BIHAR DIARIES CHAPTER THREE- HEALTH

In the heart of India, Bihar's healthcare system faces a crisis that demands immediate and decisive action. The latest Comptroller and Auditor General of India (CAG) report sheds light on a situation that can only be described as dire, revealing extensive deficiencies across the state's health sector. This article delves into the findings of a meticulous audit covering the years 2014-15 to 2019-20 in five key districts: Patna, Biharsharif, Hajipur, Jehanabad, and Madhepura. The insights gleaned from this report underscore a stark reality: a profound shortage of hospital beds, a persistent lack of medical professionals, and the absence of essential healthcare services and facilities. As we navigate through the complexities of these challenges, it becomes clear that the path to improvement requires a concerted effort from all stakeholders. This introduction sets the stage for a comprehensive analysis of Bihar's healthcare woes, as detailed in the CAG report, and underscores the urgency of collective action to remedy the state's healthcare system.

In a comprehensive report by the Comptroller and Auditor General of India (CAG), the state of healthcare in Bihar has been critically evaluated, revealing significant challenges that need urgent attention. The report, which examined the period from 2014-15 to 2019-20 across five districts (Patna, Biharsharif, Hajipur, Jehanabad, and Madhepura), highlighted a profound shortfall of hospital beds, with a gap of 52 to 92 percent compared to the Indian Public Health Standards (IPHS) requirements. This shortage is alarming, especially since the state Health Department has not increased bed capacity since 2009, leaving three district hospitals with only 24 to 32 percent of the required beds available for patient care.

The shortfall extends beyond beds to a persistent lack of medical professionals, including MBBS doctors, nurses, paramedical staff, and lab technicians, exacerbating the state's healthcare woes from 2014 to 2020. Furthermore, the absence of essential medical test facilities across 12 to 15 departments such as cardiology, gastroenterology, nephrology, and ENT, primarily due to a shortage of specialist doctors and basic infrastructure, severely compromises patient care. This inadequacy is underlined by the fact that, although 121 diagnostic facilities are stipulated per district hospital by the IPHS, only a maximum of 33 percent are available in districts like Hajipur.

Critical care for diseases such as cardiovascular conditions, cancer, and strokes is notably absent in the evaluated district hospitals, a deficiency that extends to the lack of testing facilities for conditions like Japanese encephalitis and chikungunya. Additionally, essential wards for accident/trauma, psychiatry, and isolation for infectious patients are missing, further limiting the hospitals' capacity to provide comprehensive care. Emergency surgery operation theatres are non-existent, and the shortage of essential drugs in existing facilities forces patients to seek medications externally, highlighting a dire need for improvement in emergency and critical care services.

The only ICU available in Jehanabad is crippled by a lack of staff, drugs, and medical equipment. Cardiac Care Units (CCUs), vital for treating heart conditions, are absent across the five sampled district hospitals, despite an approved CCU for Hajipur district hospital in 2012, which remains unused due to the lack of specific equipment. This situation is emblematic of broader issues in healthcare infrastructure and service provision.

Blood bank services are critically lacking, with nine of Bihar's 38 districts, including Patna, devoid of such facilities. The existing banks face licensing and operational challenges, further complicating the healthcare landscape. Prenatal care and maternal health services are alarmingly inadequate, as evidenced by high stillbirth rates and significant shortages of essential equipment, leading to 21 maternal deaths across three district hospitals during the audit period. These deficiencies reflect a systemic failure to provide basic and critical healthcare services to the population.

The Bihar Medical Services and Infrastructure Corporation Ltd (BMSICL), tasked with ensuring the uninterrupted supply of drugs and medical equipment across the state, has fallen short of its responsibilities. With only 29 percent of available funds utilized and a small fraction of projects completed, the BMSICL's inefficiencies contribute significantly to the healthcare sector's challenges in Bihar.

This CAG report is a clarion call for immediate action to address the glaring deficiencies in Bihar's healthcare system. Stakeholders at all levels must come together to implement targeted interventions aimed at improving healthcare infrastructure, increasing staffing levels, and ensuring the availability of essential medical services. Only through concerted efforts can we hope to enhance the health outcomes for the people of Bihar.