Basthi Dawakhanas: Flagship health scheme faces erosion in its core services

Hyderabad’s Basthi Dawakhanas, aimed at providing healthcare to the urban poor, are facing challenges including delayed salaries, inconsistent diagnostics, medicine shortages, poor infrastructure, and Sunday closures. These issues are reducing accessibility and effectiveness of the flagship urban health scheme

Hyderabad: Launched as a flagship health scheme to serve the urban poor by bringing quality healthcare services to their neighbourhoods, the Basthi Dawakhanas in Hyderabad have come under intense scrutiny, thanks to the gradual erosion of their overall quality.

While the vulnerable population continues to visit these facilities, in the last few years, their core services are facing multiple difficulties. Some of the stand-out features of Basthi Dawakhanas, such as the availability of all 134 diagnostic tests with same-day results, medicines for 108 different medical conditions, are no longer consistently available in all facilities in Hyderabad, according to senior public health specialists familiar with the programme.

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Another major challenge is that the caregivers in these urban health centres are facing at least a two-to-three-month salary delay. A majority of healthcare schemes operating in these facilities fall under National Health Mission’s (NHM) Centrally Sponsored Scheme (CSS). The required funding pattern for these initiatives is a 60/40 ratio (Centre/State). Inordinate delays in the release of both the State’s (40 per cent) and Centre’s (60 per cent) shares are a major cause for payment delays.

“At present, for NHM-related schemes, in almost all the health departments in Telangana, there is at least a two-month delay in release of salaries. For a long time, we have been demanding to bridge this gap so that junior-level healthcare staff receive their salaries regularly,” says senior office bearer of Telangana United Medical and Health Employees Union, Yada Naik.

In the last few years, due to delays in release of diagnostic services and holidays on Sundays, Basthi Dawakhanas have become inaccessible to the urban poor.

Basthi Dawakhanas are specifically aimed at vulnerable urban communities, who cannot afford to take leave on weekdays. However, almost all these facilities are closed on Sundays, making it extremely difficult for the urban poor to visit them.

“There is a need for constant monitoring to make such schemes successful and effective. Sometimes, such facilities run out of reagents, the infrastructure requires regular maintenance, doctors must be available on time and the diagnostic tests must be available within 24 hours so that the patient can receive timely treatment. Unfortunately, this gap continues to remain,” senior doctors said.

Challenges impacting Basthi Dawakhanas in Hyderabad:

• Inconsistent availability of all 134 different diagnostic services
• Medical test results are not released within one day
• Shortages of medicines for all 108 different medical conditions
• Delay in payment of salaries to caregivers
• Poor maintenance of infrastructure and issues with timely doctor availability
• Limited accessibility due to closures on Sundays
• Lack of availability of critical injections (e.g., rabies and anti-snake venom)