The ingenuity of People’s Primary Health Care initiative (PPHI) was conceived back in 2007 by the then President of Pakistan General Pervez Musharraf to improve primary Health care services in order to assuage poverty through quality and accessible healthcare. After ten years, it is of the essence to evaluate whether this organization has been able to achieve its desired objective of catering quality Primary health care to the deprived masses. In the wake of 18th Amendment in the Constitution of 1973, the subjects contained in the current list were devolved to the provinces. Thus, the federal support Unit (FSU) which was the federal head office of PPHI was abolished and provincial support Units were left at liberty to continue their work. In Balochistan, the PPHI was registered under Companies Registration Act, 1984 consequently, a Board of Directors was appointed to supervise the activities and frame regulations for PPHI Balochistan.
Presently, PPHI has been entrusted with the management of Basic Health Units (BHUs) across the Balochistan. PPHI invariably claims that they have made BHUs functional as previously they had been dysfunctional but, such claims are nothing more than an eye wash. PPHI’s performance can be measured by looking at the figures of maternal mortality rate and infant mortality rate in rural areas where mostly the BHUs are located. The maternal mortality rate is exceedingly high in rural Balochistan and rate of infant mortality rate is also very high. The healthcare services are almost non-existent in rural areas because the inhabitants of rural areas always complain that the BHUs under the management of semi-NOG-PPHI are always found closed and staff posted in these BHUs do not turn up on their duties.
The administration of PPHI is a great deal busy in their shenanigans that they never bother to make endeavors to take the bull on horns and deliver to the masses by curbing absenteeism of healthcare staff posted at BHUs. At the time of inception of PPHI, it was compulsory that the District managers would be taken into service from professional civil servants and particularly from Provincial Civil Service (PCS) or from Federal Civil Service (CSS) as the officers of these service groups have particular managerial experience, skills, capability, required trainings and they are experts in management of public affairs and they are not prone to political pressure. It was entirely this reason that in its early years PPHI did perform well across the country. However, after the 18th Amendment, the provincial chapters of PPHI became rudderless and hijacked by incompetent people thus; they felt comfortable to hire Managers from open market. The sole reason of doing so was that such people happen to be servile and are prone to any kind of pressures.
Initially it was compulsory that the District Support Managers (DSM) of PPHI would be taken from professional civil servants such as PCS and CSS but now they rule is not followed
The provincial government every year transfers huge chunk of funds to PPHI on account of the budget of BHUs. In addition, PPHI receives donations and grants from international donors and millions of rupees received by PPHI during District Governments have been invested in different commercial banks, the interest of which is also given to PPHI executive. The irony is that no proper audit mechanism exists within PPHI structure. However, PPHI claims to hire international standard audit firms to audit its accounts but, the fact of the matter is that the annual external audit teams have never bothered to visit district offices of PPHI and audit their accounts. Simply reports are made while sitting in the drudgery and deluxe head office in Quetta. The audit reports are also not reasonable and on the fence.
Owing to the weakness of provincial government institutions, no one has felt obliged to review the matters of PPHI and overhaul the entire composition and to ensure bringing it in the government accountability ambit. It can safely be said that if PPHI draws its funding sources from government treasury so why government must not have right to held this organization accountable. A reliable source has alleged that millions of rupees have been spent by PPHI on the pretext of improving the infrastructure of BHUs yet not a single procurement, tendering and completion record exists in the district offices of PPHI. On the other hand, no significant infrastructural improvement can be observed in BHUs of rural Balochistan which is indicative of possibility of mega corruption scams in these funds.
Almost 99 per cent female staff of PPHI posted at BHUs remain absent from their duty