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Cadre Health Management in is need of time Sindh

Health is basic right of the people of province and state responsible for provision of quality basic Health care, which is accessible, affordable and acceptable. Health department is providing primary, secondary and tertiary health Services to people through their extensive infrastructure of health facilities. Through these facilities it provides preventive, curative and promotive services to the rural, urban, and slum population of province.
Health department has large number of human resources of different categories. This includes medics, paramedics, and support staff of wide variety in nature. Department is implementing their programs and projects of different kinds by these human resources. Different cadres are working and implementing primary and specialized health care to community. General cadre is providing primary health care at all level and also managing programs and projects for prevention of health problems, which is specialized management field for which department has no cadre.
Health Department has been implementing their horizontal and vertical programs by their general cadre, having no any specialized degree in management for effective implementation of programs. In Sindh province, all institutes and projects have been running by the un-qualified health mangers, which lead to weakening of health system. In other provinces like Punjab, KPK and Baluchistan have qualified health managers having post graduate degree in management have been implementing all programs and getting required results.
That Health System is technical subject all around the globe, where countries and NGOs place qualified Doctors in public Health or Similar qualifications to run the organizations and departments. Globally Health lessons learned from different sector reforms suggests qualified Public Health Professionals are the decisive factor in improving the performance of Health system.
However in Sindh province, adequate numbers of qualified doctors in management have been serving in health department. These were trained by both public sector through their preventive programs funds and by own expenses in different institution of Pakistan. Presently these qualified Doctors are not posted on right places due to non existence of management cadre in health department. These qualified doctors working with donor agencies or posted on non management posts. Whereas doctors having no management degrees are posted on decision making positions and utilizing resources ineffectively.
The National Health Policy 2001 and National Health Conference 2004 recommended for removing professional and Managerial deficiencies in District Health system. The main deficiencies have been identified as an ineffective of District Health Officer due to lack of essential qualification and Management skills.
USAID-JSI health experts have developed a document in consultation with department of Health for creation of Health management Cadre during 2014.
Sindh Health Sector Strategy 2012 – 2020 has also recommended developing a trained Administrative Cadre to improve efficiency of Health Administration at District and Provincial level.
In the light of Situation, effectiveness of our programs is not up to mark and target could not achieve. Quality of health services is poor and its utilization is only 20 percent according to survey. People are not satisfied with services and 80 percent public getting services in private sector. Moreover prevalence of infectious diseases has been increasing in spite of running preventive programs at all level. Number of patients of TB, Malaria, Hepatitis, HIV and other diseases are increasing with passage of time due to non effectiveness of these preventive programs.
Health department Sindh has to improve their performance by effective management of resources and grasp the available opportunities in health sector. Resources are scarce, management is poor, diseases are prevalent and new health problems are emerging due to rapid urbanization process. Department needs health specialists for effective management of health programs and projects.
Health department has to recognize their management skill and make a separate management cadre of those positions which are related to management of health services. This management cadre is properly working in other provinces to improve health services for poor community living urban and rural areas.
Now it is need of time for our province Sindh that we should get benefit of our postgraduate qualified DPH, MPH, MSPH, MBA, MAS, Msc, persons after creating Management cadre.
By Dr. Abdul Razak Shaikh
MBBS, MAS (Master in Health Services Management)
Retired from Health Department Govt. of Sindh after working 29 years Services
Email: contact.abdulrazak@gmail.com

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