Agartala: The latest report of the Comptroller & Auditor General on Tripura’s health and family welfare department uncovered a host of lapses in the state’s healthcare mechanism that remained unaddressed.
The report called Subject Specific Compliance Audit on public health infrastructure and management of Health Services provided a holistic view on sampled healthcare facilities for five years in between the year 2016-17 to 2021-22.
Noting that specialist services are largely absent in the Community Health Centers which play a vital role in providing healthcare facilities in the rural areas, the report categorically stated that the Community Health Centers of the state are acting as higher bedded primary health centers.
“Though services of specialist doctors were to be made available in the CHCs as per the IPHS, no specialist service was available in the CHCs in the State except in CHC, Kherengbar where Obstetrics & Gynecology service was available only for twice a week. CHCs were serving like higher bedded PHCs only. Diagnostic services like Radiology, ECG, Ophthalmology, etc. which were required to be available in the CHCs as per the IPHS (Indian Public Health Standards) were missing. Quality assurance in the Laboratory Services as mandated under the IPHS was not done. Emergency and Trauma Care service was virtually absent in the sampled health centers,” excerpts from the report read.
Notably, Chief Minister Dr Manik Saha recently inaugurated Trauma Care services in South Tripura District hospital and Dhalai district hospital. Preparations are in the last phase to start similar facilities in North Tripura as well.
In a concerning note, the report stressed on the fact that more than 20 percent of the registered pregnant woman did not receive Ante Natal Care.
“HSCs (Health Sub Centers) are responsible for providing Ante Natal Care (ANC) service to the pregnant woman including the outreach services to the people under them, failed to provide the desired service. As a result, more than 20 per cent of the registered pregnant women did not receive four ANC check-ups during 2021-22. Besides, a large number of essential drugs were not supplied to the health institutions and stock out rate of the available medicines was high,” the report said.
On the safety and efforts of cleanliness, the report gave poor reviews to the sampled health institutions.
“FSSAI license was not obtained by any of the sampled health facilities. Health care facilities were running without any safety clearance from the Fire Department and posing a major fire threat to the patients. Hospital Infection Control Committee was found to have been formed in five out of the nine sampled health centres and failed to deliver any specific road map and plan to control hospital infection. Hospital support services, viz. dietary service, laundry, and linen service, etc, were operational in the sampled health facilities without any standard operating guidelines from the Government,” the report added.
Expressing sharp disappointment over underutilisation of funds made available to combat the pandemic and streamline service delivery in hospital, the report said, “Large funds earmarked for dealing with the pandemic situation in the State remained unutilised. Two Directorates did not surrender funds of 8.97 crore despite no immediate requirement. Progress on ramping up of health infrastructure with the focus on Paediatric care units was slow despite availability of funds. There was no reduction in the expenditure on oxygen cylinders despite the installation of PSA plants, as these plants largely remained unutilised. Assets created, were found idle and are to be re-distributed on the need basis while expired Viral Transport Medium (VTM) kits were found in use for conducting of RTPCR test to detect the presence of virus”.
The report also stated that spending on health sector was much below the desired level as envisaged in the National Health Policy 2017.
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“State is lagging behind in achieving the Sustainable Development Goals-3 (SDG-3) indicators in six out of the ten targeted areas in comparison to the national achievements against those indicators. Spending on the health sector was not at the desired level as envisaged in the National Health Policy, 2017. Though monitoring mechanism was designed and developed, regular monitoring was not done, due to which the impact assessment could not be done. Sampled Health Facilities were found not adhering to the Bio Medical Waste Management Rules. Grievance redressal mechanism was not available,” the report added.
The report was submitted to the government of Tripura in August 2023 and laid in the House of Tripura Assembly in the recently concluded.
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