Study flags regional inequality in Karnataka's public health sector

A recent study on Karnataka’s public health system shows that while the state has expanded its healthcare network over the years, critical shortages persist at the grassroots level. It particularly highlights regional inequality within the state, raising concerns over equitable access to basic health services.

The study, titled ‘Regional inequality in Health Infrastructure of Primary Health Care Institutions in Karnataka’, is co-authored by C M Lakshmana, professor and head, Population Research Centre at the Institute of Social and Economic Change (ISEC) and Devindra, research investigator. 

Karnataka currently has 2,524 Primary Health Centres (PHCs), 9,278 sub-centres, and 212 Community Health Centres (CHCs), across 31 districts and 30,715 villages. However, these numbers fall short when assessed against population norms prescribed under the Indian Public Health Standards (IPHS 2022).

The most glaring deficit is seen in rural sub-centres. Karnataka requires 9,638 sub-centres, but has only 8,762 in place, indicating a shortfall of 876 centres. This gap is most acute in North Karnataka districts such as Belagavi, Raichur, Vijayapura, and Kalaburagi, which report some of the highest deficiencies. Belagavi alone faces a shortfall of 170 rural sub-centres - highest in the state.

In contrast, several southern districts show a surplus. Hassan, for instance, has an excess of 115 rural sub-centres and 78 rural PHCs, reflecting a stark regional imbalance.

The study highlights
that while southern Karnataka broadly meets or exceeds
infrastructure norms, northern regions consistently fall behind.

“Overall, Karnataka has been a pioneer in public health at the national level. But when we look deeper into the numbers, the number of health centres doesn’t match the population norms, displaying a deep-seated regional inequality. We wanted to highlight this imbalance. Health is a state matter, and politics has played a big role in furthering this inequality,” said Lakshmana, adding that while the IPHS 2022 requires one PHC each to be established for a population of 25,000 to 30,000. South Karnataka has an individual PHC established even for a population of 10,000 in some districts. 

Urban infra under strain

Urban healthcare infrastructure is also under strain, states the study. Bengaluru Urban district records a shortfall of 125 Urban Primary Health Centres (UPHCs), largely due to rapid urbanisation and migration. Overall, all four revenue divisions in the state report shortages of urban sub-centres, with the Kalaburagi division facing the highest deficit at 91%. Human resource shortages further add to the problem. Across PHCs, there are only 2,052 doctors in rural areas and 368 in urban centres, alongside gaps in pharmacists, lab technicians, and nursing staff. Specialists at CHCs, such as surgeons and paediatricians, remain particularly scarce.

The study calls for targeted interventions to bridge these gaps, warning that without addressing regional disparities, the state’s primary healthcare system will struggle to meet growing population demands.