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Study in Bagalkot exposes lacunae in public healthcare system

A study of the public health infrastructure in Bagalkot district has highlighted some of the perennial issues that district and taluk hospitals face — non-availability of laboratory tests and diagnostic services, besides poor maintenance of equipment and hospital premises.

Major lab tests such as endoscopy, CT scan, and MRI were not even conducted in the district hospital, according to the study, conducted by the Institute for Social and Economic Change (ISEC), Bengaluru. Out of the six taluk hospitals that were taken up for the study, only three had ultrasound test facility, and none of them conducted biochemistry tests. Tests such as CBC (complete blood count) and serum bilirubin were not conducted in any of the rural health facilities. The study team, led by ISEC professor C.M. Lakshmana, found that patients were compelled to approach private hospitals, at their own cost, for tests not conducted at the healthcare centres.

Falling into disuse

The study, sponsored by the Department of Health and Family Welfare, noted that the health staff were not trained in proper use and operation of equipment, and the machinery was not properly maintained. No health worker was assigned the responsibility of maintaining the equipment and many health centres did not even have space for it. “Over a period of time, these issues together may render the health and laboratory equipment useless,” the team’s report stated. The equipment was either partially out of order or completely unusable, Dr. Lakshmana said.

The study covered 29 health institutions of Bagalkot district, including healthcare centres in six taluks, five community health centres, six primary health centres, and 11 sub-centres. The findings were based on personal visits to these institutions by a team and focus group discussions with the staff and patients. The district hospital alone provided services to over 10,000 patients a month.

Some positives

On a positive note, many staff members acknowledged the adequate availability of drugs and medicines. The computerised drug inventory system was working well and was said to be enhancing the efficiency of drug supply and distribution. However, interruptions in supply of power and untrained computer operators were two major impediments to drug inventory digitalisation, the report stated.

As a result, patients were left to purchase such drugs from private sources. Items such as sanitary napkins were not available at many centres, and space problems when it came to storing drugs was also noticed at several facilities.

Dr. Lakshmana said in the district as a whole, the team observed poor maintenance of hospital as well as residential buildings. Almost all the buildings were facing paucity of electricity and water. Non-availability of water in sufficient quantity, coupled with the shortage of Group-D employees, was the reason offered by the health staff for not maintaining cleanliness.

The gap between sanctioned posts and filled posts was highest in the case of medical officers at all the healthcare centres. In the district hospital, only 20 medical officers were working, as against the sanctioned number of 40. The shortage of medical staff was severe in taluk hospitals as well.

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