As Bihar Struggles to Contain Encephalitis Outbreak, Shortage of Manpower, Rising Vacancies Add to Woes
According to the ‘Health Index Report’ released by the NITI Aayog, Bihar is ranked 20th among the 21 large states for the year 2017-18, and only has a better score than neighbouring UP, which is at the last spot.

New Delhi: More than 150 children have lost their lives in Bihar over the last couple of days due to an outbreak of Acute Encephalitis Syndrome (AES). Taking cognizance of the alarming number of deaths in just a few days, the Supreme Court directed the Union and state governments to file an affidavit within a week on the adequacy of medicines, nutrition and hygiene.

During the hearing of the public interest litigation (PIL), the state said “things were under control”. However, contrary to the state government’s claim, all may not be well with Bihar’s health services.

According to the ‘Health Index Report’ released by the NITI Aayog on Tuesday, Bihar is ranked 20th among the 21 large states for the reference year 2017-18, and only has a better score than neighbouring Uttar Pradesh, which is at the last spot. In terms of incremental change (change in score from base year 2015-16) though, Bihar features at the bottom with a negative score change of 6.35 — highest among all large states.

A major reason behind the state’s poor show in the assessment carried out by NITI Aayog could be lack of manpower and a high number of vacancies in health services, which the report highlights.

As per official data cited in the report, nearly 60 per cent positions for ANMs (Auxiliary Nurse Midwife) at sub-centres — highest among 21 larger states — were lying vacant in Bihar in 2017-18. This is almost twice the vacancies in Karnataka, which is ranked 20th in the list for the same time period. Interestingly, Uttar Pradesh which is ranked worst on the basis of overall performance had 'zero' such vacancies along with Odisha and West Bengal with less than 1 per cent vacancies.

Similarly, staff nurses’ vacancies at PHCs (Primary Health Centres) and CHCs (Community Health Centres) were the second highest in Bihar with half of all the sanctioned positions lying vacant during 2017-18. Vacancies marginally increased during the reference year (2017-18) in comparison to the base year (2015-16). The only state ranked lower on this front was Jharkhand with 54 per cent of vacancies against the allowed strength. In this category too, Uttar Pradesh had no vacancies of staff nurses at PHCs and CHCs among larger states.

Again, almost six in every 10 positions for ‘Specialists’ at district hospitals in Bihar were vacant as of 2017-18, which is slightly better than Uttarakhand and Chhattisgarh.

The only category where the state has seen an improvement between the Base Year and the Reference Year is Medical Officers at PHCs. The state has managed to bring down the number of vacant positions of Medical Officers at PHCs from 63.6 per cent during the base year 2015-16 to 34.1 per cent in reference year 2017-18. This is the largest decline observed in any state. On the other hand, Uttarakhand saw a sharp surge in Medical Officer vacancies from 12 per cent to 70 per cent during the same time period.