Kerala - Thiruvananthapuram   

Improvement of services in periphery

Thiruvananthapuram: The strengthening of hospitals, especially maternity care services, in the periphery through the deployment of additional staff and provision of better infrastructure under the National Rural Health Mission (NRHM) have finally begun to yield results.

The number of delivery cases as well as the number of patients in outpatient and inpatient clinics at many hospitals in the periphery have gone up, while the numbers have come down in major hospitals in the city.

The change is most palpable in SAT Hospital, one of the largest tertiary care women and children hospitals in the State, which has been taking on the burden of some 16,000 delivery cases annually.

Doctors at the hospital report that the number of delivery cases there has been coming down for the past seven months. With an average of 800-odd cases every month instead of the usual 1,000 plus, the pressure has been easing up a bit.

However, though the actual number of delivery cases has gone down, the number of complicated cases has gone up.

“Our assessment is that normal labour cases are now being taken care of at various hospitals in the periphery, so that we can concentrate more on cases that require tertiary-level care,” says Zulficker Ahmed, Superintendent of SAT Hospital.

The figures show that in 2006-07, there were 13,949 delivery cases at SAT Hospital, which came down to 11,285 in 2007-08.

In comparison, the number of delivery cases handled by the W&C Hospital, Thycaud, went up from 7,124 to 7,437; Government Hospital, Peroorkada, 1,948 to 1,966. The cases handled by various taluk hospitals have also gone up slightly.

“Almost a year since we started strengthening the facilities at hospitals at the CHC-level and upwards in the periphery, results are slowly but surely trickling in. We expect better results by next year,” says G. Sunil Kumar, district programme manager of the NRHM.

“Through the NRHM, about 115 doctors and 240 staff nurses are posted on contract at various health care institutions in the district,” he said.

The focus has been on providing the service of gynaecologists and surgeons in community health centres so that delivery cases, including caesarean sections, can be handled at these institutions safely.

Some of the CHCs where additional gynaecologists were provided include Vizhinjam, Kanyakulangara, Vithura and Kesavapuram.

Gynaecological services have always been scarce in coastal areas but the Vizhinjam CHC has just started handling delivery cases after a gynaecologist was posted there on contract.

Kesavapuram, where two gynaecologists were posted, has also started taking delivery cases but there are no theatre facilities here at present.

More gynaecologists were posted at the taluk hospitals at Neyyattinkara and Nedumangad, Fort Hospital and the government hospitals at Parassala and Peroorkada.

The Neyyattinkara Taluk Hospital, where labour wards were closed last year, now have seven additional doctors including three gynaecologists.

The Nedumangad Taluk Hospital was given one additional gynaecologist and a surgeon, apart from three MBBS doctors doing compulsory rural service and the institution is now handling all delivery cases, C-sections and hysterectomies too.

The number of delivery cases here went up from 737 in 2006-07 to 860 in 2007-08 and is expected to improve further.

Two other hospitals which saw major upgradation and improvement of services were the Peroorkada and Fort hospitals where theatres were renovated and new labour rooms and wards set up.

The W&C Hospital, where gynaecological and neonatal services were brought at par with that of SAT Hospital at an investment of Rs.6 crore, has also helped eased the congestion at SAT Hospital.

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