|Govt lowers uterine prolapse treatment target|
KATHMANDU, Jan 27: The government has increased per patient operation expenses for women with prolapsed uterus at the cost of reducing its previous target by 4,000.
OM ASTHA RAI
Giving in to demands of all five Regional Health Directorates (RHDs), the Ministry of Finance (MoF) has increased an average per patient operation cost (PPOC) by Rs. 4,000. Last year, the government had fixed an average PPOC at Rs 8,333. This year, the government has fixed an average PPOC at Rs 13,333 conceding to persistent pressures by RHDs.
Despite PPOC increment, the government has not increased total amount for treatment of women with uterine prolapse. In a clever act of budget adjustment, the government has cut its target by one-third. Last year, the government had set a target of providing operation services to 12,000 women. But, this year the target is 8,000 women.
Also, the government has decreased travel expenses provided to women seeking treatment of uterine prolapse in the name of budget adjustment. Earlier, the government had allocated per head travel expenses at the rate of Rs 3,000 in the mountains, Rs 2,000 in the hills and Rs 1,000 in the Tarai. Now, women who approach hospitals and health camps get Rs 1,500 in the mountains, Rs 1,000 in the hills and Rs 500 in the Tarai as travel expenses.
Health officials involved in family health services claim that the reduction in yearly target and travel expenses may have serious repercussions in women´s health. "Seemingly, it is a minor case," says Sushma Baidawar, who oversees uterine prolapse programs at Family Health Division (FHD). "But it may hamper reduction of maternal mortality rate (MMR)."
According to the Demographic and Health Survey (DHS)-2006, over 600,000 women in Nepal have been suffering from uterine prolapse. Almost half of them are in urgent need of operation. However, various non-governmental organizations (NGOs) claim that the number of women with the condition may be far higher, given the low service delivery.
At present, only 48 district hospitals boast of Basic Obstetric Care (BOC) units. The number of district hospitals equipped with Comprehensive Obstetric Care (COC) units is just 35. BOC and COC units are vital in child deliveries. Health officials point out the lack of safe child delivery services as the main reason behind uterine prolapse facing rural women.
"Service delivery has not improved significantly," Baidawar says. "The number of women suffering from uterine prolapse, therefore, may be on steady rise." She argues that the government should not slash travel expenses since obstetric care facilities in rural areas remain quite dismal.