CAG Report Highlights Alarming Deficiencies in Bihar's Healthcare System: Underutilized Budgets, Staff Shortages, and Infrastructure Gaps
The recent Comptroller and Auditor General (CAG) report on Bihar’s health infrastructure for 2016-2022 highlights significant deficiencies in the state's healthcare system. The audit, presented during the Bihar Legislative Assembly's winter session, paints a grim picture of underutilized budgets, manpower shortages, and inadequate facilities.
Key Findings:
Underutilization of Budget:
Only ₹48,047.79 crore (69%) of the ₹69,790.83 crore allocated between FYs 2016-17 and 2021-22 was spent.
This left ₹21,743.04 crore (31%) unused.
Human Resource Shortages:
A 49% vacancy rate in key healthcare roles, including doctors, nurses, paramedics, and technical staff.
Against the WHO-recommended doctor-to-population ratio of 1:1,000, Bihar’s ratio stands at 1:2,148.
Severe shortages in staff nurses (18%-72%) and paramedics (45%-90%) across districts.
Deficient Health Infrastructure:
None of the tested Sub-District Hospitals (SDHs) had operational Operation Theatres (OTs).
Blood Storage Units (BSUs) were non-functional in all 10 inspected SDHs and CHCs due to manpower and certification gaps.
Only 54% of available ventilators in test-checked facilities were functional; others were idle due to a lack of technicians.
Shortages in Medicines and Equipment:
Essential drugs were understocked, with 14%-63% rate contracts executed by the Bihar Medical Services & Infrastructure Corporation Limited (BMSICL).
Non-availability of essential OPD and IPD drugs ranged from 21%-83%.
Significant shortages of equipment and consumables were reported.
Maternal and Child Health:
Iron and Folic Acid (IFA) supplementation for pregnant women was inadequately implemented, with only 1%-67% receiving full doses in test-checked facilities.
Maternal death reviews were conducted in only one of 24 reported cases in 16 test-checked facilities.
Planning and Policy Gaps:
Bihar lacked a comprehensive health policy aligned with the National Health Policy 2017.
Health expenditure as a percentage of the Gross State Domestic Product (GSDP) ranged between 1.33% and 1.73%, well below recommended levels.
Performance in National Goals:
The state scored 66/100 in NITI Aayog’s SDG India Index (2020-21) for SDG-3 (health), reflecting poor performance on key health indicators such as Maternal Mortality Rate, Neonatal Mortality Rate, and Total Fertility Rate.
Implications:
The report underscores systemic failures in governance, resource allocation, and health infrastructure development in Bihar. Persistent gaps threaten public health outcomes and impede the state’s ability to meet Sustainable Development Goals (SDGs).
Recommendations:
To address these challenges, the Bihar government must:
Optimize utilization of allocated funds.
Expedite recruitment to fill critical vacancies.
Strengthen healthcare infrastructure and ensure functional facilities.
Improve planning by aligning state policies with national health priorities.
Regularly monitor and audit healthcare performance to ensure accountability.
Source: The Hindu