It seems tribal healthcare in Odisha is all about brick and mortar. Odisha tom toms the fact of bringing up largest fleet of Community Health Centres (CHCs) for tribal population in the country, but when it comes to emergency healthcare delivery, the State sits at the bottom with maximum vacancies from the level of technicians to surgeons in India.
According to the report Health Infra in Tribal Areas – 2014 -15 released recently, with the country- highest 135 CHCs for tribal populace, the State looks good in outreach of health infra. However, in delivering necessary healthcare services to tribals, the State looks pathetic as it perches at the bottom nationally with vacancies of over 123 surgeons.
Consider this. State’s 135 CHCs in tribal areas require a total of 135 surgeons; the Government has sanctioned 45 surgeons whereas the actual number of surgeons in position is mere 12. Similarly, when maternal mortality rate in Odisha is quite high in tribal areas, the factual position is of the total sanctioned posts of 136 obstetricians and gynaecologists in CHCs, only 40 are in position.
Moreover, when as many as 11 tribal districts in Odisha have high infant and child mortality rate, the actual paediatricians in position in tribal CHCs are mere 13 against the actual requirement of 135 and sanctioned posts of 91.
Tribal districts in Odisha have around 426 Primary Healthcare Centres (PHCs), but nearly half of them are functioning without doctors. Besides, the State’s tribal CHCs top the country with large vacancies in almost all categories of healthcare staff.
Primary healthcare centres (PHCs) and CHCs in tribal areas require over 560 lab technicians but actual lab staff in position is only 123 leaving the vacancies at the national-highest of 438. The total shortfall of specialists at CHCs in tribal areas stands at 461, which again is highest nationally. When Chhattisgarh CHCs in tribal areas have around 60 radiographers in position against the requirement of 89, Odisha manages with mere 18 against the requirement of 135. It needs mentioning that radiographers are essential healthcare professionals who are deployed in operation theatre (OT), intensive care units etc. A total of 312 CHCs in State have OTs. Above all, the shortfall in nursing staff in tribal area CHCs is as many as 988.
A look at the State health accounts further revealed that the State budget has not provisioned a single rupee for implementing mobile health centres in Kalahandi-Balangir-Koraput (KBK) region. For medical institutions in Malkangiri, the State Government had hiked the allocation in 2014-15 by mere Rs30 lakh. Significantly, the Government has not hiked a single rupee under prevention of communicable diseases and epidemics in tribal districts for two consecutive years of 2013-14 and 2014-15. Besides, only a handful of PHCs in tribal districts have referral transport facility. Many tribal patients die owing to lack of this facility. On the contrary, Chhattisgarh has this facility in nearly 50 per cent of its PHCs.
The Unicef has identified this as a major reason behind high maternal mortality rate in tribal districts.