Do poor people deserve poor clinics?

POLICYMAKERS have a difficult job. Resources are always scarce, and there is never a definitive answer to what constitutes a ‘fair’ allocation of those resources. It is an especially difficult job for those who oversee the allocation of health care resources to match their organizations supply with the demands of those they are trying to help. With aiding some of the poorest developing countries sometimes simply setting up a clinic and providing it with resources is not effective. The needs of those people demand not only the clinics to be stocked with resources, but also for them to have adequately trained employees. I have recently come across some research on poor conditions of health care clinics in lesser economically developed nations. This research leads me to suggest that more organizations should emphasize the development of clinics already in place and improve the adequacy of human resources if they are to meet the real demand of the unhealthy.

Research shows that 40% of the women of a poor rural district in western Tanzania are bypassing their most local health care clinic to deliver their child at one they believe is satisfactory. They perceive that their local clinic is so poor quality that they risk walking extra miles to deliver at a clean facility. About 60% of mothers do not even risk leaving their homes to deliver (though this is often estimated to be a result of tradition. There is not point in supplying these local clinics if they are not serving the demands of the sick. Lots of money is being lost when these facilities go unused and bypassed. Similar research presents the inadequacy of certain very poor health care clinics in India.

The rural area of Udiapur, Rajasthan, India is not only very poor but also provided with seriously ineffective healthcare. Even though these people are exposed to clinics and make it a priority to consume health care services (contributing a considerable amount of their already small household budgets) the services they receive are insufficient. Wherever the people of Udiapur are receiving their care, about 41% of the employees claiming to be ‘doctors’ do not even have medical degrees. 18% of the employees diagnosing and injecting patients do not even have any training. This research goes on to show a correlation between these poor facilities and very poor health amongst the locals.

These two examples show that even though clinics are established and manageably accessible their poor quality demands a lot of attention. Once again, I know that resources are scarce but it is a good reminder to policymakers and health organizations that setting up clinics is not enough. I suggest further research and investment into clinical efficiency logistics to identify and ameliorate the problems preventing already established clinics from effectively serving their purpose. Also, I would suggest increasing the emphasis on human resources logistics for clinics in developing nations. This would involve developing more programs that train medical employees and contributing some of the funding used for medical supplies (syringes, medicines, etc) to medical employees. It is necessary that the supply of medical supplies correlates with qualified personnel that will use them effectively.

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