Huge gaps exist in medical facilities in Bihar, according to CAG report


The state of the health sector in Bihar is far from optimal with a severe lack of facilities and staff, according to a report by the Comptroller and Auditor General of India (CAG) tabled in the legislature of India on Wednesday. ‘State.

According to the performance and compliance audit report, the government auditor carried out performance audits in the five districts – Patna, Biharsharif, Hajipur, Jehanabad and Madhepura for the period 2014-15 to 2019-20, and has noted a deficit of 52 to 92%. of beds according to Indian Public Health Standards (IPHS) in district hospitals.

Apart from two, three district hospitals have only 24-32% beds available for patients, with the CAG report indicating that the state Department of Health had failed to increase the number of beds since 2009 .

He also pointed out that there was a persistent shortage of MBBS doctors, nurses, paramedics and lab technicians from 2014 to 2020.

District hospitals failed to provide medical testing facilities in 12-15 departments like Cardiology, Gastro, Enterology, Nephrology, ENT, etc. due to shortage of medical specialists and basic infrastructure such as buildings, medical equipment, furniture and facilities.

There are 121 diagnostic facilities mentioned in a district hospital according to IPHS in the country, but only a maximum of 33 percent of the diagnostic facilities are available in Hajipur district hospital.

Facilities for diagnosis and case management of cardiovascular diseases, cancer, myocardial infarction and stroke were not available in any of the district hospitals tested.

Four of these district hospitals do not have Japanese encephalitis and chikungunya testing facilities.

Additionally, accident/trauma and psychiatry wards and positive/negative isolation wards for infectious patients were not available in any of the district hospitals tested.

Operating theaters for emergency surgeries are not available in any of the district hospitals, while the shortage of essential drugs in OTs ranged between 64 and 91 percent, forcing patients to generally buy drugs from outside.

Intensive Care Unit (ICU) is only available in Jehanabad District Hospital but it is also short of paramedics, nurses, medicines and medical equipment.

Cardiac Care Units (CCUs) are not available in any of the five district hospitals in the sample. Bihar government had approved CCU in Hajipur district hospital in 2012 but it lacks specific equipments like CCU ventilator, defibrillator, heart monitor, ECG machine etc. and is inactive. Therefore, it was locked from 2014 until physical verification in 2021 by CAG officials.

Bihar has 38 districts and nine of them, including Patna, have no blood banks. The two operational blood banks in district hospitals do not have valid licenses.

In the four test control district hospitals, four blood banks did not have facilities to test for hepatitis A.

At Hajipur District Hospital, the four prenatal checks were provided in only 4% of cases. In other district hospitals, she was uninsured.

A high stillbirth rate was observed in Madhepura district hospital with 2.17 live births out of 100. In Biharsharif district hospital, the stillbirth rate is 1.63%. The state’s average stillbirth rate is 0.96 per 100 live births.

Meanwhile, it was also found that TT injection was not administered to all pregnant women in the district hospitals tested during the period 2014-2020 except Biharsharif, despite availability in stock.

A significant shortage of equipment (9 to 16 out of 28) was observed in all district hospitals, which compromised the ability of hospitals to provide emergency and critical care in maternity cases, resulting in 21 maternal deaths in three district hospitals tested. Biharsharif recorded 9 maternal deaths, Jehanabad 7 and Hajipur 5 during the period 2014-20.

The Bihar Medical Services and Infrastructure Corporation Ltd (BMSICL) was tasked in March 2014 to ensure an uninterrupted supply of medicines and medical equipment to all hospitals in the 38 districts of the state. However, it could not supply all the drugs in withdrawal, among other districts, especially in Patna where 70 medicines were on the Essential Medicines List (EDL), but 42% and 30% were not supplied at all. in 2017-2018 and 2018. -19, respectively.

The BMSICL could only spend 29% or Rs 3,103 crore against the available funds of Rs 10,743 crore. Out of a total of 1,097 projects undertaken by it between 2014 and 2020, only 187 could be completed, while 523 were still ongoing and 387 had not yet started.



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