High performance gap in healthcare infra, manpower availability in Gujarat: study

Acknowledging the importance of health performance in overall human development index (HDI), a study by the Indian Institute of Management, Ahmedabad (IIM-A) has laid out certain performance gaps in Gujarat's health sector.

Performance gaps in areas like life expectancy at birth, infant mortality rate and neo-natal rates have been found to be pretty high in Gujarat as compared to other states, according to the study titled 'What Determines Performance Gap Index of Healthcare in Gujarat?' Authored by Shreekant Iyengar and Ravindra Dholakia of IIM-A, the study attempts to identify the gaps in performance of the health related outcome, output and input indicators from the best performers in each indicator.

The gap would indicate the distance that Gujarat has to cover to reach the best performance in the country in each indicator. A higher value of this index indicates more gap from the best and thereby a relatively poorer performance of Gujarat.

Moreover, the paper also reviews the trends in health performance of Gujarat over time and also estimates the effectiveness of the state in converting its health inputs to outputs and outputs to outcomes. Indicators such as health infrastructure and manpower, among others were looked into to assess performance gap of Gujarat.

For instance, gap has also been found in total government hospitals and number of available beds at 96 per cent and 64 per cent, it further states, while adding that the state will have to enhance health expenditure in order to reduce these gaps.

"It is only the maternal mortality where the performance gap is low at 22 per cent putting Gujarat relatively near to the top performer. The performance gap of Gujarat in terms of the Indian system of medicine AYUSH (Ayurveda Yoga Unani Siddha Homeopathy) is also extremely large for the number of hospitals (99 per cent), beds (81 per cent) and dispensaries (86 per cent)," the study states.

In terms of manpower availability (numbers per hundred thousand of population) in the public health system of Gujarat, the gap for the number of general doctors at primary health centres (PHC) is 90 per cent and for the specialist doctors at community health centre (CHC) it is as high as 95 per cent.

"Moreover, considering the total number of doctors and nurses in the state, we find that the performance gaps are relatively lower at 50 per cent and 45 per cent respectively. However, the gap in terms of the total number of AYUSH doctors (66 per cent) is again quite high. The gaps for total and government doctors in Gujarat show that the non-availability of doctors is more severe in the public health care system than overall level in the state," the study further states.

Meanwhile, the study called for enhancing expenditure on health in Gujarat which it termed as a challenge. "The process of expanding infrastructure and increasing manpower would require significant public expenditure to be incurred. This can be placed as a major challenge to the state towards achieving better health outcomes and finding its place in the top performers among the states in the country," the study concluded.