Himachal Pradesh has failed to provide 24-hour maternal healthcare facilities at 84 percent of its primary health centres, mainly in rural areas, under the National Rural Health Mission (NRHM), the Comptroller Auditor General of India (CAG) has said.
Of the 500 primary health centres, only 81 (16 percent) have been upgraded to provide round-the-clock delivery services but none of these had basic obstetric and nursing facilities like availability of a gynecologist, staff nurses and skilled birth attendants, according to a CAG report.
It said under the NHRM framework (2005-12), the government of India had launched a strategy to make emergency maternal healthcare services like safe deliveries round the clock in rural areas.
It said out of the 500 primary health centres, labour rooms were not available in 308 and new born care units in 493.
Painting a darker picture of promoting institutional deliveries, the national auditor said it has decreased to 57 percent in 2014-15 from 42 in 2010-11.
During 2010-15, a total of 668,442 pregnant women were registered in the state.
Only 354,022 (53 percent) institutional deliveries were ensured in government institutions against the targeted deliveries of 467,909 (70 percent).
According to the CAG, the percentage of institutional deliveries in 2010-15 ranged between 42 and 59.
Under the Janani Suraksha Yojana introduced in 2005-06, 70 percent of the deliveries were to be ensured in government health institutions by 2012.
Even the facility for safe medical termination of pregnancy was available in 13 primary health centres in the state till March last year.
Himachal Pradesh is the only state in the country whose 89.96 percent of the population as per 2011 census lives in rural areas. Agriculture and horticulture provide employment to 62 percent of the total workforce, says the state’s economic survey report of 2015-16.
The CAG also picked holes in management of finances meant for the NHRM that became operational in the state in 2005.
It said 19 to 47 percent out of the total funds remained unutilized by the state during 2010-15.
It also noted that the state has failed to achieve the targets of primary and secondary immunization of children. Even the cold chain facility to store immunization vaccines was not available in 166 primary health centres.
Despite availability of funds, the state failed to establish comprehensive call centres to track mother and child.
According to the report, shortage of doctors and paramedical staff were also the reasons behind the poor implementation of the central government’s flagship programme.
Chief Minister Virbhadra Singh, in his budget speech on March 8, said the state is spending around Rs.26,000 per capita on healthcare, which is probably the highest in the country.
In order to improve affordable and equitable access to healthcare services, he announced the Himachal Pradesh Universal Health Protection Scheme under which the beneficiaries will be required to pay Rs.365 per annum for their health protection.
This scheme would provide Rs.30,000 for indoor patient treatment and Rs.175,000 for critical care treatment.