MVA’s report card a mixed bag: Covid management fair, can do better in healthcare – ET HealthWorld


MVA’s report card a mixed bag: Covid management fair, can do better in healthcare
MUMBAI: With the first novel coronavirus case in Maharashtra detected barely four months after Uddhav Thackeray was sworn in as chief minister on November 28, 2019, his Maha Vikas Aghadi government’s two-year report card reads more like a Covid management statement.

Maharashtra’s Covid burden of 66 lakh patients and 1.4 lakh deaths so far is higher than that of many countries. Experts believe the hurriedly patched-up coalition of Shiv Sena, NCP and Congress handled the pandemic better than what many feared, but there is still a lot to do. As health economist Ravi Duggal put it: “The MVA government has done a good job in comparison to other states as far as Covid is concerned, but what about routine healthcare?”

If MVA ticked the right boxes for mobilising beds quickly, recruiting temporary manpower (at times from other states) and carrying out one of the most accessible vaccination programmes in the country, some experts point out little has been done to carry out systemic changes to bolster the state’s flagging public health system. For instance, despite having over 2,000 primary health centres on paper, a well-staffed one is not easy to find in rural areas.

Doctors forecast a mild third wave and believe the lull is the time to kickstart long-term steps. “The stop-gap arrangements required to handle the pandemic caseload have to give way to permanent solutions,’’ said a state official.

During the two Covid waves, the inadequate rural healthcare infrastructure and lack of trained manpower became glaring. “Critical patients had to travel kilometres to other districts, increasing the time taken to start treatment. Simply erecting hospital buildings without trained manpower and equipment is no longer enough,” said Ramesh Patil, a health activist from Latur. Over 18,000 people were recruited on a temporary basis to work in the Covid centres, but intensivists and ICU nurses were conspicuous by their absence.

Moreover, the government was caught napping between the two waves: no measures were taken to bolster the system for the second wave. As a result, shortage of oxygen, medicines and the appearance of opportunistic infections such as mucormycosis made headlines.

The will to do something lasting seems to be missing, said experts. “The government presented a budget amid the pandemic, but made no effort to increase the health budget allocation from 0.5% of the State Gross Domestic Product (SGDP) to, say, 1% or even 1.5%,” said Duggal. The budgetary allocation for 2021-22 was Rs 16,839 crore, about 3.5% of the total budget outlay of the state government.

State health minister Rajesh Tope visited Chennai to study its drug purchase policy but hasn’t taken a step forward. “If we allow the TN system to buy our medicines, we will get three times what we get now. Wouldn’t that be helpful?” asked Duggal.

According to the National Public Health Profile 2019, Maharashtra has six doctors for every one lakh population and 67,087 people are dependent on one primary health centre. Dr Abhijit More, member of NGO Jan Swasthya Abhiyan and Aam Aadmi Party, said there are over 17,000 vacant posts in the health department. “Three exams were held to fill up these vacancies, but by a blacklisted company. The result is that no recruitment has taken place so far,” he said.

While Covid underlined the need for better mental healthcare response, the system is grossly inadequate. An official said up to 40% posts for psychiatrists and therapists are vacant. “Districts such as Satara and Sindhudurg don’t have a single psychiatrist in the government set-up,” said a senior official.

Any government has to work towards a single goal if it has to be considered health-friendly, said Duggal. “Raise the health expenditure to Rs 4,000 per capita as opposed to Rs 1,400 at present.”





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