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| It may have started from Lodharan back in August 1999 with three Basic Health Units. The man behind that experience was Mr. Jahangir Khan Tareen, at that time one man Task Fource of the Punjab Government for the Agriculture sector. These BHUs, after takeover by the National Rural Support Programme (NRSP), were run by one Medical Officer (MO) engaged at an enhanced salary. A “Revolving Fund” of Rs. 100,000 for maintaining a stock of high quality medicines was privately created for the 3 BHUs. Patients at the BHUs could purchase these medicines while medicines supplied by Government were provided free. The Fund revolved as many as twenty two times during 36 months. The three BHUs were considered “better maintained” and the monthly turn-out of patients at the three facilities registered an increase from 515 to a maximum of 2630. Given the circumstances of the Lodhran initiative, not many other avenues for change were considered possible. Later in 2003, Mr. Jahangir Khan
Tareen was MNA from Rahim Yar Khan and an Advisor to the Chief Minister
Punjab on “New Initiatives in the Social Sector”. He
is now the Federal Minister for Industries, Production and Special
Initiatives. It was Mr. Tareen who prevailed upon the PRSP to be
the engine for the Rahim Yar Khan Pilot. It is difficult to say
in what way the Lodhran experience became the precursor of the Rahim
Yar Khan (RYK) Pilot except that both are conceived around BHUs
and both cluster a number of BHUs in the care of one Medical Officer.
The similarity may not, however, go beyond these two features. But
the Lodhran experience may have encouraged thoughts along more ambitious
lines. From PRSP’s side, it must be conceded here that it
did not know everything important about the Initiative that it had
agreed to launch. However, one thing that PRSP understood perfectly
from the start was the importance of Healthcare to poverty. An Initiative
to provide primary healthcare service to the rural communities,
therefore, had a powerful appeal for the PRSP. The strategy for
achieving the objective was admittedly vague in the beginning. The
relevance of PRSP to the Initiative in the form of a precise role
was likewise ambiguous. It was important, therefore, to formulate
a strategy and evolve a role which drew upon the special strengths
of the PRSP. |
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