Karnataka’s rural community health clinics have shortage of specialists

By Hamsaveni N

Community health centres

(CHCs) in rural Karnataka face a shortage of specialist physicians and surgeons, causing a delay in treatment.

According to data from Rural Health Statistics under the Ministry of Family and Welfare, in Karnataka out of the 461 sanctioned posts of specialty doctor in CHCs, 263 are in position and 198 posts are vacant. With the requirement of 728 posts, Karnataka has a shortfall of 465 specialist posts.

The three levels of the health system under the National Health Mission start with sub-centres (the first point of contact). Then come public health centres (PHCs), followed by CHCs and district hospitals.

Karnataka has 8,891 sub-centres, 2,141 PHCs, and 182 CHCs.

Iraya Swami Hiremath, a differently abled person from Haveri, informed The Observer that the shortage of specialists in the Savanur CHC is forcing patients to rush to district hospitals in emergencies.

“Rural areas are always ignored. Most people in my taluk are farmers and lack a good financial status to afford private treatment. Unavailability of specialists like radiologists, obstetricians and specialty surgeons in rural areas forces us to visit private hospitals. A few who can’t afford the treatment at private hospitals ignore their health issues and suffer.”

A 100-bed CHC in Kushtagi, Koppal district, which needs at least 14 specialty doctors, has only six. Patients in Kushtagi said there is a need for pediatricians as children and newborns keep falling sick often and their families cannot afford to get treatment at private hospitals.

During a visit to the Kengeri CHC, The Observer found that though there is no shortage of doctors, the number of beds is inadequate. The centre is supposed to have 30 beds.

Doctors there said: “The inflow of patients is high in this CHC. As we have all specialty treatments, available including dental care, many patients come for check-ups. But we don’t have the capacity to accommodate the crowd in our CHC. We need more beds to support the growing numbers of…. Our CHC should at least have 100 beds.”

Shuba, a doctor at the Nayandahalli PHC in Bengaluru, spoke about the impact of the shortage of doctors, specialists and hospital staff on patients. “In urban areas, people can afford private treatment if they can’t reach out to government hospitals. We also have initiatives like Namma Clinics. But it is not the same with people in rural areas, mainly those who are settled in the deepest of villages. Our country is still dealing with poverty and people cannot afford costly treatments. The government should focus on rural areas and the patients over there.

She continued: “The way doctors are treated in our country is terrible. We are seeing the number of medical talents travelling to other countries to pursue medical education after MBBS; most of them settle down there. The government should take steps to ensure our human resource does not go out and is utilized for the country. It should make sure a doctor will be taken care of well if he is posted in a rural area. These days most medical students don’t prefer going to rural areas. Their concerns should be addressed quickly.”

The Observer tried to contact Randeep. P, commissioner of the Karnataka Health and Welfare Department, but he was unavailable to talk.

According to an article in The Print, the number of allopaths at PHCs increased from 20,308 in 2005 to 30,640 in 2022 — a 50.9 per cent increase. There is a shortfall of 3.1 per cent in allopathic doctors at PHCs. Specialists at CHCs increased from 3,550 in 2005 to 4,485 in 2022.

But there is a shortfall of 83.2 per cent of surgeons, 74.2 per cent of obstetricians and gynecologists, 79.1 per cent of physicians and 81.6% of pediatricians. Overall, there is a shortfall of 79.5 per cent specialists at the CHCs, the article said. hamsaveni.n@iijnm.org