Performance Audit on Management of Public Health Infrastructure and Health Services, Gujarat

An assessment of the availability, accessibility and usability of healthcare at every level in Gujarat — from sub-centres to medical college hospitals — covering 2016-22. The audit found no state human resource policy for public health institutions, persistent shortages of doctors, specialists and paramedics that worsen away from the cities, most approved construction dropped or never begun, and a health budget below the share the state's own policy framework calls for.

State: Gujarat
Audit period: 1 Apr 2016 — 31 Mar 2022
Presented: 28 Mar 2025

Findings

Specialist doctor vacancies were 28 per cent at medical college hospitals, 36 per cent at district hospitals and 51 per cent at sub-district hospitals against sanctioned strength.
“Vacancy of specialist doctors was 28 per cent in MCHs, 36 per cent in DHs and 51 per cent in SDHs against the sanction strength.”Executive Summary
In 22 of Gujarat's 33 districts more than 25 per cent of doctor posts were vacant, and in 19 districts more than 25 per cent of paramedic posts.
“Out of 33 districts, shortage of more than 25 per cent doctors and paramedics was noticed in 22 and 19 districts respectively.”Executive Summary
Of 5,332 construction works approved during 2016-22, only 24 per cent were completed and 70 per cent were either dropped or never started.
“Against the approval of 5,332 works during 2016-22, 24 per cent of works were completed by Project Implementation Unit and 70 per cent of works were either dropped or not started yet.”Executive Summary
The health budget was 5.42 per cent of the total state budget in 2021-22, below the target of more than eight per cent.
“The percentage of the health budget to the total State budget for the year 2021-22 was 5.42 which was less than the target of more than eight per cent”Executive Summary

Findings

Specialist doctor vacancies were 28 per cent at medical college hospitals, 36 per cent at district hospitals and 51 per cent at sub-district hospitals against sanctioned strength.

“Vacancy of specialist doctors was 28 per cent in MCHs, 36 per cent in DHs and 51 per cent in SDHs against the sanction strength.”Executive Summary

In 22 of Gujarat's 33 districts more than 25 per cent of doctor posts were vacant, and in 19 districts more than 25 per cent of paramedic posts.

“Out of 33 districts, shortage of more than 25 per cent doctors and paramedics was noticed in 22 and 19 districts respectively.”Executive Summary

Of 5,332 construction works approved during 2016-22, only 24 per cent were completed and 70 per cent were either dropped or never started.

“Against the approval of 5,332 works during 2016-22, 24 per cent of works were completed by Project Implementation Unit and 70 per cent of works were either dropped or not started yet.”Executive Summary

The health budget was 5.42 per cent of the total state budget in 2021-22, below the target of more than eight per cent.

“The percentage of the health budget to the total State budget for the year 2021-22 was 5.42 which was less than the target of more than eight per cent”Executive Summary