Analysis

Odisha has only 1 doctor for 13,154 patients in rural areas

Bhubaneswar: The Odisha government has recently contested the Health Index report of NITI Aayog saying it does not portray a comprehensive picture of the sustained efforts made by the Government in the sector.

The national think-tank’s report ‘Healthy States, Progressive India’ had shown that Odisha had slipped in its ranking during the assessment period as major indicators had shown little improvement.

However, the state government’s health department – on February 12, 2018 said better health outcomes require sustained efforts over a long term whereas in the NITI Aayog Report, comparison has been made only between two years.

“This does not give a comprehensive view,” the state government contested.

“The Composite Index has not considered key outcome indicators like Infant Mortality Rate (IMR) and Total Fertility Rate (TFR) where Odisha has made significant progress, consistently, over the past two decades,” the health department said.

Not only this, the department also maintained that findings of NFHS-4 have not been taken into consideration for institutional delivery where status of Odisha for reference year 2015-16 has shown much better progress.

The Odisha government thinks the NFHS-4 report is more comprehensive with a larger sample size, with more proximity towards data accuracy. To drive its point home, the department said indicators like 24×7 PHC and Cardiac Intensive Care Units were included in the composite index of NITI Aayog though these are not a mandate across most States, including Odisha, where PHCs are not bedded facilities.

It’s no denying the fact the Odisha government has made significant improvement in key some processes indicators such as ante-natal care registration, functionalisation of FRUs, proportion of vacancies or specialists at district headquarter hospitals, zero vacancy in ANM and staff nurse and percentage of birth registration. Average occupancy of officers for improved governance has gone up too.

It’s also a fact that Odisha is among a few states like Kerala, Tamil Nadu, Bihar and Delhi to have initiated accreditation of Public health facilities for providing high quality services as per National Quality Assurance Standard. Besides treatment success rate in Odisha in TB is among the best and the state’s score in composite index has risen from 39.23 to 39.43 in the report.

However, the government cannot deny the fact over 70 per cent of state’s rural population still do not have access to minimum healthcare. Crunch of doctors and paramedics in primary health centres, community health centres , district headquarters is remains a major concern area.

Take the example of Jagatsinghpur district headquarters hospital (DHH). Of 58 sanctioned posts, 15 doctors are posted in the district headquarters hospital. Similarly, against the total sanctioned strength of 157, hospitals in the district are running with only 68 doctors. This implies that the district has only 43 per cent doctors and paramedics.

One can well imagine if this is the situation in a developed coastal district, how could be the scene in the backward western and southern Odisha districts.

The state, according to government’s own admission, has only one doctor for 13,154 patients in rural Odisha against the national average of 1:1668.

Another shocking fact is that the state has 19,000 registered practitioners. However, doctors in government-run health centres, including medical college hospital, stand at a minimal figure of 3,500. It implies that only 18.42 per cent registered practitioners is prefers to work in government sectors despite the incentives and perks given by the state government in 2016.

In 2017, as many as 49 doctors had deserted Primary Health Centres (PHCs) resulting in allopathic doctors’ vacancy rising to 353 in number.

The government must identify the cause of these problems and find a proper remedy which would go a long way to provide healthcare to the rural masses.

The World Health Organisation norm calls for one doctor to attend a population of 3,500. According to this barometre, Odisha falls back and records a 65 per cent to 85 per cent doctors in all its 30 districts. At least 200 doctors are required in state-run hospitals as against current available strength of a little above 2,000 in rural areas.

Besides, human resources, the state government would also lay special focus on infrastructure development in PHCs, CHCs and DHHSs, besides improving road conditions so that the pregnant women and others requiring emergency services can easily be brought to hospitals by ambulance services.

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