The recently concluded Assembly session bypassed the health care issues in Meghalaya. Legislators don’t seem to read the newspapers. If they did, they would notice that nearly every single day the 108 GVK EMRI officials report of women delivering babies inside the ambulances. Clearly the health infrastructure in Meghalaya, especially its periphery is woefully inadequate. The Sub-centres in the distant villages are the first contact point between the primary health care system and the community. Normally Sub-Centres are to be manned by at least one Auxiliary Nurse Midwife (ANM) / Female Health Worker and one Male Health Worker. Under National Rural Health Mission (NRHM), there is a provision for one additional ANM on contract basis. Sub-Centres are primarily aimed at providing services related to maternal and child health, family welfare, nutrition, immunization, diarrhoea control and control of communicable diseases. Sub-Centres are provided with basic drugs for minor ailments to take care of essential health needs of men, women and children.
At the next level is the Primary Health Centre (PHC) which is envisaged to provide integrated curative and preventive health care to the rural population with emphasis on preventive and promotive aspects of health care. A PHC should be manned by a Medical Officer supported by 14 paramedical and other staff. Under NRHM, there is a provision for two additional Staff Nurses at PHCs on contract basis. PHCs are supposed to have at least 4 – 6 beds for patients. At the next level is the Community Health Centre (CHC) which is to be manned by four Medical Specialists, namely Surgeon, Physician, Gynaecologist and Paediatrician supported by paramedical and other staff. CHCs should have 30 beds for in-patients with one OT, X-ray, Labour Room and Laboratory facilities. CHCs are referral centres for PHCs and also provide facilities for obstetric care and specialist consultations. But a physical visit to the above health centres will reveal that they don’t conform to the norms. Most CHCs don’t have the wherewithal required for a labour room or the life saving equipments, hence pregnant women in labour are told to avail the services of district hospitals. In Shillong Ganesh Das Hospital can no longer cater to the inflow of patients to the maternity ward. We don’t know how many women in Meghalaya die of childbirth or immediately after because there is no data for Maternal Mortality in Meghalaya in 2015-16. Clearly women’s health issues are not a priority for elected representatives.