Assessment of Public Healthcare Services in Bihar: A Study on Performance of Resource Utilisation and Service Delivery

Aims and Objectives: The aim of the study was to examine the effectiveness of public health resources and the efficiency of public health providers at different facility levels in Bihar. The study sought to identify the drawbacks in the existing system that hinder proper and efficient utilization of public funds. It focused on evaluating the resource flow from the perspective of efficient allocation and utilization, covering various levels of health facilities, and assessing their performance.

Methodology: The study utilized both primary and secondary data to evaluate the performance of health facilities at different levels, including District Hospitals (DH), Sub-divisional Hospitals (SDH), Community Health Centres (CHC), Primary Health Centres (PHC), and Sub-Health Centres (SC). A comparative assessment was conducted between high-performing and low-performing districts in Bihar to understand the efficiency of fund allocation and utilization, and the performance of health services. The study also analyzed adherence to the Indian Public Health Standards (IPHS) in terms of service delivery, manpower, and infrastructure.

Findings:

• Health facilities did not adhere to the IPHS standards for service provision, manpower, and infrastructure.
• Deficiencies in manpower and infrastructure, including machinery and equipment, led to suboptimal service delivery.
• Quality index scores for outdoor, indoor, and emergency care patients were negatively impacted by these deficiencies.
• Inefficiencies in fund allocation and utilization were identified, particularly in low-performing districts.
• Significant disparities were observed between high-performing and low-performing districts in terms of health service delivery.

Recommendations:

• Provide timely incentives and transportation support to ASHA workers to improve their effectiveness, especially in hard-to-reach areas.
• Enhance the effectiveness of training programs for healthcare employees.
• Increase public awareness about health programs to improve service uptake.
• Implement regular monitoring of health facility performance by higher authorities to address existing challenges and promote better functioning.
• Upgrade public healthcare facilities in accordance with IPHS guidelines to ensure efficient functioning.