Absenteeism of doctors is a huge problem and different states have their own ways of tackling it.
Mobile health units are a good way to help aid the rural pockets. In Assam, we have a three-vehicle unit for every district, which is working beautifully. One handles diagnostics, the other has a mobile operation theatre and the third is an SUV that carries the doctors and other staff.
Even in Uttarakhand, there are mobile units on the pattern of EMRI (Emergency Management and Research Institute) ambulances for immunisations and childbirths. In 2008, they did about 282 in-van deliveries.
In 2005, under the National Rural Health Mission, we had allowed the local village healthcare body — the Rogi Kalyan Samitis — to hire doctors on contract. This way, one could get the local talent for local hospitals and also a local mechanism to keep these doctors in check.
Actually, we at the Centre can only give suggestions and sanctions, but health is a state subject and it is entirely up to a particular state to adopt a solution or not.
(Naresh Dayal is Union Health Secretary)
Mobile clinics are good for people living in rural and sub-urban regions. They cater to the needy, who cannot reach PHCs and district hospitals. However, operations and complicated treatments should be conducted in the proximity of district hospitals.
Dr. S. Palanivelu, Senior Regional Director (Health & Family Welfare), Tamil Nadu.
The UP government does not have any mobile clinics, though they are now planning to introduce a mobile medical team. Mobile clinics are more helpful in the states like Uttarakhand, where due to the rough terrain, people in sub-urban and rural parts find it hard to reach primary health centres and district hospitals. But mobile hospitals cannot substitute the need for PHCs. If you want to regulate the attendance of doctors at PHCs, the chief medical officers need to strict and pay regular surprise visits to PHCs.
Dr. S.K. Chowdhery Regional Director (Health & Family Welfare), Uttar Pradesh
(As told to Kumar Abishek)