* State now has only three doctors against 10,000 patients * WHO stipulation is a minimum ratio of 1:1000
BY OUR STAFF REPORTER
GUWAHATI, Feb 13: At a time when the present regime in Dispur is making tall claims of being successful to bring about sea changes in the Health sector, the Niti Aayog, the Centre’s policy-making thinktank, has assessed Assam as one of the worst performing States in the country in terms of successfully fulfilling various health parameters.
The Health Index, developed by the Niti Aayog, has ranked Assam at 16th position among 21 larger States in the country. Assam has even slipped from its own earlier scores (15th position) recorded during 2014-15.
”This is a matter of concern and should nudge states into reviewing and revitalising their programmatic efforts,” the Niti Aayog report designed as “Healthy States, Progressive India”, said.
The Health Index has assessed States on the proportions of low birth weight of newborns, their immunization, tuberculosis treatment success rates, the amounts of persol or out-of-pocket expenses families pay for deliveries in government hospitals and vacancies in primary health centres, among other measures.
Along with Rajasthan, Odisha and Bengal, Assam has the highest proportion (15 per cent higher) of low birth weight newborns. The Niti Aayog which prepared the report by compiling data and reports of 2014-15 (as base year) and 2015-16 (reference year), has found that Assam has made limited improvement in terms of immunization, neotal mortality rate, institutiol deliveries, people living with HIV on anti-retroviral therapy and tuberculosis treatment success.
The Health Index has also listed Assam as one of the 16 States and Union territories across India that do not have functiol cardiac care units (CCUs) in Government-funded hospitals in any of their districts except in medical colleges.
Based on the composite Health Index scores, the Niti Aayog has categorized the States into three groups — Aspirants, Achievers and Front-runners. Assam has been put in Aspirants category which implies that it is one of the bottom one-third States with index score below 48. Being in the Aspirants category Assam will have to be given substantial scope for improvement and require concerted efforts. Incremental performance measures the change in the Health Index from base to reference year which is masked by the year-specific ranking. It is important to identify the year-on-year pace of improvement made by States. Based on incremental performance the Niti Aayog has categorized the States into four groups and Assam has been placed in “least improved” group.
Ranking was done in three categories — larger States, smaller States and Union Territories — to ensure comparison among similar entities.
Among smaller states, Mizoram ranked first followed by Manipur on overall performance, while Manipur followed by Goa were the top ranked states in annual incremental performance.
Developed by Niti Aayog, with technical assistance from the World Bank, and in consultation with the Health Ministry, the states and UTs have been ranked on their year-on-year incremental change in health outcomes as well as their overall performance with respect to each other.
Even though the officials in the State Health department are tight lipped about the Niti Aayong’s latest report saying that they are studying the same, senior doctors both serving and retired said the report has only exposed reality.
“The State Health department is only making claims of bringing about changes or improvement in the health sector. But in reality nothing such changes have been witnessed. Huge amount of money has been pumped towards constructing buildings of hospitals, health centres and procuring equipments. But mere construction of buildings and procurement of equipment do not ensure healthcare unless the State can create adequate number of doctors, nurses and para medics to serve patients,” a senior doctor at Gauhati Medical College & Hospital said.
The State now has only three doctors against 10,000 patients, which goes against the World Health Organisation’s stipulation of a minimum ratio of 1:1000. Sources said the crisis may further deepen with large number of fresh medical graduates showing reluctance to join the government hospitals. Nearly 50% of the posts in the Healthcare sector are currently lying vacant and whenever the State Government publishes advertisements to fill up such vacant posts, the number of applicants is far less than the number of posts.
A report of the Union Health Ministry published in 2017 has revealed that against the sanctioned strength of 1,014 doctors in Public Health Centres (PHCs), there are 932 doctors, creating a shortfall of 82 doctors. Similarly, out of 2,798 nursing staff in PHC and Community Health Centres (CHCs), 246 posts are lying vacant.
Similarly, against the requirement of 1,014 PHC health assistants (male), there is a huge shortfall of 908 staffs. Out of 1,014 PHCs in the State, 90 PHCs are running sans any electricity supply, 129 have no water supply facilities and 53 PHCs have no motorable approach roads. This besides, 251 PHCs have no labour room and 985 PHCs are lacking in operation theaters.
As many as 2,298 sub centres out of 4,621, have no regular water supply facilities and a total of 2,263 sub centres are running without electricity supply. Altogether 414 sub centres have no motorable approach road.
Out of 151 community health centres (CHCs) in the State, 105 are functioning without X-Ray machines, 57 without quarters for specialist doctors and 23 are running without referral transport. Only 45 CHCs have functiol operation theatres, 133 have functiol labour rooms, 77 have stabilization units for newborns and 134 have newborn care corner.
A retired doctor who was once closely associated with development of Assam Medical College & Hospital in Dibrugarh said until and unless the State Government takes a holistic step towards creating adequate and dedicated manpower to serve patients mere pumping of money and announcement of grandiose plans to bring about revolutiory changes in health care sector will be a simply wastage. “Niti Aayog report must be an eye opener for the State Health department,” he said.