Transcript review of health deparmtent by chief secretary dated 07.05.2012

Punjab Profile
Population : 2.77 crores (2011 Census)
Districts
20
Divisions
5
Sub divisions/ Tehsils
81
Towns
142
Blocks
144
Health Blocks
118
Inhabited villages
12,278
INSTITUTIONS
GOVT
SECTOR
PRIVATE
SECTOR
3
6
Secondary Level Hospitals (District/ SubDivisional / Community Health Hospitals)
176
983
Primary Level Health Institutions (Primary Health
Centres/ Clinics/ Poly-Clinics/ Dispensaries)
1761
3046
Sub-Centres at Village Level
2950
--
26
10
4916
4045
Medical Colleges
Mobile Hospitals
Total
CATEGORY
INDIA
PUNJAB
1
Crude Birth Rate (per thousand)
(SRS 2010 published in December 2011)
22.1
16.6
2
Total Fertility Rate
(SRS 2010 published in March 2012),
NFHS-III (2005-06)
2.5
2.7
1.8
2.0
3
Death Rate
(SRS 2010 published in December 2011)
7.3
7.0
4
Sex Ratio (per thousand)
Census 2001
Census 2011
933
940
876
893
5
Sex Ratio (0 to 6 years) (per thousand)
Census 2001
Census 2011
927
914
798
846
6
Maternal Mortality Ratio (per lakh) live births
(SRS data of 2001-03 published in 2005)
(SRS data of 2004-06 published in April 2009)
(SRS data of 2007-09 published in June 2011)
301
254
212
178
192
172
SN
CATEGORY
INDIA
PUNJAB
7.
Infant Mortality Rate (per thousand) live births
(SRS 2008 published in October 2009)
(SRS 2009 published in January 2011)
(SRS 2010 published in December 2011)
53
50
47
41
38
34
8.
Any Ante Natal Care (%)
DLHS – III (2007-08)
CES 2009 published in 2010
75.2
89.6
83.3
95.3
9.
Ante Natal Care (%)
(3 or more visits)
NFHS-III (2005-06)
DLHS – III (2007-08)
CES 2009 published in 2010
52
75.3
68.7
75
65.1
73.4
10.
Institutional deliveries (%)
NFHS – III (2005-06)
DLHS – III (2007-08)
41
47
53
63.3
11.
% age of children fully immunized
NFHS-III (2005-06)
DLHS-III (2007-08)
CES 2009 published in 2010
44.0
54.1
61.0
60.0
79.9
83.6
Year/Item
2007-08
2008-09
2009-10
2010-11
2011-12
Plan
103
95
169
150
315
Non Plan
686
739
930
1054
1344
Centrally Sponsored
Schemes
162
173
218
246
277
Total (Rs. Cr)
951
1007
1317
1450
1936
Per capita Outlay
(Rs.)
389
412
539
595
794
4
44
16
88
115
Non Plan
649
691
821
951
1133
Centrally Sponsored
Schemes
105
158
211
278
305
Total (Rs. Cr)
758
893
1048
1317
1553
Per capita
Expenditure (Rs.)
289
334
388
481
560
%age GSDP
0.52
0.51
0.51
0.54
0.56
Budget
Expenditure
Plan
• Director Health and Family Welfare
– Primary Health Care, Disease Control Programme,
Regulations of Act (Food and Drug) and General
Administration.
• Director Health Services (Family Welfare)
– Implementation of Family Welfare, Maternal RCH,
Immunization, JSY and PNDT Act.
• Director Health Services (Social Insurance)
– Manages 7 ESI Hospitals, 70 ESI Dispensaries for the
insured industrial and other workers.
• Punjab Health Systems Corporation
Manages 176 secondary level hospitals.
Main agency of the Department for infrastructure
development.
• State Health Society
Manages and monitors implementation of NRHM in the
state.
• Directorate of Ayurveda
– Manages 5 Ayurvedic Hospitals and 524 Ayurvedic
Dispensaries.
– Licensing Authority of Ayurveda Manufacturing Units.
– Handles around 21 lac OPD patients per annum.
• Homoeopathy Directorate
– Manages 264 dispensaries and handles around 27.00
lacs OPD patients per annum.
• Punjab State AIDS Control Society
– Implement Government of India sponsored National
AIDS Control Programme.
Infrastructure Development
•
The Government of India in its 4th report of the Common
Review Mission published in January, 2011 rated our health
infrastructure as excellent and stated that the Punjab would
be the first state to close the gap by 2012.
•
Major initiatives for upgradation of infrastructure under the
Core Plan.
 Two district hospitals (Nawan Shahar, Muktsar under construction)

Five new Sub-Divisional Hospitals at Khadoor Sahib (complete),
Bholath, Moonak, Tappa, and Guddha in advanced stage of
completion and other 3 will be completed by 31.5.2012.

Upgradation of Sub-Divisional Hospitals at Baba Bakala and Badal
to be completed by 31.5.2012.
•
Construction of 32 new Community Health Centres. 10 to
be completed by 30.4.2012 and the remaining 22 by
31.7.2012.
Manpower
•
Major recruitment drive in the last two years

Doctors recruited
…

Doctors to be recruited by Aug 2012

Ayurvedic and Homoeopathy Doctors

Staff Nurses

Paramedical Staff
Total No. of doctors presently available
•
…
…
…
…
…
804
525
330
1455
1600
2143
Recruitment under process for 574 Specialist doctors, 518
Medical Officers, 114 Dental Doctors and 1650 paramedics.
Free Emergency Response Services
•
240 Ambulances operationalized.
•
These Ambulances attend to
emergencies and delivery cases.
•
Daily 800 emergencies are attended. 1.60 lacs lives have
been saved (till 14.4.2012).
•
Total project cost is Rs.70 crore.
trauma,
medical
Advanced medical Equipment
•
Aphersis machines, Blood separators, Phaco machines,
Dialysis units, New Dental Chairs, Laboratory equipment
provided in the hospitals.
Drug-De-addiction Centre
•
20 Bedded Drug De-addiction Centres operationalized at
Talwandi Sabo. Drug De-addiction Centres in 7 district
hospitals operationalized. In the remaining 13 districts, these would
be operationalized in the current year.
•
252 Awareness camps were organized for school children by
Homoeopathy Department.
Cancer Control Programme
•
A corpus of Rs.30 crore was set up for financial
assistance up
to Rs.1.5 lac per cancer patient. 2329
patients were given
assistance of Rs.25 crore.
Rashtriya Swasthya Bima Yojana
•
An insurance cover of Rs.30,000/- to BPL families
extended. 2.04 lacs BPL families enrolled. Rs.16 crore
claims paid to the BPL families.
State Illness Fund
•
A corpus of Rs.2.50 crore established to provide financial
assistance to BPL families up to Rs.1.50 lacs for
treatment of terminal illness.
Trauma Centres
•
Three Trauma Centres at a cost of Rs.12 crore set up in
Civil Hospitals, Pathankot, Amritsar and Jalandhar. 1
more at Khanna will be operational by May, 2012.
Nursing Schools
•
3 Nursing Schools i.e. at Jalandhar, Patiala and Amritsar
were operationalized. 4 more at Gurdaspur, Bathinda,
Sangrur and Ropar would be operationalized during the
current year.
Super Specialty Cancer Hospital under PPP format
• Two 200 bedded super specialty hospitals have been set up
under PPP format at Mohali and Bathinda.
• 5% of the revenue to be paid by the private providers (MAX
Healthcare) to be utilized for treatment of poor patients
•
The state signed a Memorandum of Understanding
with Government of India on 15.6.2006 for
implementation of NRHM in the state.
•
The main aim of the NRHM is to fill critical gaps in the
delivery of Rural Healthcare Services in terms of civil
infrastructure, equipment and manpower.
•
Implementation of Family Welfare, Mother and Child
Healthcare Programmes alongwith selected Disease
Control Programme in an integrated manner.
•
•
•
•
•
•
•
Reduction in Infant Mortality Rate (IMR) and Maternal
Mortality Ratio (MMR).
Universalize access to Public Health Services for
Women’s Health, Child Health, Water, Hygiene,
Sanitation and Nutrition.
Prevention and control of Communicable and NonCommunicable Diseases, including locally Endemic
Diseases
Access to integrated comprehensive Primary Healthcare.
Ensuring
population
stabilization,
gender
and
demographic balance.
Revitalize local health traditions and mainstream
AYUSH.
Promotion of healthy life styles.
As per latest official figures published so far:-
•
Infant Mortality Rate declined by 4 points from 38 in
2009 to 34 in 2010 as per SRS bulletin 2011 (very few
states have achieved this target). IMR indicator of India
is 47.
•
Maternal Mortality Ratio has come down from 192
(2004-06) to 172 (2007-09) as per SRS bulletin 2011.
MMR indicator of India is 212.
•
Sex Ratio improved from 876 (Census 2001) to 893
(Census 2011). Sex Ratio of India is 914 (Census 2011).
•
2011-12 IS THE FIRST AND ONLY YEAR SINCE 2005-06
(The first year of start of NRHM in India) during which fund
utilization has been more than 100% over approved plan
Year
Financial Achievements (Rs. in Crores)
Allocation/approved plan
Expenditure
by GOI
%age over
allocation
2005-06 (100:0)
98.24
59.71
61%
2006-07 (100:0)
162.71
83.26
51%
2007-08 (85:15)
190.37
104.69
55%
2008-09(85:15)
272.44
186.97
69 %
2009-10(85:15)
252.90
220.84
87 %
2010-11(85:15)
382.52
317.11
83 %
2011-12(85:15)
365.83
375.78
103%
•
Again, 2011-12 emerged as the First and only Year during
which NRHM Punjab managed to get released additional Rs 22
Crore in excess of the approved GOI allocation to the state during
the year as depicted below
Year
Financial Achievements (Rs. in Crores)
Allocation/approved
Receipts
+/- receipts
plan by GOI
2005-06 to
2009-10
844
738
-106
2010-11
283
251
-33
Sub Total
1127
989
-139
2011-12
276
298
+22
•
Janani Shishu Suraksha Karyakaram - A new scheme JSSK was introduced during 2011-12 for providing ‘Free
Delivery Services’ to pregnant women. Under this scheme
free admission, diagnostics, drugs, consumables, blood
and referral transport are provided. Institutional Deliveries
in Government Hospitals have registered phenomenal
increase as shown below:.
Year
Total Institutional Deliveries in
Government Hospitals
Percentage Increase over
last year
2008-09
66533
2009-10
87954
32.20
2010-11
114811
30.54
2011-12
157018
36.76
Janani SurakshaYojana- (Cash incentive to BPL mothers for
institutional deliveries @ Rs.700 for Rural & Rs 600 for urban area
and Rs 500 for home delivery)
Under this scheme during 2011-12, there has been a spurt in number
of beneficiaries availing benefits as shown below:Year
Total JSY
beneficiaries
Institutional
Deliveries JSY
Percentage of Institutional
deliveries
2008-09
67911
27561
41
2009-10
96721
42589
44
2010-11
107861
610610
56.5
2011-12
109405
81948
75
•
Strengthening of healthcare deliveries specifically
Emergency Obstetric Care in Community Health Centres
and strengthening of 24x7 delivery services in Primary
Health Centres.
•
Establishment of 25 Blood Storage Units in 25 CHCs
and in remaining 89 CHCs, the work is in progress.
•
For proper implementation of these schemes, 19
Gynecologists, 24 Pediatricians, 40 Female Medical
Officers, 1131 Staff Nurses and 1282 ANMs have been
recruited on contract basis under NRHM.
National Vector Borne Disease Control Programme:
For effective control of the endemic Dengue and
Malaria in the state.
National Iodine Deficiency Disorder Control Programme:
The Government of India has appreciated the efforts of the
State IDD Cell in effectively implementing the programme
and considers the model adopted as “Unique” in the country.
•
State and District IDD Labs established.
•
Survey completed in five districts (2011-12).
School Health Programme
•
•
•
•
Extensive School Health Check-ups in all 19810 (Government +
Government aided/recognized) undertaken.
Out of 33224 school visits planned, 32458 (98%) visits completed.
Under this programme 22.80 lacs students were examined and
advised to get services through State Health Network where ever
required .
School going children suffering from Congenital Heart Disease,
Rheumatic Heart Disease, Cancer and Thalassemia are provided free
treatment in PGI, CMC, DMC, Silver Oak, IVY and MD Oswal
Cancer Hospitals – 735 RHD & CHD cases operated. 221 Cancer
and 108 Thalassemia ailing children put on treatment.
ASHA (Community Level Healthcare)
•
•
•
•
•
•
•
•
Total number of ASHAs selected : 16800 in villages.
Total number of ASHA Facilitators selected: 898
Total number of ASHAs trained : 16214
Total number of ASHAs provided with drug kits:
16463
State trainers have been trained
ASHAs have been provided with I-cards.
ASHAs have been provided with Uniform.
Bank accounts of ASHAs have been opened up and
payment is being made through Bank account only
Infrastructure Upgradation under NRHM
•
Continuing the effort, infrastructure up gradation of Health
Institutions (All DHs, 25 SDHs, 123 CHCs, 246 PHCs and 460
Sub- Centres) undertaken.
•
Civil Works of Rs. 90 crores completed and of Rs. 50 crores
under progress
•
The Maternity Wards and Labour Rooms of the District
Hospitals are being upgraded. 11 work completed.
•
Major Civil Work has been taken up in 3 SDHs Patti,
Pathankot & Batala work has been completed.
•
CHCs Lehragagga being upgraded to 50-bedded Hospital
at
the cost of Rs. 3.08 Crore
•
CHC Dhakoli (Mohali) has been taken up for major
construction at a cost of Rs. 292.25 lakh work and the work
is completed.
Infrastructure Upgradation under NRHM
Other important Civil Work under NRHM
•
Major Civil Work of 5 District Hospitals were
undertaken. 4 Completed (Mohali, Ludhiana, Patiala &
Bathinda) and 1 in progress (40% completed in
Gurdaspur)
•
Civil Work at 211 PHCs undertaken. Work completed
140, Work assigned to Department of Rural
Development 46.
•
Repair & Renovation of 253 Sub-Centres undertaken –
Work at 127 completed, rest in progress.
•
207 New Buildings of existing Sub-Centres are being
constructed – 84 work completed.
•
•
No polio case in the state since 2009.
2nd doze of measles – launched on 20/12/2010. All children receive
Measles-2 along with DPT Booster at the age of 1½ years.
DPT3 vaccine
Measles
vaccine
Full Immunization
(children (12-23
month) receiving 1
dose BCG, 3 doses of
DPT/OPV each and 1
measles vaccine)
DPT Booster Dose
(children aged 18-23 months
who received DPT booster
dose)
India
71.5
74.1
61
41.4
Punjab
91.4
87.3
83.6
39.9
3
7
1
17
Ranking in
country
Accessibility and promotion of
Health Schemes
Service Guarantee
• IEC & reference material for service
guarantee designed and displayed for
the service provider and community.
• Unique Signages for the FRUs and
24x7 PHCs.
• Protocol for EmOC displayed at
labour room for reference.
• IEC material on available services
for community.
• Radio & TV Spots, Print Media,
Hoardings,
LED
Displays
at
prominent places and other folk
media.
Mainstreaming of AYUSH
Ayurveda
• 524 Dispensaries and 5 (50-bedded) Hospitals, 7 ISM Wings in District
Hospitals operational –Medical Officers & Dispensers provided alongwith
that there is a provision of Rs. 50,000 for drugs for each institution.
Homeopathy
• 111 Dispensaries operational –Medical Officers & Dispensers provided.
Drugs worth Rs. 7 Lakh provided.
Co-location under NRHM
• Provision of one Ayurvedic Doctor and Dispenser in 236 PHCs (24x7), one
Homeopathy Doctor & Dispenser in 114 CHCs and two Homeopathy
Doctor & Dispenser 20 DHs
• 205 Ayurvedic doctors in PHCs and 104 Homeopathic doctors in CHCs
recruited on contract basis under NRHM.
• 182 Ayurvedic Dispensers in PHCs and 107 Homeopathic Dispensers in
CHCs recruited on contract basis under NRHM.
Proposed PIP Budget for the Financial Year 2012-13
Part
Scheme/Programme
Rs. in Crores
Proposed Amount
RCH Flexible Pool
118.69
NRHM Mission Flexible Pool
206.22
C
Immunization and PPI Operation Cost
14.69
D
NIDDCP
0.22
IDSP
2.78
NVBDCP
3.55
NLEP
1.84
NPCB
6.61
RNTCP
10.00
A
B&E
Proposed PIP Budget for the Financial Year 2012-13
Part
11
Scheme/Programme
Proposed Amount
(Rs in Crores)
Tobacco Control
0.67
Cancer Control
0.18
Direction & Admn. (Treasury route)
75.48
TOTAL
440.93
New initiatives proposed in PIP 2012-13
•
•
•
•
•
•
•
•
Free diagnostics through Mammography Units & cervical cancer
among women.
Setting up of New Born Stabilization Units at 10 DHs, 12 SDHs and
6 CHCs conducting more than 50 deliveries.
Infant Death Audit – approximately 16000 deaths apprehended.
Programme for Cancer Control – screening camps in districts –
1080 camps and IEC.
Tobacco Control Programme – public awareness material &
mobility support.
Capacity Building Programme for management units under NRHM
i.e. Training of Government rules/ procedures etc. to all employees,
employed under NRHM but never trained (Around 4,000)
Dental check-up of all school going children.
Besides this, during discussion with GOI a pilot project on universal
screening of 40+age will be discussed to approve over and above
the NRHM PIP.
Highlights of the proposed PIP 2012-13
•
•
•
•
•
•
Implementation of Janani Shishu Suraksha Karyakaram, JSY
and Family Welfare.
School Health Programme including routine check-up of all
school going children and treatment of complicated diseases
among children – CHD/ RHD, Thalassemia, Cancer etc.
Tracking Machines for 900 ultrasound centres.
Trainings - focusing on Maternal, Child Health and other
programmes.
ASHA Programme – trainings, drug kits & incentives.
Mandatory Grants.
Highlights of the proposed PIP 2012-13
•
•
•
•
•
Infrastructure up-gradation of 10 DH and 5 SDH based on
NABH / ISO standards.
Construction of Maternity Ward at District Hospital Barnala and
OPD Block at Sub-Divisional Hospital Khanna.
Construction of new building of 40 Sub-Centres and repair and
renovation of 75 Sub-Centres.
Procurement and supply of equipment and drugs.
Contractual appointment of one AYUSH Doctor and
Dispensers in all 24x7 PHCs (Ayurveda) in all CHCs, SDH and
2 in all DH (Homoeopathy).
Punjab Nirogi Yojana: Financial assistance to the tune of Rs. 1.50 lacs is being
provided to BPL families for treatment of life threatening diseases
Rashtriya Swasthya Bima Yojana: Under this scheme, indoor medical care is
being provided to a BPL family up to Rs.30000/- in the 147 Government and 185
Private Hospitals.
Establishment of Trauma Centre: It is a 100% Government of India sponsored
scheme, 3 Trauma Centres has been set up and 1 is under completion.
Upgradation and Strengthening of Nursing Services (Human Resource Health):
The Government of India has sanctioned Rs.50 crore for establishment of 5
Nursing Schools in the District Hospitals.
Strengthening of Teaching Facilities in Government Mental Hospital, Amritsar :
This is a 100% centrally sponsored scheme.
Mainstreaming of AYUSH under NRHM for procurement and supply of
essential drugs:
Upgradation of AYUSH hospitals.
Strengthening of Drug Testing Laboratory of Ayush.
Establishment of ISM & H Wing of District Allopathic Hospitals.
Establishment of 116 OPD clinics in PHCs.
Upgradation of Government Ayurvedic Dispensaries.
•
Providing Hotline facilities in the District and Sub
Divisional Hospitals
•
Strengthening of Logistic Services
•
Strengthening of Hospital Management Information
Systems
•
Strengthening of Fire Safety Services
•
Strengthening of Drug De-addiction Centres
•
Cancer Relief Fund
•
Strengthening of Urban Health Infrastructure
•
Establishment of Mobile Cancer Detection Units
•
Incentive for delivery under Mata Kaushalya Scheme
•
Incentives for IMR
•
Strengthening of Civil Registration System
•
Upgradation and extension of Ayurvedic Pharmacy and
Stores.
Tuberculosis Control Programme
All 20 Districts implementing DOTS programme and by July
2012, all will start implementing DOTS plus programme.
During 2011, total 39,206 patients enrolled.
Cure Rate of TB is 88%.
AIDS Control Programme
Punjab State is a high vulnerable State.
Estimated adult prevalence
0.32% (India : 0.31%)
Total HIV cases detected in ICTC 30466 cases
8719 AIDS Cases undergoing treatment in 6 ART Centres in the
state.
Leprosy Control Programme
State is a low prevalence State.
Prevalence rate is 0.23 per 10000
532 patients are under treatment
State has achieved the GOI goal i.e. <1/10000
Polio Eradication Programme
Polio free State.
No case of Polio in the State in 2010 and 2011
Blindness Control Programme
2.10 lakh cataract operations done in State in the year 2011-12 which
is amongst highest per lakh population in the country.
National School Health Programme
34.59 lakh students were medically checked up in 2011.
4.03 lakh schools covered under Intensive Dental Health School
Programme
PHSC MANAGES 176 SECONDARY LEVEL
HOSPITALS

19 District Hospitals (DH)

2 Special Hospitals (SH)

36 Sub-Divisional Hospitals (SDH)

119 Block Level Community Health Centres (CHC)

One special Institute of Mental Health (Government Mental Hospital),
Amritsar.
New Upgradation and construction under Core Plan:



District Hospitals – 2
Sub-Divisional Hospitals : New – 5, Upgradation – 2
Community Health Centres : New – 29, Upgradation – 3
INDICATOR
Comparative Position
Jan-Dec
2009
Jan-Dec
2010
Jan- Dec
2011
%age Increase /
Decrease 2010 /
2011
Admissions
506444
566790
617743
8.99
Out Patients
10667090
11082390
11358126
2.49
 DH
84.57
90.77
90.76
0.00
SDH
72.28
76
76.36
0.47
CHC
36.23
41.92
43.24
3.14
Surgeries
467656
516229
531339
2.93
Deliveries
62793
78094
108979
39.55
X-ray and Scanning Tests
869105
943047
982204
4.15
Lab. Tests
6207645
6988173
7567543
8.29
BOR %age

User Charges which are collected by the Secondary level
Health Institutions are being utilized by the hospitals itself

45% of collections are being spent for purchase of drugs

25% on improving facilities to patients

15% each on building and equipment maintenance.

During the FY 11/12, Rs.30.28 crore user charges were
collected as against Rs.26.33 crore during the FY 10/11.
CONT…
{Rs. Lakhs}
PARTICULARS
Period (FY) Audited
09-10
Tentative FY
11-12
Expected %age increase
in FY
11-12 as
compared to FY 10-11
15
10-11
Collections
2267.80
2633.58
3028.62
Utilization
2052.65
2433.28
2848.67
Drugs
883.16
1102.65
1323.16
20
Imp. Facilities to Patients
712.68
855.66
1026.79
20
Maintenance of building
233.13
230.11
241.62
5
Maintenance of equipment
223.68
244.86
257.10
5

Jan Aushadhi Stores in Districts

Implementation of Telemedicine Project

Monitoring Referral Ambulances Project

Strengthening of Mortuary Services

Accreditation of Hospitals with NABH and ISO

Strengthening of Physiotherapy Services

Single rate contract in the state for purchase of





Medicines,
Consumables,
Scanning Material,
Lab. Reagents,
Hospital Linen and Hospital Furniture

Under different packages for the purchases being made by
different Directorates / Wings of the Department from State Plan,
Non-Plan, NRHM funds, Zila Parishads funds and user charges
collections.

The tenders for all packages have been invited which are being
received and will be evaluated.

The Government of India has notified the Food Safety and Standard
Rules, 2011 w.e.f. 5.8.2011.

The State Government has already appointed Commissioner for Food
Safety.

The State Government has prepared a proposal to set up a separate Food
and Drug Administration to fulfill the following objectives.
•
•
To enforce the Food, Drugs and Cosmetics Act fairly, to uphold
safety standards and to protect consumers.
To set up the Drugs Technical Advisory Board, Drugs Consultative
Committee, Indian Pharmacopoeia Committee and Central
Committee for Food Standards.
•
To regulate the analysis of samples of drugs and food through Drug and
Food Control Laboratories.
•
To give additional revenue generation through an increase in fees.
•
To facilitate Human Resources Development through training and
encouraging self-developmental efforts of employees.
•
To disseminate useful information to the public, industry and trade
through meetings, lectures, organization of seminars, exhibition,
workshops and brainstorming sessions.

Inadequate and untimely release of state plan scheme funds and
state share of centrally sponsored schemes.

Vacant posts of doctors and paramedics. Presently, 1250 posts of
doctors and 3600 posts of paramedics are vacant.

Non-availability of doctors of critical specialties like
Gynaecologists, Paediatrics, Radiologists, Anaesthetists in the state
(overall shortage)

Inadequate administrative staff in the Directorate, districts and
specifically in newly formed districts.

Inadequate provision for office and POL expenses in Non Plan
Budget.

Deteriorating conditions of residential quarters and nonavailability of adequate funds for maintenance for which
approximately Rs.25 crore is required.

Virtually non-existent maintenance provisions for hospitals.
Around Rs. 15 crore is required every year.

Totally inadequate provision for security services in the hospitals.
There is an immediate requirement of security personnel and
installation of CCTV cameras.

Requirement of additional DG sets in the hospitals.

Requirement of additional ambulances in the hospitals

Insufficient provision for continuous trainings for clinical skills and
hands on trainings.

Insufficient provision for maintenance of equipment.