The Comptroller and Auditor General (CAG) has heavily criticised the state of healthcare in Chhattisgarh between 2012 and 2017 in its performance audit on the National Rural Health Mission in the state. The CAG has found that the state has a shortage of specialist doctors to the tune of 89 per cent and also suffered from a shortage of drugs, essential equipment, and that targets of infant mortality and maternal mortality rates were being missed. The CAG audit report was placed on the floor of the Assembly on Thursday.
According to the report, the performance audit on NRHM with special focus on reproductive and child health for the 2012-2017 period — when the Raman Singh-led BJP government was in power — was conducted during April-July 2017 and covered seven out of 27 districts by sampling method.
The audit found, “The state suffers from shortages of human resources in critical positions of specialist doctors to the extent of 89 percent, medical officers by 36 percent, staff nurses by 34 percent and paramedics by 12 percent against their sanctioned strengths. These shortages adversely affected the delivery of health care services by the district hospitals, community health centres (CHC) and primary health centres(PHC).”
The Congress had emphasised healthcare in its election manifesto, and promised a “universal healthcare” scheme in which free and quality services would be provided to those in need. Now voted to power, the Bhupesh Baghel government has its work cut out, with the CAG critiquing the previous state government’s performance in NRHM. A major challenge for the new government would be the huge shortage of specialist doctors — pegged at 89 per cent by the CAG in its performance audit.
The report further said that in the hospitals and health centres it sampled, patients were also deprived of necessary treatment due to shortage of medical equipment (between 25 and 69 per cent), drugs and consumables(between 40 and 76 per cent), laboratory services (between 36 and 71 per cent) and were referred to other hospitals. “20 CHCs, 88 PHCs and 768 SHCs did not have designated government buildings and were operational from private buildings, other government buildings etc. as on March 2017 which lacked space, infrastructure, delivery service, OPD facilities, labour rooms, beds, water connectivity, toilets etc. These deficiencies impaired the healthcare services through these health centres,” the report said.
The report said that there was “significant shortage” of essential equipment to the extent of 38 per cent at district hospitals, 53 per cent at CHCs, and deficit of drugs and consumables were up to 40 to 75 per cent in district hospitals, 33 to 75 per cent in CHCs and 45 to 75 per cent in PHCs on account of failure of Chhattisgarh Medical Services Corporation Limited to supply the drugs and equipment despite receiving indents from the state health department on grounds of non-availability of rate contract for medicines, non-receipt of tenders, late receipt of annual demand from Directorate of Health Services etc.
“In the absence of adequate improvement in health care facilities, the infant and maternal mortality rates (IMR- 39/1000, MMR- 173/1,00,000) were far short of the NRHM goals (IMR-less than 25/1000, and MMR less than 100/1,00,000),” the audit report said.