The guidelines laid down for Primary Health Centres (PHCs) by the Indian Public Health Standards are not being followed in any of the 100 PHCs that were randomly inspected by the District Legal Services Authorities (DLSAs) across the State, said a report submitted to the High Court of Karnataka.
“As per the IPHS guidelines, medical care must essentially include out-patient services, 24x7 emergency services, referral services, and inpatient services with six beds. Such medical care facilities are not uniformly available in all 100 PHC’s visited. Only 50 PHCs visited by DLSAs were functioning 24x7,” stated the report submitted by the Member-Secretary of the Karnataka State Legal Services Authority (KSLSA).
Response sought
A Division Bench comprising acting Chief Justice Satish Chandra Sharma and Justice Sachin Sankar Magadum, that noted the report, directed the State government to submit its response to the KSLSA’s findings. The court had sought report by DLSA by conducting surprise visits to three PHCs randomly in every district.
There was no emergency ambulance service available in 76 centres; 26 centres had no labour room; the psychiatric treatment facility was available in only 45 centres of the total 100 PHCs and one Community Health Centre (CHC) inspected by the DLSAs, the report pointed out.
Though the IPHS guidelines prescribe plinth area from 4,036 sq.ft to 4,843 sq.ft depending on whether an operation theatre facility is opted for or not, eight inspected PHCs had a plinth area of less than 1,000 sq.ft, 27 centres an area of 1,000 to 3,000 sq.ft, and 60 above 3,000 sq.ft, the KSLSA reported.
Lack of uniformity
Stating that there is no uniformity either in the staff pattern or in the infrastructure provided to PHCs, the report pointed out that the majority of staff in PHCs are health workers and health assistants though IPHS guidelines prescribe only one male and female health worker per PHC.
No duty doctors
“No quality medical service can be expected from health workers in the absence of requisite medical officers and midwives,” the report stated while pointing out that duty doctors were not available in many PHCs during prime hours.
Of the 100 PHCs inspected, 67 did not have residential accommodation for doctors and paramedical staff, the KSLSA said, while pointing out that most DLSAs reported that no cleanliness was maintained in most of the inspected PHCs.