Sam - Namma clinic - does it work?

Namma clinic ESE

Sumitra visited the neighborhood doctor since she had a fever, who then gave her some medication and sent her home. She lost strength, nevertheless, and her situation did not get better. Her husband made the decision to transport her to the city's major hospital, a three-hour bus ride away.

Sumitra was in critical condition when they got to the hospital and had to be admitted to the intensive care unit. Sumitra was identified as having a severe malaria case after spending many days in the hospital. She received therapy and finally made a full recovery, but her family had to sell some of their possessions to fund the expense of her care because it was much more expensive than they could afford. 

Sumitra's tale is used by Abhijit Banerjee in his book “Poor Economics” to highlight the value of primary healthcare facilities in rural areas. He contends that Sumitra's fever could have been identified and treated before it turned into a potentially fatal condition if she had had access to a neighbourhood basic healthcare facility. This would have spared her and her family the price and inconvenience of traveling to a hospital that was far away as well as the cost of receiving intensive care therapy.

Though Banerjee’s study is on rural health, a lot of similarities can be found between the problems that both Urban and Rural communities face, like the availability of health centers, doctors, basic medicines, and treatments. The objective of these different kinds of clinics is to aid the EWS (Economically weaker section).  

The state government announced the creation of Namma clinics or Urban Health and Wellness Centres (U-HWCs) as per the 2022–23 state budget in an effort to decentralize primary healthcare. The initiative's main goal is to make sure that low-income households and communities can easily access and afford basic medical services and infrastructure. 438 Namma Clinics will be built by the state, 243 of which will be located inside the BBMP wards of Bengaluru.

Namma Clinics are expected to be installed in all 243 BBMP wards in the city. Currently, there is 1 Public Health Centre (PHC) for every 50,000 people. With the Namma Clinic, the state government says that each Namma clinic will cater to 15,000-20,000 people. However, the average population in each BBMP ward is approximately 42,000. Thus, one clinic in each ward is not the best possible solution. 

Abhijit Banerjee contends that the conventional method of constructing sizable hospitals and clinics is ineffective for addressing the healthcare needs of the underprivileged. He supports a more specialised strategy instead, with an emphasis on basic healthcare services and preventive treatment. He proposes that this strategy can be accomplished by opening modest, neighbourhood health facilities that are open to the underprivileged.

Namma Clinics mainly aims to cater to the economically weaker sections (EWS). These clinics function between 9 am and 4:30 pm which is typically within the working hours of these low income populations. If Namma Clinic is a welfare scheme put in place to benefit the EWS, then one cannot expect them to leave a day’s work and miss out on their pay to get treated in a hospital. Thus, a revision in the working hours of these clinics is essential. 

One of the team members had a conversation with a nurse who was posted in one of the Namma Clinics near Kengeri but resided in Banashankari. This was an impromptu conversation while waiting by the BBMP office to meet Dr. A.S. Balasundar, Chief Health Officer, to obtain information on Namma Clinic. The nurse complained about the meager salary and the long-distance posting. Several media reports confirm the same about poor remunerations to the doctors and nurses. 

As per media reports, the government has spent 155 cr on setting up Namma Clinics across the state. However, the BBMP website nor any media sources provide the accurate figures specific to each district. An RTI has been raised to obtain information on the same, as our team reached a dead end when we contacted the BBMP health department.  

In conclusion, until the clinics are made available 24hrs, and in much more numbers, no significant difference can be found, which poses the risk of scrapping the idea of Namma Clinics in the future.

Let’s remember that Banerjee emphasizes the necessity of health education programmes to raise knowledge of preventative healthcare practises among the underprivileged and the significance of rewarding healthcare personnel for high-quality services. He emphasizes the significance of including local communities in the development and execution of healthcare programmes, as well as the relevance of adjusting healthcare offerings to the particular requirements of the communities they are intended to serve. 

Remarks:

All the data for this  article has been acquired through official websites, RTI and in-person conversations. Visualizations were created using Flourish.