The Drug De-addiction Programme (DDAP) under Ministry of Health and Family Welfare is experiencing hiccups in its implementation, decodes the program's latest progress report 2015-16.
The programme is plagued by scores of problems ranging from shortage of staff, medicines to funds. Along with establishing about 124 De-addiction Centres (DACs) in various government district hospitals and psychiatry departments of medical colleges, the Union Health Ministry is also to establish 'Drug Treatment Clinics' (DTCs) in various parts of the country.
These DTCs are associated with a government hospital, and provide exclusive contractual staff (doctor, nurse, counsellor), and medicines for the treatment of all types of substance use disorders; the expenses for these would be borne by the DDAP.
As per the report, the program is encountering several challenges in carrying out various activities of DTC. "Looking at the phenomenal response to the scheme and need of medicines for the large number of patients, the budget originally earmarked for purchase of medicines is proving to be inadequate. The shortage of funds is being felt in both the centrally procured medicines as well as the medicines purchased directly by DTCs. There is a need to increase the budget allocated for procurement of medicines," the report stated.
The report recommended that additionally, the provision of budgets as per DTC basis may be relooked as some of the clinics have much higher patient load as compared to others. "Instead, the budget for medicines may be estimated based on the projected requirement for various medicines during the financial year,' report further stated.
The scheme envisages establishment of 22 DTCs by the end of 2016-17. However, NDDTC and other Regional Centres have been receiving requests for support under the scheme from several government hospitals and institutions. Many of these hospitals and institutions are located in states with high burden of drug abuse problems such as Punjab, Manipur, Nagaland, Rajasthan, etc.
The staff crunch and lesser remuneration is further troubling the program. "The entire process of establishing a new DTC is longer than envisaged. From identification to making a DTC functional takes up to six months or even longer on most occasions. Attrition in the staff appointed at DTCs leads to staff turnover, and consequently there is a need for training the newly inducted staff," the report said.
"In some instances, the remuneration provided in the DTC scheme is lower than the salary being offered for similar positions elsewhere in the state. This has resulted in nil response to advertisements for DTC posts in some cases and is one of the reasons for staff attrition in others," it said.
Earlier evaluation exercises carried out in the last decade also show that almost one-third of the DACs were non-functional, one-third were partially functioning and only one-third were functioning adequately.
The reduction for alcohol and drug use is the mandate of primarily two ministries Ministry of Social Justice and Empowerment (MSJE), and Ministry of Health and Family Welfare—through DDAP. While the MSJE program is implemented by NGOs, Union Health Ministry bears the responsibility of managing DACs and DTCs.
Report suggests
The budget earmarked for purchase of medicines are proving to be inadequate. Thus, there is a need to increase the budget.
The provision of budgets as per DTC basis may be relooked as some of the clinics have much higher patient load as compared to others.
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