success further in Nagina and Taoru blocks,” said an elated Rajuddin.

For further information please contact:

Ms. Pooja O Murada
Sehgal Foundation
Plot No. 34, Sector 44, Institutional Area
Gurgaon, 122002 (Haryana), India

Tel: +91-124-4744118
Fax: +91-124-4744123
Email: poojamurada@smsfoundation.org
Website: http://www.smsfoundation.org/