MoU not renewed, govt grants pending: Chhota Udepur’s solely obstetric and neonatal care centre to close March-end

THE TRIBAL district of Chhota Udepur is about to lose its solely Comprehensive Emergency Obstetric and Neonatal Care (CEmONC) centre at Jabugam (now in Bodeli taluka), which caters to a inhabitants of near 12 lakhs, sees greater than 4,000 out-patient division (OPD) consultations and almost 300 free-of-charge pure and assisted deliveries, together with high-risk pregnancies, each month.
A 3-year memorandum of understanding (MoU) between the Gujarat Health and Family Welfare Department (GH&FW) and the Deepak Foundation, for the working of the Jabugam centre underneath a public-private partnership (PPP) mannequin expired in March final 12 months and has not been renewed but.
According to the district administration, the muse, a CSR arm of the Vadodara-based Deepak Nitrite Ltd, was “asked to continue” working the unit. However, with the federal government grants due for the monetary years 2017-18 and 2018-19, aside from the non-renewal of the MoU, the muse discovered it unsustainable to proceed and has relieved 23 of its employees. The MoU was due for renewal on April 1, 2020.
Earlier this month, District Collector Sujal Mayatra wrote to the GH&FW division within the matter, whereas BJP MLA Abesinh Tadvi wrote to Deputy Chief Minister Nitin Patel, who holds the well being portfolio, urging that the MoU be renewed quickly. More lately, Congress legislator Sukhram Rathwa had raised the difficulty within the ongoing Assembly session.
The basis, which has been working the centre since 2016, informed The Indian Express that in October final 12 months the well being division officers had assured the difficulty can be regarded into, however with nothing shifting it has determined to close down from March 31.
Chief District Health Officer (CDHO), Chhota Udepur, Dr MR Chaudhari stated, “The MoU is directly between the state health department and the Deepak Foundation, so the district administration has no role in resolving the issue. We can only send reminders and requests and the District Collector has already written to the government seeking urgent attention in the matter. The centre is the only one in the district for the entire tribal population and patients from even Madhya Pradesh visit here to benefit from the service. It will be an extreme setback to the healthcare system of the district.”
The unit, Chaudhari stated, had helped in decreasing MMR and creating consciousness among the many tribal inhabitants about pregnancies and deliveries. “For years, they (the tribals) relied on home births, which was the main factor behind high MMR here,” he added.
According to the CDHO, the district neither has employees nor funds to run the centre because it was “dealing with the Covid-19 situation and vaccinations simultaneously”. After the Deepak Foundation leaves on March 31, the state well being division must make a name to determine what can be the subsequent step, he added.
Sunita Rathwa, the in-charge of the Jabugam CEmONC administration, stated as many as 100 deliveries are scheduled for the primary week of April itself. With no phrase from the federal government, nonetheless, the centre needed to relieve 23 employees members and ask sufferers to search for different medical doctors to proceed their follow-ups.
Dr Mukesh Dobaria, a gynaecologist on the CEmONC centre, informed The Indian Express, “Because of the lower socio-economic status of tribal population, we advise them to go SSG hospital in Vadodara (about 80 kilometres from the centre), which is the only other closest facility for free deliveries. But most of the patients refuse to travel that far.”
In his letter to the Deputy CM on March 8, Sankheda BJP MLA Tadvi stated, the CEmONC “has been instrumental in ensuring a decline in the rate of infant and maternal mortality ratios (MMR). But for the last three years, CEmONC has not received the stipulated grant from the government. The centre has not received Rs 78.24 lakh in the financial year 2018-19 and Rs 77.71 lakh in FY 2019-20. In the ongoing FY 2020-21, it has not received any grant at all although the year is coming to an end.”
Urging that the grants are launched and the difficulty resolved on the earliest, Tadvi additionally identified that the muse had been serving on the CEmNOC centre with out the official renewal of the MoU. “The state government has not yet signed the MoU and all these things have caused a financial burden on the foundation, which is finding it difficult to sustain such an important healthcare facility for the tribal district”, the letter said.
Congress MLA from Pavi Jetpur, Ratwa additionally raised the matter within the Assembly. “Chhota Udepur district has a severe shortage of doctors and paramedic staff. It is my request that for tribal areas, the government must spend and fill these vacancies. The CEmONC centre being run by Deepak Foundation has done excellent work in the area. But for the last two years, they have not received any of the stipulated government grants and are relieving 23 staff members. Imagine the condition of the patients, who are seeking the healthcare facility,” the legislator stated.
Mayatra’s March 19 letter requested that the MoU be renewed on the earliest in order that “the emergency services for maternal and newborn care can continue uninterrupted”.
In an announcement to The Indian Express, the Deepak Foundation stated the GH&FW division requested them to submit a proposal for the renewal of the MoU with an estimated finances for the PPP undertaking on November 6, 2019 — 5 months earlier than it was set to run out in March 2020.
“The Foundation submitted the proposal on November 19, 2020. Usually, the renewal is for three years. In April 2020, the National Health Mission approved the Program Implementation Plan (PIP) submitted by the state government of Gujarat, which also reflects on the record of proceedings (ROP) on the website of the NHM. Thereafter, we communicated with Dr Nilam Patel, the Additional Director of GH&FW department, as well as with the former director of NHM and state Principal Secretary GH&FW Dr Jayanti Ravi to seek a signed copy of the MoU as well as the official response regarding the pending dues and the release of the first instalment of the pending payment to meet the expenses incurred during the first quarter of FY 2020-21. In October 2020, Dr Ravi assured us through a telephonic conversation about looking into the pending file,” the muse’s Dr Mukesh Giri Goswami, who can also be the in-charge medical service CEmONC, Jabugam.
Dr Goswami stated the centre noticed 4,527 regular deliveries and 1,357 high-risk deliveries between April 1, 2019, and March 31, 2020. It noticed 3,402 regular deliveries and 1,127 high-risk deliveries from April 1, 2020, to February 28 this 12 months.
According to CDHO Chaudhari, anaemia and malnutrition are widespread issues amongst pregnant ladies within the district resulting in youngsters born with deformities. “The birth weight becomes a cause of concern as many newborns weigh between 1 kg and 1.5 kg. The centre has been crucial in ensuring the survival of babies with poor birth weight apart from maternal care, as the age of the mother and the family income also plays a very important role,” Chaudhari stated.
When contacted, Additional Director of Health and Family Welfare Dr Nilam Patel stated, “The file is pending with the government.” Dr Jayanti Ravi didn’t reply to calls or textual content messages.