Health infrastructure lacks in basics in Odisha

 Health infrastructure lacks in basics
Expressbuzz, Nov 29, 2009
Sanjeev Kumar Patro

BHUBANESWAR: Can a health centre function without supply of water, electricity and, most importantly, lab technicians? Well, it is in Orissa.Consider this. As high as 35 per cent of health sub-centres that form the backbone of village health care delivery apparatus function without regular supply of water and around 24 per cent without power connection. The PHCs stand little better at 9 per cent without regular water supply and electricity.Over 90 per cent of the PHCs function without lab technicians though diagnosis of malaria, dysentery, cholera etc. depends on tests.Of a total of 1,279 PHCs, only 9.4 per cent have round-the-clock delivery service and only 9 per cent have telephones.While a PHC caters to 24,462 people or 15 villages only around 9 per cent of them have between four and six beds.In the 10th Plan period the Government had set the target of opening up 447 health sub-centres but they have been on the papers only.None has come up even though the required subcentres are at least 7,283 and the State currently has only 6,688.Thus, around two per cent of the villages are still out of the basic health care loop.Against the target of opening up 108 CHCs, the actual achievement stood at 74. A glance at the subsequent plan periods further shows how the State administration has failed to open up a single sub-centre since the Eighth Plan period with only the 11th Plan period seeing around 700 new sub- centres. Also, with around 20 per cent shortfall in CHC requirement, Ninth and 11th Plan periods did not have a single addition.There are no referral units at CHC level and only two exist at the sub-district level against 120 and 78 respectively in Andhra Pradesh. This when a World Health Organisation report has cautioned that lack of referral units contribute largely to high maternal mortality rates in Orissa. The human resource deployment in rural areas stands very poor as over 80 per cent PHCs are manned by a lone doctor.The CHCs are no better with 496 against the requirement of 924 specialists.Specialists like paediatricians and gynaecologists are not positioned in CHCs when the State tops in MMR and IMR. The huge shortfall of around 2,260 nurse-midwives in PHCs and CHCs coupled with only around 9 per cent PHCs having a labour room cast a shadow on the NRHM’s drive to improve institutional deliveries in rural areas.Against the norm of one radiographer per CHC, there is a huge shortfall of over 220.