Compliance Audit on Public Health Infrastructure and Management of Primary Health Services in Tripura

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AuthorCAG of India
Date Accessioned2024-06-21T09:43:11Z
Date Available2024-06-21T09:43:11Z
Date of Publication2023
AbstractThe present Subject Specific Compliance Audit (SSCA) covers the primary health care services which provide health facilities at village and block levels. The SSCA also provide a holistic view of improvement of necessary infrastructure, created for meeting emergencies related issues and service delivery by the sampled health institutions for the period 2016-17 to 2021-22. 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 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. A large number of essential drugs were not supplied to the health institutions and stock out rate of the available medicines was high. HSCs are responsible for providing 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 PWs did not receive four ANC check-ups during 2021-22. Hospital support services, viz. dietary service, laundry, and linen service, etc. were in operational in the sampled health facilities without any standard operating guidelines from the Government. 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. Sampled Health Facilities were found in not adhering to the Bio Medical Waste Management Rules. The CHC, Kumarghat had low bed occupancy and an alarmingly high referred out rate of 194 per 1,000 indicating that this hospital had struggled to provide quality services. Similarly, PHCs, Ganganagar and Champaknagar were also struggling to provide good services to the patients as reflected with the high Referral Out, LAMA and Absconding rate. Grievance redressal mechanism was not available. 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 VTMs were found in use for conducting of RTPCR test to detect the presence of virus. State is lagging behind in achieving the 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.
Identifier URIhttps://resourcerepository.azimpremjiuniversity.edu.in/handle/apurr/373
LanguageEnglish
PublisherCAG of India
Series2 of 2023
TitleCompliance Audit on Public Health Infrastructure and Management of Primary Health Services in Tripura
Item TypeAudit Report
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