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P A Francis
Wednesday, August 2, 2017, 08:00 Hrs  [IST]

A recent audit of health infrastructure in the country by the Comptroller and Auditor General of India has revealed some startling facts about the state of neglect of this vital sector by the Centre and state governments. The audit says that a massive amount of Rs. 9,509 crore remained unspent by 27 states under National Rural Health Mission in 2015-16. The unspent amount under this head was Rs. 7,375 crore in 2011-12 and continued to grow over the years. As the States consistently left funds unspent, the basic health infrastructure in the country, such as, primary health centres, sub-centres and community health centres, remained woefully short of required numbers while the population continued to grow. Among the states, some like Bihar, Jharkhand, Sikkim, Uttarakhand and West Bengal have only half as many health centres as needed. The CAG report points out that in 17 States, 428 medical equipments such as ultrasound, ECG, X-ray, cardiac monitors, etc. costing over Rs. 30 crore, were lying idle because of lack of trained doctors and technicians. Sixty seven primary centres in 13 States do not have doctors, 10 per cent of the sub-centres do not even have a female health worker, while 65 per cent do not have a male health worker. And a massive 77 to 87 per cent shortfall of medical professionals such as general surgeon, physician, gynaecologist, paediatrician and anaesthetist has been found in community health centres of these states. This, along with regular shortage of essential medicines formed the ground for the country in failing to achieve some of the crucial health targets under the Millennium Development Goals (MDG), which were to be achieved by 2015.
The Primary Health Centres are the cornerstone of rural healthcare infrastructure in India. PHCs and their sub-centres are expected to meet the healthcare needs of the vast rural population. And they are established and maintained by the state governments under the Minimum Needs Programme (MNP)/Basic Minimum Services (BMS) Programme. PHCs act as a referral unit for 6 Sub Centres and expected to have 4-6 beds for patients. Apart from the regular medical treatments, PHCs have some special focuses like Infant immunization programs, Anti-epidemic programs, birth control programs, pregnancy & related care and emergencies. As of March 2016, India has only 25,354 PHCs functioning in the country and Uttar Pradesh has the largest number at 3,392 followed by Karnataka with 2,160 and Maharashtra with 1,645. This is a highly inadequate considering the present size of the rural population. Most of the state governments have failed to increase the number of Primary Health Centres (PHCs) with the growth of the population. Many of these PHCs are run without a doctor, inadequate para medical staff and medicines. This is happening at a time when both infectious and life style diseases are increasingly affecting the rural population. As the state governments continue to fail in providing these basic healthcare facilities in rural areas, quacks and other unqualified medical practitioners flourish to the detriment of health of the poor. This calls for an urgent adoption of the New National Health Policy with main focus on strengthening and the rural healthcare infrastructure and other facilities.


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