Rajasthan govt. has already made an announcement for making medicines available for free to everyone who registers for treatment in any public health facility and so has the government of Bihar.However what still is an issue of concern is how the process will be carried out and what would be the mechanisms adopted for implementation and monitoring of free medicines in these states. Another challenge would also be to convince people to access services from public health settings which would require massive awareness campaigns and to change people’s mindsets about generic and free medicines. A strong citizen based monitoring system of these services will also have to be established to ensure that quality and uninterrupted health care services are delivered to all who seek it. What still seems like a big loophole is the fact that despite these announcements by the state governments, there are virtually no steps undertaken by the same governments to regulate private health practices.
Civil society organizations all over the country will have a crucial role to play in advocating for free medicines and treatment in their respective states. Government might have an important role to play in the implementation of the whole project, but there are some major areas where the civil society organizations and the community members will need to intervene and play a crucial part. Without sufficient knowledge about the risks and benefits of using medicines and when and how to use them, often people will not get the expected clinical outcomes and may suffer adverse effects. Governments have a responsibility to ensure both – the quality of medicines and the quality of the information about medicines being available to consumers. For instance there will be need to carry out huge awareness campaigns in order to sensitize the masses about the free medicine provision at govt. health facilities and to promote more and more people to access public health services. Since people generally are apprehensive about using medicines which are comparatively less expensive or free (as they tend to doubt the efficacy of these medicines in comparison to those which are more expensive), people will have to be oriented and their mind sets changed. This would require mass campaigning especially at the grassroots. Apart from this, even the health workers at village level and the health service providers will also have to be oriented.
Apart from this a strong system of citizen based monitoring of health services will also have to be developed. Unless the health services are monitored in a proper and systematic way, the success of the free medicine provision even if implemented would remain doubtful. A strong system of monitoring would ensure that periodic data is generated on the status of health services delivery and that the quality of services is upgraded. This is only possible if specific tools of monitoring and data generation are brought into use. Monitoring is essential to ensure good quality of care or resource utilization. Monitoring that is supportive, educational and face-to-face, will be more effective and better accepted by prescribers than simple inspection and punishment. Drug use studies can be used to monitor and evaluate drug use patterns, identify drug use problems, or to measure the impact of strategies to improve drug use. Prescription audit and feedback consists of analyzing prescription appropriateness and then giving feedback.
Therefore, there seems like an urgent need to sensitize civil society organizations about the importance and need for free treatment provision at govt. health facilities and to orient them about the very important role which they can play in making this happen. Given the rich outreach and hold that the civil society organizations have at the grassroots, they can also play a significant role in motivating people to access govt. health services and benefit from the free treatment provision. They can also play an important role in monitoring of health services and ensuring community’s participation into it.
Keeping this into consideration,Prayas hereby proposes to conduct orientation workshops for civil society organization members, especially the partners of Oxfam India on the above mentioned issues in order to pave way for a nation wide campaign on free treatment for all at govt. health facilities.