KOCHI: In Kerala, 175 primary health centres (PHC) were identified for upgradation from 2011-16 to provide 24×7 emergency services. But, none of them were upgraded, said the comptroller and auditor general’s audit (CAG) report. CAG’s performance audit on reproductive and child health tried to ascertain the adequacy of physical infrastructure and delivery facilities through surveys.
Admitting this, directorate of health services assistant director Dr Bipin K Gopal said: “The plan to run primary health centres 24 hours a day didn’t materialize due to the shortage of doctors and other staff. However, now the government has extended clinic timings to 6pm to serve a larger population.”

The audit further pointed out that of the 1,158 facilities (community health centres-234 and PHC924) in Kerala, only 23 CHCs provided proper services for child delivery. The remaining facilities were not functioning as delivery points as they lacked basic infrastructure, manpower and equipment.

In other states people turn away from community health centres due to distance factor, little or no access to public transport and unhygienic surroundings. On the other hand in Kerala it is because women prefer private hospitals for child delivery.

This was admitted during a meeting with CAG officials. Health and family welfare department officials had stated that 75% of the pregnant women in Kerala use antenatal care services at government institutions. But, when it came to child delivery, they preferred private hospitals.

The main reasons they cited were the general perception among people that delivery at a private hospital was safer and painless in addition to the availability of better paediatric services.

Secretary General of Kerala Federation of Obstetrics & Gynaecology Dr Fessy Louis said patients would definitely choose government hospitals if there are adequate facilities and doctors. “When health standards improve, the expectations of people also increase and they expect the facilities at government hospitals to be as good as the ones in private hospitals” said Louis.

Deliveries with obstetric complications were observed in 19% cases. In 13 states, including Kerala, the audit observed an increasing trend of obstetric complications over the years. Mobile medical units were partially operational in 10 states, including Kerala, the audit added.