The Report of the Comptroller and Auditor General of India on Performance Audit of the Reproductive and Child Health under the National and Rural Health Mission has found that essential drugs for patients were not available in 24 states, as reported by the Business Standard.
They also found out these medicines were issued without prescribed quality checks or noticing expiry dates, which exposes the patients to numerous health risks.
The report by the Comptroller and Auditor General of India (CAG) was produced before Parliament on Friday, 21 July, and it also highlighted the shortage of doctors and paramedics in almost all selected facilities. According to a report by the Hindustan Times, the CAG also criticised the government for not being able to manage funds properly; the unspent amount was found to have increased by 30% between 2011 and 2016.
Unavailability of medicines
- Contraceptive pills, Vitamin A and ORS packs are not available in over 20 states in the country – including Assam, Bihar, Chhattisgarh, Gujarat, Haryana, Madhya Pradesh, Karnataka and Telangana.
- Non-availability of Paracetamol, B Complex and albendazole was a huge problem in all the 24 states.
- In eight states, essential obstetric kits were not available in some health facilities.
- Furthermore, the CAG report also added that the administration did not maintain the number of antenatal check-ups in 20 states.
- Shortfall in administering folic acid and iron tablets has also been noticed in all the 28 states.
“Similarly, in four states (Arunachal Pradesh, Jammu and Kashmir, Manipur and Meghalaya) less than 50% of pregnant women were immunised with both doses of Tetanus Toxoid vaccine (TT1 and TT2),” the report said. Apart from this, the report also spoke about Infant Mortality Rates higher than 40 in states like Assam (49) Bihar (42) Chhattisgarh (43) Madhya Pradesh (52) Odisha (49) and Uttar Pradesh (48). Deficiencies have been noted in the implementation of Janani Suraksha Yojana as well, pointed out the CAG Report. Delayed payments to beneficiaries, non-payment of initiatives to beneficiaries and payment to 12, 723 excess number of beneficiaries are among the loopholes of implementation of the Yojana.
Shortage of doctors
There has been an acute shortage of medicines and doctors at government hospitals, as reported by the CAG. Shortage of specialists are plaguing healthcare delivery in the country. The health secretary CK Mishra, though, has dismissed this reports and he has been quoted saying, “These are stray incidents and shouldn’t generalise. We now have an absolutely robust quality control mechanism in place.”
There is a shortage of doctor especially in villages and districts which are observed in almost all select facilities. This leads to people being forced to travel longer distances for treatment.
“In the selected community health centres of 27 states, the average shortfall of five types of specialists (general surgeon, general physician, obstetrician/gynaecologist, paediatrician and anesthetist) ranged between 77 and 87 per cent,” pointed out the CAG report.
Shortage of doctor sin most of the facilities have lead to high-end medical equipments like ultrasound, blood -storage units and X-ray machines not being used. The report added that 428 machines and equipment worth 30.39 crores are not being used at several healthcare facilities in the district and village centres. Despite the availability of medical equipment, services aren’t provided to patients since there are no trained staff to run the machines. At some outlets, there isn’t space to install these machines as well.
According to Firstpost, Arunachal Pradesh, Assam, Himachal pradesh and Uttar Pradesh have inadequate cold storage facilities for storing vaccines. The states have no deep freezers or ice-lined refrigerators and vaccine carriers to maintain vaccines at the prescribed range of temperature, stated the CAG report.
There is a major service shortfall at sub-centres, primary health centres and community health centres all over the country. The shortfall in an average ranged between 24 % to 28% whereas in state s like Bihar, Sikkim, Jharkhand, West Bengal and Uttarakhand, the shortfall was more than 50%.
The unspent amounts with the 27 states rose from Rs 7,375 crore in 2011 – 12 to Rs 9,509 crore in 15-16. The worst performing states and Union Territories include Meghalaya, Andaman & Nicobar islands, Uttar Pradesh, Telangana and Karnataka.The CAG also recommended the health ministry to optimise and rationalise the funds flow keeping the absorbing capacity of the health facilities in view. The CAG has also asked to maintain and monitor the details of interest on unutilized funds to ensure effective utilisation.
There have been large gaps in the delivery of health care services to the citizens of the country and they are evident in the healthcare outcomes. The Logical Indian urges the health ministry in effectively aiming at plugging these gaps so that health care services are better meted out to the common people.