Himalayan News Service

Kavrepalanchowk, May 25

The government has established a sub-health centre in every Village Development Committee (VDC) of the country with the objective of putting its slogan ‘Health For All’ into practice. However it has not yet been able to provide sufficient amount of medicines for the health centres.

A survey carried out last year had found that the medicines provided by the government to these centres lasted for only three to five months. As a result of the insufficient supply for drugs, the health workers are also found subscribing low dose of medicines and for a lesser time period than actually required.

The study also found that that the average time spent by the health practitioners to examine a patient in these centre was just around three minutes and this obstructed the right diagnosis of diseases and unnecessary prescription of antibiotics.

The health ministry, department of drug supplies buys medicines listed under the ‘essential drug list’ and sends it to the regional medical stores which in turn dispatches it to the District Health Offices in all the 75 districts of the country, says Bal Krishna Bhusal, chief of Kavre District Health Office.

Medicines sent from the central level take around six months to reach the health centres via the district health office. As research showed that around 60 seconds is spent in distributing the medicines to the patients, they don’t get right information about it, because of which the rational use of the medicines is not materialised, say experts.

However, the government has been providing financial assistance—Rs 25,000, Rs 50,000 and Rs 75,000 respectively for the sub-health centre, health centre and primary health centre while the 15-bed district hospital receives Rs 200,000. But more than half of the amount is spent in buying cotton, bandage, syringe, antiseptic and disinfectant, and the scarcity of medicines continues for the remaining part of the year, adds Bhusal.

Apart from these problem, necessity of prescription for buying medicines at the local market, pressure of patients, mystification of the amount collected as fees, lack of skilled manpower, no records of patients and lack of monitoring and supervision have been found to have deprived the people of the essential medicines.

The health ministry and the local development ministry with cooperation of UNICEF-Nepal has begun the ‘Community Drug Programme’ (CDP) with the objective of solving the problem of drug supply management in the country, said Dr Prakash Aryal, the central region health directorate.

The CDP was first initiated by the World Health Organisation (WHO) in 1982-86 in 18 districts of Nepal. The programme was carried out on a trial basis in 122 health centres in these districts. This concept initiated from the Sisuwa Health Post of Kaski district was copied in 1994 as a model programme in Morang and Banke districts as well. This programme is presently under expansion in Kailali, Dhanusa, Chitwan, Parsa, Sunsari and Kavre districts.

Continuity and right use of medicines are the basic factors of quality medical service and the CDP was developed incorporating these two aspect, says Bal Krishna Khakurel, WHO, drug programme officer.

Referring to the free medical services provided by the state in various countries across the world, Krishna Prasad Sapkota, chairman of District Development Committee (DDC) Federation of Nepal, says it is the responsibility of the state to provide free health services to its people. Since the Community Drug Programme is a programme run by the people for the people, the programme hopes for maximum mobilisation of the local people, says the UNICEF-Nepal.