Move to enable pregnant women to access healthcare free of cost in public institutions; docs to work on incentive basis
To increase institutional childbirths, ensure better maternal and childcare and overcome a shortage of specialist doctors in the public sector, the state government will for the first time rope in private medical practitioners to serve at its healthcare institutions.
Gynaecologists, paediatricians and anaesthetists with their own private practice will work in government-run sub-district, rural and womens’ hospitals in tribal, Naxal-affected and rural areas on a work-based incentive basis. This will enable pregnant women to access health care and deliver their children free-of-cost in public healthcare institutions and reduce their out-of-pocket expenses.
The project to strengthen these first referral units was launched on a pilot basis in Pune and later at Satara and Solapur before being extended to the entire state.
“The idea is to provide obstetric services in rural hospitals, sub-district hospitals and district hospitals,” said Dr Sanjeev Kumar, Commissioner (Health) and Mission Director (National Health Mission), adding that the goal was reducing neo-natal and maternal mortalities.
Kumar said they aimed at attracting private medical practitioners through work-based incentives.
“We will appoint specialists on contract on full-time or on-call basis to overcome their shortage in rural areas. So far, we have made 270 appointments in 245 identified referral units with more on the anvil based on manpower needs and patient load,” said a senior health department official.
He explained that apart from vacancies, the health department’s doctors also handled emergencies, OPD services, post-mortems and medico-legal cases, which put pressure on them. Involving private doctors for gynaecological and paediatric services will reduce some of this burden. “In absence of gynaecologists, even MBBS doctors can handle such cases. But specialist help is needed for C-sections, abnormal presentation, assessment and high-risk cases ,” the official added.
Gynaecologists and paediatricians will have two options—working full-time on a fixed monthly payment in addition to extra remuneration for every procedure like caesareans, assisted delivery and OPD or work on an on-call basis and get paid per procedure. Anaesthetists will be paid Rs 4,000 per case.
The fixed charge will depend on whether the area falls in a tribal, Naxalite violence-affected or non-tribal, non-Naxal area. Doctors on-call will be able to continue with their private practice.
However, Dr Abhijit More, co-convenor, Jan Arogya Abhiyaan, stressed that the state should draw up standard treatment norms and payment guidelines and ensure regular monitoring.
HEALTHY BOOST
- Gynaecologists and paediatricians will have two options—working full-time on a fixed monthly payment along with extra remuneration for every procedure like caesareans and OPD or work on on-call basis and get paid per procedure. Anaesthetists will be paid Rs 4,000 per case
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