*HONORABLE HEALTH MINISTER OF GOVERNMENT OF KARNATAKA, HAVE YOU GOT YOUR PRIORITIES RIGHT?*
*PERFORMANCE REPORT on Health Outcomes/Indicators: Government of Karnataka*
- The health outcomes in Karnataka *still lag behind neighbouring States* like Kerala and Tamil Nadu.
- The Maternal Mortality Ratio reported for Karnataka is 133 per 100,000 live births in 2015; *the highest among the four southern States*.
- The Infant Mortality Rate in Karnataka is 28 per 1,000 live births, *higher than* rates in Kerala and Tamil Nadu which is 12 and 22 respectively.
- The *seven districts of north Karnataka* namely, Yadgir, Gulbarga, Raichur, Koppal, Ballary, Bidar and Bagalkot and *one district in south Karnataka* namely, Chamaraja nagar *have poor health indicators* compared to most other districts.
- In a comprehensive study conducted by IIM Ahmedabad to analyses the performance of Indian states with regard to health of their populace, *Karnataka fell from 7th rank in 2009 to 10th rank in 2013*. In comparison, Maharashtra (1) & Tamil Nadu (2) retained their ranks and Andhra Pradesh ( from 4 to 3) and Kerala (8 to 5) improved their ranks.
- In the State of the States Awards 2016 ranking published by India Today, *Karnataka state fell from 7th in 2013 to 11th rank in 2014*.
*PERFORMANCE REPORT on Health Infrastructure & Services: Government of Karnataka*
- Karnataka has 5 health dispensaries per 100,000 people, *lowest among southern states*; Andhra Pradesh (23), Tamil Nadu (14), & Kerala (61)
- Karnataka has one Community Health Centre to serve 142 villages, *lowest accessibility among southern states*; Andhra Pradesh (1 per 95 villages), Tamil Nadu (1 per 42 villages), & Kerala (1 per 5 villages).
- Karnataka has one Community Health Centre for every 906 sq. km of rural area, *lowest accessibility among southern states*; Andhra Pradesh (1 per 872 sq. km.), Tamil Nadu (1 per 305 sq. km.), & Kerala (1 per 160 sq. km.)
- Karnataka has 705 doctors per 100,000 people, *lowest among its neighbors*; Maharashtra (1,068), Andhra Pradesh (843), Tamil Nadu (1,098), & Kerala (1,636)
- *40% of total specialists seats* (Surgeons, OB&GY, Physicians & Paediatricians) in Community Health Centres in Karnataka were *vacant* as of 31st March 2016. This is in spite of Karnataka having the highest number of medical colleges and third highest number of doctors trained in the country.
*PERFORMANCE REPORT on Health Expenditure: Government of Karnataka*
- Karnataka government's health expenditure as a proportion to the Gross State Domestic Product (GSDP) *has decreased* from 1.46 (2000-01) to 1.0 (2013-14).
- Karnataka government's spending on drugs remains *low* in the State and has *decreased* from 7.9% of total health expenditure in 2001-02 to 6.3% of total health expenditure in 2011-12.
- According to the Karnataka Lokayukta, *25% of the public health budget in the State is lost to corruption* at various levels in the health system.
Is this making *"healthcare affordable to masses"?*
Is this *"Government at work"?*
Is this *"Building Karnataka"?*
Considering all of the above, one would think that Health ministry's hands are full and has it's priorities clear on where the focus should be; i.e. improving public health infrastructure and services. But what we see is this draconian and reckless KPMEA bill; a deliberate attempt to divert attention from the real problems in the public health sector, a populist agenda to create and exploit a divide among public and private players for votes in the upcoming election, a reckless move to undermine the private sector which stepped in to fill the void created by the very absence of a strong and quality public healthcare system.
- According to the 71stNational Sample Survey Organization (NSSO) Survey (2014), Karnataka is the only State other than Andhra Pradesh, which has seen *a decline in the utilization of public health services in the last decade from 34% to 26%.*
- The private sector has grown exponentially in the State in the last decade with people choosing care more often from the private sector, *often due to inadequacy of care, medicines or services in the Government sector*.
- According to DLHS-4, for acute illnesses more than *60% of the population preferred treatment from the private sector and for chronic illness this number further rose to 70%.*
How do you make healthcare available to everyone in the state if you make private hospitals unsustainable by capping their prices without any understanding of their economics? How do you improve doctor to population ratio if you intimidate them with imprisonment without due legal process and by a Grievance Redressal Committee filled with bureaucrats and government officials who have failed in their duty on this front in the first place?
What the state needs is the visionary leadership which makes government and private sector work closely to provide quality healthcare to all centered around patient safety, that is realistic and sustainable.
*Our politicians think they can fool the public, i.e. us, by making populist announcements before elections? Share these facts with as many people of Karnataka as possible. Make sure this reaches to our Honorable Chief Minister and Health Minister. Ask these questions to your local & state politicians and government health officials. Remember that you're paying for their salaries and government expenditure through the taxes you pay. Hold them accountable for their responsibilities and performance. Bring transparency and eradicate corruption.*
*Make a difference by bringing good governance.*
(Issued in public interest)
Sources:
- Rural Health Statistics 2014-15, Government of India, http://wcd.nic.in/sites/default/files/RHS_1.pdf
- Development of a Health Index of Indian States, https://www.indiaoppi.com/sites/default/files/PDF%20files/Development%20of%20a%20Health%20Index%20of%20Indian%20States.pdf
- The Karnataka public health policy by Task Force of Karnataka Jnana Aayoga (KJA), established by Government of Karnataka http://www.karnataka.gov.in/jnanaayoga/Pages/KJA-Recommendation-on-KPHP.aspx
- State of the States Awards 2016, India Today, http://indiatoday.intoday.in/story/state-of-the-states-kerala-health-schemes/1/398428.html
- https://timesofindia.indiatimes.com/city/bengaluru/88000-foreign-patients-came
*PERFORMANCE REPORT on Health Outcomes/Indicators: Government of Karnataka*
- The health outcomes in Karnataka *still lag behind neighbouring States* like Kerala and Tamil Nadu.
- The Maternal Mortality Ratio reported for Karnataka is 133 per 100,000 live births in 2015; *the highest among the four southern States*.
- The Infant Mortality Rate in Karnataka is 28 per 1,000 live births, *higher than* rates in Kerala and Tamil Nadu which is 12 and 22 respectively.
- The *seven districts of north Karnataka* namely, Yadgir, Gulbarga, Raichur, Koppal, Ballary, Bidar and Bagalkot and *one district in south Karnataka* namely, Chamaraja nagar *have poor health indicators* compared to most other districts.
- In a comprehensive study conducted by IIM Ahmedabad to analyses the performance of Indian states with regard to health of their populace, *Karnataka fell from 7th rank in 2009 to 10th rank in 2013*. In comparison, Maharashtra (1) & Tamil Nadu (2) retained their ranks and Andhra Pradesh ( from 4 to 3) and Kerala (8 to 5) improved their ranks.
- In the State of the States Awards 2016 ranking published by India Today, *Karnataka state fell from 7th in 2013 to 11th rank in 2014*.
*PERFORMANCE REPORT on Health Infrastructure & Services: Government of Karnataka*
- Karnataka has 5 health dispensaries per 100,000 people, *lowest among southern states*; Andhra Pradesh (23), Tamil Nadu (14), & Kerala (61)
- Karnataka has one Community Health Centre to serve 142 villages, *lowest accessibility among southern states*; Andhra Pradesh (1 per 95 villages), Tamil Nadu (1 per 42 villages), & Kerala (1 per 5 villages).
- Karnataka has one Community Health Centre for every 906 sq. km of rural area, *lowest accessibility among southern states*; Andhra Pradesh (1 per 872 sq. km.), Tamil Nadu (1 per 305 sq. km.), & Kerala (1 per 160 sq. km.)
- Karnataka has 705 doctors per 100,000 people, *lowest among its neighbors*; Maharashtra (1,068), Andhra Pradesh (843), Tamil Nadu (1,098), & Kerala (1,636)
- *40% of total specialists seats* (Surgeons, OB&GY, Physicians & Paediatricians) in Community Health Centres in Karnataka were *vacant* as of 31st March 2016. This is in spite of Karnataka having the highest number of medical colleges and third highest number of doctors trained in the country.
*PERFORMANCE REPORT on Health Expenditure: Government of Karnataka*
- Karnataka government's health expenditure as a proportion to the Gross State Domestic Product (GSDP) *has decreased* from 1.46 (2000-01) to 1.0 (2013-14).
- Karnataka government's spending on drugs remains *low* in the State and has *decreased* from 7.9% of total health expenditure in 2001-02 to 6.3% of total health expenditure in 2011-12.
- According to the Karnataka Lokayukta, *25% of the public health budget in the State is lost to corruption* at various levels in the health system.
Is this making *"healthcare affordable to masses"?*
Is this *"Government at work"?*
Is this *"Building Karnataka"?*
Considering all of the above, one would think that Health ministry's hands are full and has it's priorities clear on where the focus should be; i.e. improving public health infrastructure and services. But what we see is this draconian and reckless KPMEA bill; a deliberate attempt to divert attention from the real problems in the public health sector, a populist agenda to create and exploit a divide among public and private players for votes in the upcoming election, a reckless move to undermine the private sector which stepped in to fill the void created by the very absence of a strong and quality public healthcare system.
- According to the 71stNational Sample Survey Organization (NSSO) Survey (2014), Karnataka is the only State other than Andhra Pradesh, which has seen *a decline in the utilization of public health services in the last decade from 34% to 26%.*
- The private sector has grown exponentially in the State in the last decade with people choosing care more often from the private sector, *often due to inadequacy of care, medicines or services in the Government sector*.
- According to DLHS-4, for acute illnesses more than *60% of the population preferred treatment from the private sector and for chronic illness this number further rose to 70%.*
How do you make healthcare available to everyone in the state if you make private hospitals unsustainable by capping their prices without any understanding of their economics? How do you improve doctor to population ratio if you intimidate them with imprisonment without due legal process and by a Grievance Redressal Committee filled with bureaucrats and government officials who have failed in their duty on this front in the first place?
What the state needs is the visionary leadership which makes government and private sector work closely to provide quality healthcare to all centered around patient safety, that is realistic and sustainable.
*Our politicians think they can fool the public, i.e. us, by making populist announcements before elections? Share these facts with as many people of Karnataka as possible. Make sure this reaches to our Honorable Chief Minister and Health Minister. Ask these questions to your local & state politicians and government health officials. Remember that you're paying for their salaries and government expenditure through the taxes you pay. Hold them accountable for their responsibilities and performance. Bring transparency and eradicate corruption.*
*Make a difference by bringing good governance.*
(Issued in public interest)
Sources:
- Rural Health Statistics 2014-15, Government of India, http://wcd.nic.in/sites/default/files/RHS_1.pdf
- Development of a Health Index of Indian States, https://www.indiaoppi.com/sites/default/files/PDF%20files/Development%20of%20a%20Health%20Index%20of%20Indian%20States.pdf
- The Karnataka public health policy by Task Force of Karnataka Jnana Aayoga (KJA), established by Government of Karnataka http://www.karnataka.gov.in/jnanaayoga/Pages/KJA-Recommendation-on-KPHP.aspx
- State of the States Awards 2016, India Today, http://indiatoday.intoday.in/story/state-of-the-states-kerala-health-schemes/1/398428.html
- https://timesofindia.indiatimes.com/city/bengaluru/88000-foreign-patients-came
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