Re: NACP III: Work Force Development issues

[Guest guest]

Friends,

I would like to endorse what Ashok Row Kavi has pointed out. Only government can

deliver health care throughout the country, especially to poor people.

There is an important difference in the AIDS Control Programme from all the

other National health programmes. The difference is that as part of the NACP,

to my knowledge, not one permanent staff position has been created throughout

India. This might seem strange. In every other national programme, be it the RCH

programme, Malaria programme, TB programme, or the leprosy programme, there are

hundreds or thousands of permanent staff including specialist doctors, nurses

and all categories of paramedical and other health staff. But the entire AIDS

control programme is being carried on by staff that are either on deputation or

on contract.

This policy has major implications for the sustenance of the programme. There is

no continuity. People come and go. People get trained, work, gain experience,

then leave after their term is over and are no longer available to carry on the

programme.

In the case of contract staff, the attrition rate is high, since when a more

lucrative offer comes, often in a totally different area such as water supply or

Tsunami relief, they just leave.

There are not very many people in the State AIDS Control societies or at

managerial positions at the national level with more than a few years of

experience in the HIV field. Some way has to be found to retain trained

professional staff in the HIV area.

Just as in the case of staff, attention has to be paid to developing

infrastructure such as greater number of hospital beds, laboratory facilities

etc for tackling the increased care needs of PWHA. After VCTCs have become more

common, more and more people are getting tested and finding themselves positive.

But PWHA are finding out the hard way that local hospitals are just not equipped

for their care.

The shortage may be in sensitized and trained staff, lab facilities or systems

for infection control or just vacant beds.

Health is a state subject. For increasing manpower and infrastructure, states

should put in their own money as well. Only a few states are actually using

their own funds now. But permanent staff positions may not be created, if

states are not persuaded to fund part of the programme themselves.

There is yet another major hitch. The NACP is mainly funded by external

agencies. Generally external agencies are not happy to create new staff

positions with their funds. How do we manage this?

Dr.Prasanna Kumar

E-mail: mpkumar@...