Health infra uneven across districts: Karnataka Health Vision Group report

Health facilities in the state, ranging from sub-centres to general hospitals are unevenly distributed, says a recent report released by the government-appointed Karnataka Health Vision Group.

Those in north Karnataka, especially, fall way behind.

The government is supposed to ensure healthcare through facilities at different levels - sub-centres, primary health centres (PHCs), community health centres (CHCs) and taluk/general hospitals.

Bigger facilities like district hospitals and medical colleges come after this.

As per the Indian Public Health Standards (IPHS), one PHC should be set up for every 30,000 people in plain areas and one for every 20,000 people in less accessible areas.

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But, of the 30 districts in the state (excluding Vijayanagara), 13 have fewer than required number of PHCs.

For instance, Dharwad has 37 per cent fewer PHCs than required and Ballari falls 35 per cent short than the required numbers.

Chikkamagaluru and Hassan have 137 per cent and 121 per cent respectively, that is more PHCs than required.

The Vision Group’s report, based on 2021 data, shows CHCs are perhaps the most ignored type of facility.

Of all districts, only one - Kodagu - met the CHC requirement. However, in the next tier, the number of general hospitals was relatively better, with the distribution across districts being more even. Yet, 12 districts had fewer general hospitals than required.

Dr Gururaj G, who headed the Vision Group, said, “The distribution of facilities is lower especially in Kalyana Karnataka districts. This imbalance needs to be set right.”

He said Karnataka has upgraded many of its sub-centres to form 5,829 ‘health and wellness centres’ under Ayushman Bharat programme. These centres are set up as per a 2018 scheme, and are supposed to provide a broader range of services than sub-centres.

“But they need to be upgraded with sufficient infrastructure, manpower and logistics,” Gururaj said.

In fact, Dharwad is one of the worst-off districts, in terms of all facilities.

The district doesn’t have a CHC at all, though it’s required to have 18 of these for its total population of 21.3 lakh.

Dharwad also has 30 per cent fewer general hospitals and 54 per cent fewer sub-centres than required.

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Whereas some other districts have a consistently higher number of facilities at all levels.

For example, Chikkamagaluru has 65 per cent more sub-centres than required, 137 per cent more PHCs and 164 per cent more general hospitals.

Sub-centres are to provide at least six hours of routine OPD services daily. They provide reproductive health services and treatment for minor ailments.

The PHCs provide full-time OPD and some in-patient services. The CHCs, as secondary care facilities, are equipped with certain specialists and for certain surgeries.

General hospitals are to provide more speciality services as well as accident and trauma care.

The absence of these decentralised facilities means people have to travel longer distances to access basic healthcare.