Audit reviewed the National Rural Health Mission (NRHM) scheme aimed to provide accessible, affordable, accountable, effective and reliable health care facilities in rural areas to strengthen public health systems. The State suffers from shortages of human resources in critical positions in the District Hospitals (DHs), Community Health Centres (CHCs) and Primary Health Centres (PHCs) which adversely affected the delivery of mandate of NRHM. These included shortages of specialist doctors to the extent of 89 per cent, Medical Officers (MO) by 36 per cent, staff nurses by 34 per cent and paramedics by 12 per cent against their sanctioned strengths. These shortages could not be bridged as 752 doctors appointed during 2012-13 to 2017-18 (February 2018) did not join the Department, for reasons not known to the Department. Even where doctors were available, the patients were still deprived of necessary treatments for various illnesses and diagnostic services in these health centres due to shortages of medical equipment, drugs and consumables, laboratory services, and were referred to other hospitals such as Dr. Bhim Rao Ambedkar Hospital, Raipur, Chhattisgarh Institute of Medical Sciences, Bilaspur etc., as observed from the indoor patient department (IPD) registers.

The State could not create sufficient infrastructure to bridge the gaps between requirement and available health facilities as 186 construction works could not be completed by the Department despite lapse of 20 to 56 months from the date of sanction on grounds of non-participation of bidders, high tender premiums, delays in identification and finalisation of availability of land. The State suffered from significant shortages of essential drugs, consumables and equipment at various levels of health centers as Chhattisgarh Medical Services Corporation limited tasked with these supply failed on grounds of non-availability of rate contract for medicines, non-receipt of tenders, late receipt of annual demand from Directorate of Health Services etc. Due to shortage of specialists and MOs, the Department could not upgrade 39 per cent of targeted CHCs as first referral units and 45 per cent of targeted PHCs to provide 24x7 services.