When disturbing images like patients transported on cot or a mother delivering on road or on a CHC’s floor proving nightmare for the State Government on a daily basis, the enthusiastic fact for the Odisha Government is in per capita capital outlay on health, the State figured among the top-five States in country. Such a reassuring fact for the BJD Government was brought to the fore by an analysis of RBI’s 2018-19 State Finances Report, released recently. As per the RBI data analysis, Gujarat with a per capita capital outlay on health at ₹303 topped the nation. Odisha with a per capita capital outlay of ₹190 followed Haryana, Chhattisgarh, and Karnataka. Significant here is all top per capita capital spenders, except Chhattisgarh, are developed States. Odisha is also ahead of other focus States like Bihar, UP, MP, Jharkhand, and Rajasthan.
Moreover, by earmarking a total spending (revenue + capital) of 5.1 percent of total budget on health in 2018-19, Odisha stayed above the average spending on health pegged at 4.8 percent of 18 States in 2018-19. It needs mentioning that capital outlay or expenditure is more important than revenue expenditure, as it entails creation of new quality health infrastructure and services in State. It’s the lack or paucity of such infra like beds or ambulance services which has catapulted Odisha on to national arena for wrong reasons. The health centers in Odisha fared poor in having the basic infra. Around 12 percent Primary Health Centers (PHCs) in the State have no water supply vis-a-vis none in Bihar. Over 8 percent PHCs still don’t have electricity connections vis-a-vis none in Bihar. Odisha’s only 15 percent Community Health Centers (CHCs) have at least 30 beds vis –a-vis 100 percent in Andhra Pradesh, Bihar, Telengana, and Karnataka.
As per data available, when nationally on an average each rural hospital has 14 beds, each rural hospital in Odisha has on average around four beds. In urban hospitals, when on an average each hospital in Odisha has around 82 beds, the beds nationally per urban hospital are around 114. While infant mortality in Odisha is still a concern, the surprising fact is only a paltry 7 percent CHCs have functional stabilisation units for new born vis-a-vis of 48 percent and 41 percent in other focus States like Rajasthan and MP, respectively. Similarly, a mere around 19 percent CHCs in Odisha have functional x-ray machines vis-a-vis 100 percent in Bihar. Interestingly, the per capita revenue expenditure, including salary expenses on doctors, technicians etc, on health in Odisha in 2018-19 has been around ₹1074.
But when 1480 specialist doctors are required for its 370 CHCs, only 884 are sanctioned and of that mere 318 are in position leading to a vacancy of around 566 and a high shortfall of around 1162. The State’s PHCs have 345 doctor vacancies. The notable fact here is in per capita revenue expenditure on health in 2018-19 Odisha is positioned at number-10 nationally and follows States like Kerala, Chhattisgarh, Haryana, Assam, Telengana, Rajasthan, Karnataka, Punjab, and Tamil Nadu. – Daily Pioneer