The medical fraternity has taken a strong objection to ASHAs (Accredited Social Health Activists) dispensing strong antibiotics to few months old babies.
Nine lakhs ASHAs are now authorised to dispense co-trimoxazole and gentamicin to millions of babies born in rural India. Doctors point out that while co-trimoxazole can cause jaundice to babies less than two months old and subsequent brain dysfunction, gentamicin (an injectable) is toxic to both the kidneys and ears.
School of Health Sciences in the Yashwantrao Chavan Open University, Nashik, director Dr Shyam Ashtekar, along with 17 senior doctors have written to Prime Minister Manmohan Singh and health minister Ghulam Nabi Azad warning against the serious consequences of these untrained and poorly paid nine lakh ASHAs dispensing strong drugs without having received any prior training.
Dr Ashtekar, who has been a member of the ASHA monitoring committee, in his letter to the Prime Minister, has highlighted that the ASHAs receive a very low remuneration of `400 per month (and less) and receive little system support.
“Expecting them to dispense hazardous medicines from the National Rural Health Mission’s childcare programme without any proper monitoring is a recipe for disaster,” said Dr Thelma Narayan, also a member of the ASHA monitoring committee.
“The ministry of health and family welfare has overlooked these hazards despite unfavourable textbook references and a clear no by a 17-member expert committee set up by the Maharashtra state government,” said Dr Ashtekar.
Some of the other experts include, Mumbai hospital joint director Archana Patil, Wadia Hospital, Mumbai, medical director Y.K. Ambedkar, head of paediatric (Hon), KISMS, Simin Irani, MUHS ex-vice-chancellor Mrudula Phadke, Prof. (paediatrics) N.R. Sutay at J.J. Hospital, Mumbai, and DDHS assistant director S.S. Nagaonkar .
These doctors recommended that amoxicillin tablet (125 mg) be given to ANMs instead.
These doctors also recommend that if there is no improvement by amoxicillin, then the primary health centre medical officer should add the injection amikacin. “The reason why amikacin is recommended over gentamicin is because no studies have been conducted to know the long-term effects of gentamicin, claimed Dr Ashtekar