Sunday, December 25, 2016

The problem with the mindless implementation of the PCPNDT Act

The Surat health officer said - " We have fixed a target to reach 1,000 girls against 1,000 boys."

http://indianexpress.com/article/cities/ahmedabad/surat-sex-ratio-has-improved-in-2014-15-says-crs-data-4443680/


This is exactly the fear doctors had when the PCPNDT Act was passed. The normal sex ratio at birth is 950 girls to 1000 boys. However, in their over-zealousness to prove that they are working hard, government health officials have started setting mindless "targets" and made a mockery of medical facts ! They will continue barking up the wrong tree, because of their ignorance.

1 comment:

  1. The restrictions on the use of Ultrasound under the PCPNDT act is in fact not a good idea. Ultrasound is an important easy investigation which can be used even in rural areas The act is putting on more and more criteria on the use of Ultrasound which is not a good idea The act once allowed MBBS doctors to do Ultrasound. Later it said you need to pass an examination to do Ultrasound. The members who made this act presumes that MBBS Doctors will do sex determination and Radiology Doctors will not do sex determination. It seems to suggest that only MBBS doctors who pass another qualifying examination will not do sex determination. That’s not true. Qualities like integrity and honesty is not based on any training or examination. Everyone must be allowed to do Ultrasound examination. By restricting its use by many criteria’s will only prevent the use of this simple affordable investigation in the diagnosis and management of many cases.
    Currently while doing in Ultrasound we are made to sign two copies of a form saying that we are not disclosing sex. Also we are made to take two to four ultrasound pictures of scan and made to put in the file. MBBS doctors were once allowed to do scan. Then an amendment came in 2014 which said you have to pass another examination to do scan, The act actually prevents the use of Ultrasound by MBBS doctors . Ultrasound is the cheapest imaging modality currently available and can help a long way in diagnosing and treating common diseases. We must not make an attempt to restrict its use in the name of PCPNDT act.

    Instead what’s needed is better vigilance and action to prevent female feticide. I have few suggestions
    1) Each District must have a cell for Medical termination of pregnancy. Medical termination of pregnancy is the final pathway in female feticide . No MTP in second trimester must happen without prior permission of this committee. Fetal sex can be determined after second trimester and no second trimester termination should happen with out the prior approval of this committee.
    2) Please do not put restrictions on Ultrasound and its use. Use of Ultrasound is like sthetescope in modern day clinical practice and its use must be made more liberal. Please do not restrict the use of Ultrasound. MBBS doctors must be allowed to do Ultrasound. It must be remembered that every doctor can tell sex whether he is MBBS or Postgraduate. Qulaities like integrity and honesty has no correlation with degrees.
    3) There must be a good vigilance cell in each district for monitoring of all scan centres. There must be regular raids and inspection of all scan centres to prevent female sex determination and female feticide.
    LASTLY I WOULD AGAIN REQUEST YOU DO NOT PUT RESTRICTION ON THE USE OF A SIMPLE INVESTIGATION WHICH CAN BE GREAT USE IN DIAGNOSING AND MANAGING CASES< ULTRASOUDN AND ITS USE MUST EB ENCOURAGED. THER IS NO POINT IN TARGETTING ULTRASOUND MACHINES AND SONOLOGITS. EVERY DOCTOR MUST BE ALLOWED TO USE ULTRASOUND MACHINES. I AM SURE WE NEED TO PROGRESS AND REGRESS.
    AFTER THE INTRODUCTION OF PCPNDT ACT SEX RATIOS HAVENT IMPROVED IN MANY STATES AND THIS ITSELF SHOWS THAT THE ACT ITSELF IS A FAILURE, DO NOT PUT RESTRICTIONS ON THE USE FO ULTRASOUDN INSTEAD WE NEED BETTER VIGILANCE AGAINST SEX DETERMINATION AND FEMALE FETICIDE.

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