This story is from February 18, 2019

Maharashtra to recruit Unani graduates to provide primary healthcare

As part of Ayushman Bharat, over 1.5 lakh health and wellness centre are estimated to come up in the country.
Maharashtra to recruit Unani graduates to provide primary healthcare
Picture used for representational purpose only
MUMBAI: Unani graduates will now join ayurveds to provide primary healthcare after the state recently got a special sanction from the Centre to recruit them for the post of mid-level providers (MLPs) at health and wellness centres. Interestingly, a similar proposal to recruit dentists for the same job profile has been turned down by the Centre, saying that their basic training didn't delve into childbirth and antenatal care, which would be a crucial ask in rural areas.

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As part of Ayushman Bharat, over 1.5 lakh health and wellness centre are estimated to come up in the country. In Maharashtra, over 4,000 sub-centres will be upgraded into health and wellness centres in a phased manner by 2020, for which the state requires more than 8,000 MLPs. After the first round of recruitments for 1,260 posts last year, the state realised that the demand for MLPs can't be fulfilled by ayurveda graduates alone, and hence had sought the Centre's permission to appoint unani and dentists for the post of MLPs. The salaries have been fixed at Rs 40,000, of which Rs 15,000 will be performance linked.
"The permission to recruit unani degree-holders came in last week. It will help us to fill up close to 10,000 posts over the next few years to strengthen primary healthcare in rural areas," said public health minister Eknath Shinde. "The idea is to diagnose and treat these diseases early so that incidence of strokes and cardiovascular diseases can be brought down."
The ayurveda and unani graduates will undergo a six-month training following a exit exam before they are recruited as an MLP. Health and wellness centres have been designed to cater to 12 health issues, including childbirth, infant care, non-communicable diseases, mental health, oral and eye care and basic emergencies. Each centre will be linked with a primary healthcentre. Sources told TOI that the first batch of recruits who are currently undergoing training at 35 centres have raised an objection to the exit exam.

However, questions are already being raised on the capability of MLPs to treat non-communicable diseases like diabetes and hypertension. Clarifying this, state officials said they wouldn't be allowed to prescribe medicines for such. "For non-communicable diseases, the medical officer at the primary healthcare centre, who is an MBBS graduate, will prescribe medicines. MLPs will only dispense medicines every month and keep a check on the condition of patients," said Dr Satish Pawar of the Directorate of Health Services. MLPs will be treating basic ailments and will be allowed to prescribe 26-27 kinds of medicines, including basic antibiotics, he added.
Surveys have shown that only 11% of people in rural areas, and 3% in urban areas took treatment at primary health facilities. Only 8% of outpatient care was provided by primary care facilities in the public sector. Dr Pawar said the health and wellness centres will reduce load on secondary and tertiary centres and reduce basic out-of-pocket expenses.
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