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Citizen Report Card Study Health Sector Kashmore and Shikarpur - Sindh

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Citizen Report Card Study Health Sector Kashmore and Shikarpur - Sindh Citizen Report Card Study Health Sector Kashmore and Shikarpur - Sindh TRANSPARENCY INTERNATIONAL PAKISTAN Provision of health to the citizens is one of the primary responsibility of the Government. Health is also Goal 3 of the UN Sustainable Development Goals, to which the Government of Pakistan is also a signatory. This Goal states ‘Ensure healthy lives and promote wellbeing for all at all ages’. These goals have to be achieved by 2030. As the health sector is the domain of the Provincial Government, TI Pakistan undertook this research to report the strengths and weaknesses in the health sector of Sindh, particularly District Kashmore and District Shikarpur. The objective of the study is to provide the Sindh government with an external review of the services offered to the general public with recommendations to address gaps to provide relief to citizens of the province. Besides the government, this research will be disseminated amongst the civil society organizations, academia, media, public and other stakeholders. It is hoped that the Sindh Government will utilize this report to improve the performance of health services at the district level regarding facilities provided to the general public. This research has been made possible due to a grant from Transparency International Secretariat. Saad Rashid Executive Director Transparency International Pakistan © 2018 www.transparency.org.pk 1 TRANSPARENCY INTERNATIONAL PAKISTAN Ashfaque Ahmed & Saad Rashid [email protected] [email protected] Transparency International Pakistan would like to thank Mr. Mukhtiar Ahmed Noonari, President Human Friends Citizens Community Board Thul, and members of his team for collaboration in the study. Every effort has been made to verify the accuracy of the information contained in this report. All information was believed to be correct as of March 2018 as per sources quoted in this report. Nevertheless, Transparency International Pakistan cannot guarantee the accuracy and completeness of the contents beyond the sources verified for the purpose of the study. Nor can Transparency International Pakistan accept responsibility for the consequences of its uses for other purposes or in other contexts. Contributions to this report by authors external to Transparency International Pakistan do not necessarily reflect the views of Transparency International Pakistan. 2 TRANSPARENCY INTERNATIONAL PAKISTAN 3 TRANSPARENCY INTERNATIONAL PAKISTAN 4 TRANSPARENCY INTERNATIONAL PAKISTAN Table of Contents 1. Introduction ............................................................................................................................................. 9 1.1 Background ............................................................................................................... 9 1.2 An Overview of the Health Facilities in Sindh ....................................................... 13 1.3 Study Objectives ..................................................................................................... 16 1.4 Duration .................................................................................................................. 16 1.5 Scope ....................................................................................................................... 16 2. Research Method ................................................................................................................................ 17 2.1 Research Design...................................................................................................... 17 2.2 Focus Group Discussion ......................................................................................... 17 2.3 Sampling Technique and Size ................................................................................. 18 2.4 Instrument of data collection .................................................................................. 18 3. Analysis and Results .......................................................................................................................... 19 4. Recommendations .............................................................................................................................. 31 5. Bibliography ......................................................................................................................................... 32 5 TRANSPARENCY INTERNATIONAL PAKISTAN List of Acronyms BHU Basic Health Unit CD Civil Dispensary CH Civil Hospital DHO District Health Officers DHQ District Headquarter hospitals EPI Expanded Program on Immunization FP&PHC Family Planning and Primary Health Care HFs Health Facilities LC Leprosy Centre MCH Mother and Child Health Care Centre MS Medical Superintendent PPHI People’s Primary Healthcare Initiative PPP Public Private Partnership RHC Rural Health Center SHC Secondary Health Center SRSO Sindh Rural Support Organization TBC Tuberculosis Centre THQ Tehsil Headquarter hospitals TI-P Transparency International Pakistan VHP Vertical Health Programs WHO World Health Organization 6 TRANSPARENCY INTERNATIONAL PAKISTAN List of Tables Table 1.1 Primary Healthcare Facilities in Sindh ............................................................. 14 Table 1.2 Secondary Healthcare Facilities in Sindh ......................................................... 14 Table 1.3 Health Facilities ................................................................................................ 16 Table 3.1 Gender ............................................................................................................... 19 Table 3.2 Easy Availability of Beds ................................................................................. 19 Table 3.3 Effective Spending of funds by Government .................................................... 19 Table 3.4 Equal Treatment provided by Doctors .............................................................. 20 Table 3.5 Punctuality of Doctors ..................................................................................... 20 Table 3.6 Doctors pay Attention to the patients ............................................................... 21 Table 3.7 Satisfactory behavior of Doctors with patients ................................................. 21 Table 3.8 Doctors be allowed Private Practice ................................................................. 22 Table 3.9 Availability of Medicines ................................................................................. 22 Table 3.10 Laboratory Tests ............................................................................................. 22 Table 3. 11 Preference of doctors for lab tests .................................................................. 23 Table 3.12 Bribe for Obtaining Free Medicines ............................................................... 23 Table 3.13 Counterfeit Medicines ..................................................................................... 23 Table 3.14 Distance travelled to reach hospital ................................................................ 24 Table 3.15 Satisfaction with House-keeping .................................................................... 24 Table 3.16 Availability of Toilets ..................................................................................... 25 Table 3.17 Availability of Good Quality Food ............................................................... 25 Table 3.18 Availability of Waiting Area .......................................................................... 25 Table 3.19 Treatment of all diseases in OPD .................................................................... 26 Table 3.20 Cleanliness around Hospitals .......................................................................... 26 Table 3.21 Incidents of Bribery ........................................................................................ 26 Table 3.22 Government Top Priorities ............................................................................. 27 Table 3.23 Availability of Complaint Management System ............................................. 27 Table 3.24 Complaint Redressal ....................................................................................... 28 Table 3.25 Separate Emergency Rooms ........................................................................... 28 Table 3.26 Generators remain Functional ......................................................................... 28 Table 3.27 Waiting Time .................................................................................................. 29 Table 3.28 Staff Cooperation ........................................................................................... 29 Table 3.29 X-Ray Machine Functional ............................................................................. 29 Table 3.30 Availability of Wheelchairs ............................................................................ 30 Table 3.31 Ultrasound machine Functional ...................................................................... 30 7 TRANSPARENCY INTERNATIONAL PAKISTAN List of Figures Figure 1.1 Emergency room in RHC facility, Kashmore.................................................... 9 Figure 1.2 Equipment used in Emergency, Kashmore ...................................................... 10 Figure 1.3 THQ, Kashmore .............................................................................................. 10 Figure 1.4 Emergency DHQ Shikarpur ...........................................................................
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