AAP Report Card-I: Out of 1,000 Mohalla Clinics promised, only 191 delivered

By Nivedita Singh

New Delhi, July 14 (IANS) The Aam Aadmi Party (AAP), which has been praised for its work in the field of health, has not been able to provide the promised 1,000 Mohalla Clinics even after 4.5 years of rule, as only 191 clinics were operational till March.

Initially, the project got delayed as the AAP government and the L-G's office were at loggerheads over clearance of various flagship projects of the party, including Mohalla Clinics.

While Chief Minister Arvind Kejriwal promised 1,000 clinics to the city in June 2016, it was only in September 2017 that the Lt. Governor gave his nod to the project. Until July 4, 2018, the city Cabinet had to take the approval from the L-G for all its decisions, it was only after the July 4 verdict of the Supreme Court that the Delhi Cabinet got its decision-making power.

However, after the approval from the L-G, the project could not fully take off due to non-availability of land, with various land-owning agencies, including the DDA, not willing to provide land for the clinics.

The Health Department claims that over 55 lakh people have been served at the clinics. "The average footfall of one clinic per day is about 90 people."

The AAP came to power in Delhi in February 2015, and its term will end in February 2020.

In its 2015 manifesto, the party promised to create 900 new Primary Health Centres (PHCs), but after a year in power, Kejriwal promised 1,000 clinics.

The government had kept December 2016 as the deadline for the Aam Aadmi Mohalla Clinic (AAMC) project -- the opening of primary healthcare centres to ensure free doctor consultations, tests and medicines to people. Having failed to meet the deadline, the government set March 2017 target.

Initially, the AAP government had planned to have a clinic -- with a doctor, a pharmacist, a clinic assistant/multitasking worker -- in a radius of 5 km over a population of 10,000-15,000.

According to a Health Department official, sites for 721 clinics have been identified until March. Permission for 614 sites has been given from the land-owning agencies.

"By this year-end, the number of clinics will go up as the work is in full swing," the official said.

The official added that land identification and finalisation have been a major issue before the department, as the land is not under the Delhi government.

"Land acquisition is taking most of the time, and there is no knowing how long it will take. The other agencies were not very keen on giving us the land for clinics. The process is: as soon as we are able to identify and finalise the land, the construction part is initiated," the official said.

The sites for the clinics were inspected by the officials from the Health Department, PWD and the land-owning agency.

"After the land is finalised and approved, the land-owning agency has to issue an NOC," he added.

The PWD is then given a period of six months to build the clinic, while three months' time is assigned to ensure electricity and water supply along with posting of the staff -- a doctor, a pharmacist, and a multi-task worker.

The setting up of clinics has been envisaged in the form of a Pre-Engineered Insulated Box Type Re-located Structure which are to be manufactured and installed through PWD.

The clinics, functional on all day between Monday and Saturday, provide services such as basic medical care based on standard treatment protocols which include curative care for common illnesses like fever, diarrhoea, skin problems, respiratory problems etc., first aid for injuries and burns, dressing and management of minor wounds and referral services. It also allows 212 lab tests.

"While the medicines are provided free of cost to the patients as per the essential drug list, the lab investigations were carried out by the empanelled laboratories," the official said.

Along with providing health-related information, education and awareness, the clinics also provide preventive services such as antenatal and postnatal care of pregnant women, assessment of nutritional status and counselling and a preventive and promotive component of National/State Health Programmes.

The Mohalla Clinic project has been praised by Kofi Annan, former secretary general of United Nations and Gro Harlem Brundtland, former director-general of World Health Organisation, with the world leaders seeing it as a move towards achieving better health coverage.

Gro Harlem Brundtland along with former United Nations secretary-general Ban Ki-Moon visited one of the clinics last year and were "deeply impressed."

Before the AAP came to power, the Delhi government was providing health care services through primary, secondary and tertiary facilities out of which the primary care was delivered through dispensaries, secondary health care delivered through multi-speciality hospitals and tertiary health care services through super-speciality hospitals.

After the AAP came to power, in order to fill the gaps in services, there has been a paradigm shift in reorganising of health care services.

Now the Delhi government provides a four-tier health care delivery system, with Aam Aadmi Mohalla Clinics for primary health care, multi-speciality polyclinics for secondary health care in the form of OPD consultation by specialist doctors including diagnostics, multi-speciality Hospitals for IPD care (earlier called secondary level hospital) and super-speciality hospitals (earlier called tertiary level hospital).

The health services provided by the Delhi government is not only catering to the people of Delhi, but also to the population from neighbouring states.

To improve the health services, the government is remodelling 94 dispensaries to start polyclinics to provide specialized health care to the citizens, along with 25 existing polyclinics.

In the manifesto, AAP had also promised to add 30,000 more beds in Delhi hospitals,

However, the government failed to reach the promise, although it has almost doubled the number of beds in the hospitals.

While there were 7,226 beds in the city in 2015, the total cumulative bed strength of Delhi Hospitals has increased to 13,819.

(Nivedita Singh can be contacted at nivedita.singh@ians.in)