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| LETTER TO THE EDITOR |
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| Year : 2013 | Volume
: 57
| Issue : 2 | Page : 118-119 |
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Challenges in neurological practice in primary health-care facilities
Sirshendu Chaudhuri
Superintendent, Singot Rural Hospital, Burdwan, West Bengal, India
| Date of Web Publication | 15-Jul-2013 |
Correspondence Address:
Sirshendu Chaudhuri
Superintendent, C/O Amalendu Chaudhuri, RD. No. 5, Rishi Aurobindo Pally, Durgapur, West Bengal - 713 201
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0019-557X.114981
How to cite this article:
Chaudhuri S. Challenges in neurological practice in primary health-care facilities. Indian J Public Health 2013;57:118-9 |
Sir,
With reference to the review article by Pandey, [1] I want to put some facts and opinion, which I think missing but relevant, especially in regard to primary health facilities.
The author has mentioned about inadequate drugs in primary health-care facilities. Truly that is one problem. Other problems such as delayed presentation and delayed diagnosis may be potential problems. Delayed presentations are often due to inadequate transport, initial quack treatment, negligence (poor awareness) in rural areas. Delayed diagnosis broadly may be due to two reasons. First, general duty medical officers (GDMOs) lack proper knowledge to diagnose a neurological disorder. Second, lack of basic diagnostic facilities as mentioned by the author.
Chaos by patient party in this type of setting is another problem particularly in acute cases like cerebrovascular accidents. To avoid such situations, patients are usually referred to the higher centers. Patients with chronic neurological disorder (say-movement disorder) are referred to the tertiary centers. They seldom go there in fear of loss of daily wages. If at all visit, it is unlikely for them to comply with the long-term treatment.
In "solution" part, author has mentioned that "most of the neurological disorders can be treated at primary health-care
level by ensuring availability of the basic resources like drugs." That may be a vital point, but timely diagnosis before that is very crucial. Up gradation of knowledge of GDMOs by periodic training, introducing basic diagnostic facilities (such as cytological examination of cerebrospinal fluid, computed tomography scan) by PPP model may be helpful. Finally, a well-established reporting system and surveillance system may help a lot.
 References | |  |
| 1. | Pandey S. Challenges in neurological practice in developing countries. Indian J Public Health 2012;56:227-30. 
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