Primary health centres, sub-centres and community health centres across 28 states and union territories of India face a 24 to 38 percent shortage in the availability of medical personnel, says the latest report published by the Comptroller and Auditor General (CAG) of India.
The report is part of the CAG's assessment of the National Health Mission (NHM), which was started in 2005.
IndiaSpend, the country's first data-journalism initiative, has detailed the lack of physical infrastructure and human resources at public health centres in the country, in the report.
According to the survey, 73 percent of sub-centres were found to be at a distance of more than three kilometres from the remotest village and 28 percent of them could not be accessed using public transport and 17 percent sub-centres were found to be in unhygienic conditions.
The report also observed that 24 states even had instances of non-availability of essential drugs. Eight out of these 24 states lacked the availability of essential medicines and consumables such as Vitamin-A, contraceptive pills, oral rehydration solution (ORS) packets and essential obstertic kits at their health centres.
The National Health Mission was launched in 2005 as the country's largest health programme. The programme's aim was to provide universal access to healthcare facilities. Under the programme, state health societies are given funds in order to strengthen local health systems, institutions and capabilities. But the report by IndiaSpend presents a totally different scenario. According to the report, the funds were not being utilised by the states in an optimum manner and a 29 percent rise in the balance left with the states in the five years leading to 2016 was observed.
The National Health Mission is also aimed at ensuring uninterrupted and quality healthcare by increasing the availability of doctors, specialists, paramedical staff, auxiliary nursing midwives and accredited social health associates. As per the mission guidelines, state governments should fill up existing vacancies with new contractual appointments, the funds for which, are allocated by the Centre.
However, in the CAG report, it was observed that there was a shortfall of 50 percent in the availability of staff at health centres in Bihar, Jharkhand, Sikkim, Uttarakhand and West Bengal. The state of Bihar had shortages in community health centres by as much as 92 percent.
The report also suggests that 77 percent to 87 percent of community health centres have been functioning without specialst doctors like gynaecologists and paediatricians. In its response, the minsitry had cited reasons such as inadequate availability of personnel and irrational deployment of doctors and specialists by state governments, for the shortage.
In its report, CAG also noted that 17 states had not used equipment for the ultrasound, X-ray, ECG, cardiac monitoring machines due to the non-availability of doctors and trained professionals. As many as 428 such equipment worth Rs 30 crore are yet to be used.
The survey was done across 1,443 sub-centres, 514 primary health centres, 300 community health centres and 134 district hospitals.
