Social
Assessment Study for Karnataka Health Systems Development
Project
Page
3 of 10
The community has a stereotypical image about government
hospitals i.e. they are dirty and overcrowded, there are
long waiting hours, behavior of the staff are rude and the
treatment is not very effective. A large number of positions
of doctors and ANMs were reported to be lying vacant. The
service timings of these hospitals are considered to be
inconvenient. Women and adolescents reported lack of privacy
and confidentiality as one of the reasons for their not
utilizing government facilities. The SC and the ST community
also perceived discrimination by staff at the health centers.
Corruption and private practice by the doctors were found
to be important causes of dissatisfaction among clients.
Despite all these negative perceptions, the poor and other
disadvantaged groups are forced to avail treatment from
government hospitals because of their economic compulsions
and free availability of treatment in these hospitals.
Surprisingly,
in a few government health centres a high client satisfaction
was found. The reason for this contrast was identified to
be the good behavior, technical competence and commitment
of the doctors working in these centres.
The
community is quite dissatisfied with the services of ANMs
due to their infrequent visits to the villages and their
homes. The community also complained that the ANMs do not
provide them the necessary medicines during their visits.
The
community expressed a high opinion about private health
practitioners and perceives their treatment to be more effective.
The
health service providers have their own set of limitations
in providing satisfactory services to the community. Lack
of residential quarter to staff is forcing them to reside
away from the headquarters. Some of the sub center clinics
in rural areas are not held regularly because the public
transport facilities are very untimely. The staff is working
in the tribal and remote areas for a number of years without
any appreciation or incentives of any kind. Promotions of
the staffs is pending for a long time. Supervision is weak
at all levels. No vehicle is available at the disposal of
PHCs. The community expectations from govt. health institutions
and hospitals are very high.
