PESHAWAR: Delay in sending demand for creation of new posts by district health of fices is likely to adversely affect the government`s plan to strengthen healthcare delivery at primary level health f acilities.

Sources say that health department awaits response from districts regarding creation of new posts. The demand will be sent to finance department by end of this month.

Sources said that basic health units, upgraded as rural health centres didn`t have more staff and the people didn`t benefit from those facilities owing to lack of mechanism at the district level to make solid cases with justification.

Sources said that posts of doctors, nurses, paramedics were vacant in the health facilities. `District health of ficers are supposed to have schedule of new expenditure (SNEs) and find more time to take up their cases with the finance department and stand more chances of getting the required posts sanc-tioned,` they added.

They said that director-general health services issued instructions to DHOs to send their proposals for its timely processing but the response was lackluster.

`The health department receives proposals for additional staff in health but these are rejected by finance department owing to lack of financing and budgeting skills on the part of DHOs, who send the proposal but can`t impress the authorised departments,` said sources.

To help the districts in budget making, a financial management cell has been established in health department two months ago.

The cell aims to enhance capacity of district health offices, including DHOs, medical superintendents and others.

Two year ago, the health department set up financial management cell at provincial level to facilitate districts in making budgets, including capacity-building in demand for need-based new posts and timely utilisation of funds.

The cell was established after finance department showed concerns that many of the submissions by health department for next year budget were incomplete, f aulty and sent very late.

The DHOs find more time to discuss the observations of finance department when they send the proposals earlier. They justifytheir demands for staff trough documents.

According to rules, districts should send their demand to the health department by January every year. `Owing to incorrect proposals, the demands for posts get rejected by the government and same is repeated next year,` said sources.

The health department has appointed 80 per cent doctors and other staff at BHUs and RHCs and expects the districts to ask for new posts according to their needs.

`To ensure basic minimum package health services, the government has awarded special package to doctors in far off areas with an increase from R100,000 to Rs140,000 per month, salaries and health professional allowance to other staff. The department is angry at the slackness of DHOs,` said sources.

They said that owing to non-availability of staff, patients couldn`t get effective services at the primary health facilities. `Seminars and workshops have been held in Swat, Abbottabad and Dera Ismail Khan for capacity-building of DHOs and other staff. Training in other districts will start from February 20,` said sources.

They said that a DHO filled all vacant positions in his district recently but most of his counterparts in other districts neither knew about the financial matters nor had support and filled a format when pressed from the top.