Performance Audit Report on Public Health Infrastructure and Management of Health Services in West Bengal for the year ended March 2022, Government of West Bengal

निष्कर्ष

1. राज्य भर में विशेषज्ञ चिकित्सकों के 36 प्रतिशत और सामान्य ड्यूटी चिकित्सा अधिकारियों के 49 प्रतिशत पद रिक्त थे; परीक्षित जिलों में यह कमी लगभग 41 प्रतिशत थी।

   “There was a significant shortage in the cadre of Medical Officers (Specialists & General Duty Medical Officers). At the State level, the shortage of Medical Officers (Specialists) was 36 per cent and that of Medical Officers (General Duty Medical Officers) was 49 per cent, while in the test-checked districts, the shortage in the cadre of Medical Officers was around 41 per cent.”Executive Summary

2. 89 प्रतिशत उप-केंद्रों में कोई पुरुष स्वास्थ्य कर्मी नहीं था; सामुदायिक स्वास्थ्य केंद्रों में विशेषज्ञ चिकित्सा अधिकारियों की कमी 91.14 प्रतिशत थी, और जिला अस्पतालों में सामान्य ड्यूटी परिचारकों की कमी 63.20 प्रतिशत।

   “As many as 89 per cent of the Sub-Centres (SCs) in the State did not have any Health Worker (Male). The shortage of Medical Officers was 54.27 per cent, while shortage of specialist MOs was 91.14 per cent, in the Community Health Centres (CHCs) of the State. In the District Hospitals, the shortage of General Duty Attendants was 63.20 per cent.”Executive Summary

3. तीन वर्षों में राज्य भर में 55,000 प्रसव घरों पर हुए और उनमें से 99.56 प्रतिशत में कोई प्रशिक्षित प्रसव परिचारक नहीं था, फिर भी एक भी उप-केंद्र को प्रसव कराने की सुविधा से युक्त नहीं किया गया।

   “MOs did not visit 45 per cent of the SCs, even once a month. Though 55,000 deliveries had been conducted at homes, across the State, in the last three years, none of the SCs had been upgraded with facilities for conducting deliveries. The Traditional Birth Attendants and ASHA were not even trained with necessary skills, in 12 per cent of the SCs. Moreover, 99.56 per cent of home deliveries were not assisted by Skilled Birth Attendants.”Executive Summary

4. सीज़ेरियन सहित आपातकालीन प्रसूति देखभाल 90 प्रतिशत प्राथमिक स्वास्थ्य केंद्रों में उपलब्ध नहीं थी, और उनमें से 70 प्रतिशत में कोई चालू बिस्तर नहीं था; पंजीकृत गर्भवती महिलाओं में से 35 प्रतिशत की एक बार भी चिकित्सा अधिकारी द्वारा जाँच नहीं हुई।

   “Accident and other Emergency/ Casualty services were not available in 71 per cent of PHCs; while, Emergency Obstetric Care, including surgical interventions like caesarean section and other medical interventions were not available in 90 per cent of the PHCs in the State. As high as 70 per cent of the PHCs did not have any functional beds. Of the pregnant women registered, 35 per cent had not got checked-up even once, by MOs-PHC, out of their four scheduled ante-natal check-ups.”Executive Summary

5. राज्य के 348 सामुदायिक स्वास्थ्य केंद्रों में से 284 में आपातकालीन प्रसूति देखभाल नहीं थी, 22 में नवजात देखभाल नहीं और 51 में बीमार बच्चों के लिए आपातकालीन देखभाल नहीं; उनमें से 285 में कोई रक्त भंडारण इकाई नहीं थी।

   “Of the 348 CHCs in the State, Emergency Obstetric Care, including surgical interventions like caesarian sections and other interventions, were absent in 284 CHCs. There was no provision of new-born care in 22 CHCs, while emergency care to sick children had not been provided in 51 CHCs.”Executive Summary

6. जिला अस्पतालों में अधिसूचित आवश्यक दवाओं में से 63 प्रतिशत कभी ख़रीदी ही नहीं गईं, और मार्च 2022 तक विभाग के पास कोई लिखित औषधि नीति नहीं थी।

   “The Department did not have any documented drug policy, as of March 2022... In District Hospitals, 63 per cent of notified essential drugs had never been procured. Many of the other drugs had remained out of stock for long periods.”Executive Summary

7. दिसंबर 2023 तक पीएम केयर्स और कॉरपोरेट सामाजिक दायित्व निधि से मिले ऑक्सीजन संयंत्रों में से 57.33 प्रतिशत या तो चालू नहीं हुए या काम नहीं कर रहे थे, और परीक्षित अस्पतालों में आईसीयू वेंटिलेटर तथा ऑक्सीजन कॉन्संट्रेटर पैक पड़े मिले।

   “ICU ventilators and Oxygen Concentrators received under PMCARES were not made operational and were found lying packed in test-checked hospitals. In the State, 57.33 per cent of the Pressure Swing Absorption (PSA) oxygen generating plants, received under PMCARES and Corporate Social Responsibility (CSR) scheme, were either not commissioned and/ or not functional as of December 2023.”Executive Summary

8. स्वास्थ्य क्षेत्र पर ख़र्च राष्ट्रीय स्वास्थ्य नीति के 2025 तक 2.5 प्रतिशत के लक्ष्य के मुक़ाबले जीएसडीपी का 1.23 प्रतिशत रहा, और 2017-22 में राजस्व व्यय 125 प्रतिशत बढ़ने के बावजूद स्वास्थ्य पर पूँजीगत व्यय 12 प्रतिशत घटा।

   “As of 2021-22, the level of health sector expenditure in the State (1.23 per cent of GSDP) was far below the target (2.5 per cent by 2025) set in the National Health Policy (NHP).”Executive Summary