Report GH Farooqui
CHITRAL: As many as 163 out of the total 196 employees of the Aga Khan Health Service (AGHS) Chitral continued their protest sit-in the Chitral town for three days.
As a result, service delivery in the health centres run by the AKHS in different parts of then area is badly affected, causing immense hardship to the patients.
Talking to this correspondent, the protesting employees said the organization was planning to terminate their services without giving them any incentives. They said initially the AKHS had planned to sack about 77 employees but when the staff put pressure on the authorities the number was reduced to 15 to 20 employees.
They said if the AKHS wants to carry out a downsizing it should give its employees golden handshake incentives or provide them pension as was done by the Aga Khan Rural Support Programme, or any other institute of the Aga Khan Development Network (AKDN).
Most of the protesters staging the sit-in were women who said they had worked in the organization for years and if they were sent home at this age they would not be able to get jobs anywhere else.
The protesters said if they were sacked without pension or golden handshake, they would continue their protest and even extend it to other parts of the country.
When this correspondent visited the AKHS office in Chitral, the staff there tried to pressure him not to report the matter. Later, Dr Zafar Ahmad, the head of Community Health and Government Relations, told this correspondent from Islamabad on phone that they were closing seven health centres in Chitral. He said the AKHS had already informed the employees that the centres having very low patient visits would be shut but the staff went on a strike.
AKHS-Pakistan press release
In a statement, the AKHS Pakistan said in order to increase efficiency and serve growing needs of its patients, AKHS is recalibrating its health service delivery to ensure that it can remain independent and self-sustainable. A cornerstone of this approach is to ensure partnerships with national and local governments and other health service providers – both within AKDN, such as the Aga Khan University, and outside AKDN, such as government health facilities — to ensure improved health services in the long term.
In some cases, the recalibration will mean that certain health functions will be built on an effective hub and spoke model. The AKHS,P Service Model will feature:
- Hubs: The Gilgit Medical Centre and the Booni Medical Centre, which will consist of 46 and 37 bed secondary health care units, respectively, with ‘core’ specialised services in paediatrics, obstetrics/gynaecology, internal medicine and surgery, as well as other specialised services in e.g. orthopaedics, ophthalmology, psychiatry etc., that are reflective of local needs. The Gilgit and Booni Medical Centres are connected with the ‘super-hub’ at the Aga Khan University Hospital in Karachi for e-health services. The two Medical Centres serve as the referral units for the Compehensive Health Centres (CHCs) and play an active role in supervision and capacity building of the CHCs’ staff, including via outreach and e-health.
- Sub-hubs: The six CHCs (7-18 beds) are to be staffed by generalist rural family medicine physicians trained to diagnose and treat a large variety of common diseases, e.g., obstetric complications, emergency surgeries and stabilisation of severe medical and paediatric conditions. CHCs are the referral units for the BHCs, and CHC staff also provide outreach clinics in BHCs.
- Spokes: Staffed with Lady Health Visitors (LHVs) and Community Health Nurses (CHNs), the Basic Health Centres (BHCs) offer health promotion and disease prevention services, including screening for non- communicable diseases (NCDs). There are advanced discussions with AKU’s School of Nursing and Midwifery (AKU-SONAM) to start modular upgrading courses for the LHVs, as well as primary health care services with a focus on reproductive, maternal (including normal deliveries), and child health. The BHCs are the link between the formal health system and the community; and these will be linked via mobile health (m-health) services.
The recalibration is essential to improve efficiency so that AKHS, a non-profit organization, can continue to provide affordable healthcare to the community. The new model will ensure both quality and affordability.