The Karnataka State Health Department is embarking on a crucial initiative to drastically cut maternal mortality rates and provide equitable access to urgent obstetric care in rural regions. This strategic overhaul focuses on streamlining the deployment of essential Mother and Child Health (MCH) specialists—including gynecologists, anesthetists, and pediatricians—across all taluk hospitals and community health centers (CHCs).
Speaking to the media on Friday, Health Minister Dinesh Gundu Rao explained that this groundbreaking step aims to empower all taluk hospitals to operate as fully-fledged Comprehensive Emergency Obstetric and Newborn Care (CEmONC) facilities. This means they will be equipped to manage complex deliveries, perform Caesarean sections, and address newborn emergencies around the clock, ensuring no critical minute is lost.
Minister Gundu Rao highlighted the introduction of a ‘double triad’ rotational system, guaranteeing that these vital specialists are available 24/7. ‘This will effectively eliminate the need for costly and often dangerous referrals to larger tertiary hospitals, where delays can tragically lead to fatalities,’ he stated, confirming that the State Cabinet had given its full approval to the proposal just a day prior.
Current Staffing Challenges
Despite established positions, many taluk hospitals and CHCs currently struggle with only a single sanctioned post for each of these crucial MCH specialists. The Minister revealed that a staggering two-thirds of Karnataka’s 148 taluk hospitals rely on just one gynecologist, anesthetist, or pediatrician, a dire situation made even worse by widespread vacancies.
An in-depth review of CHC performance uncovered significant discrepancies. Out of 274 CHCs, a mere 41 manage more than 30 deliveries monthly, while 230 centers handle fewer. To rectify this imbalance, specialists from these ‘underperforming’ CHCs will be strategically reassigned to busier taluk hospitals and certain CHCs slated for upgrade to CEmONC status. This ensures that at least 189 facilities—encompassing all 148 taluk hospitals and 41 selected CHCs—will be staffed with two specialists from each MCH triad discipline.
Considering Local Needs and Geography
The plan also thoughtfully considers geographical factors. Mr. Gundu Rao cited the example of the CHC at MM Hills in Chamarajanagar: ‘Despite its lower performance metrics, this center will maintain its full MCH triad team because the closest referral hospital is over an hour’s journey away, making local access critical.’
Conversely, the Minister explained that CHCs deemed ‘non-performing’ will transition to Basic Emergency Obstetric and Newborn Care (BEmONC) facilities. ‘These centers will still retain pediatricians, supplemented by additional medical officers and dentists, guaranteeing a broad spectrum of maternal and general health services,’ he assured. To compensate for the specialist redeployments, each BEmONC facility will receive two extra MBBS doctors from the National Health Mission pool.
The restructuring plan extends to nursing staff as well. With over 600 of the 883 designated 24×7 Primary Health Centres conducting fewer than six deliveries monthly, nurses from these low-utilization centers will be reallocated, with three nurses moving to each of the newly strengthened CEmONC facilities.
Addressing Diagnostic Gaps
In a proactive move to bridge diagnostic gaps, the government has approved the creation of 114 new radiologist positions. These roles will be filled by reassigning surplus MCH triad specialists following the rationalization process. Currently, the 189 facilities only have 75 sanctioned radiologists, highlighting a significant shortfall.
Given the increasing prevalence of high-risk pregnancies, often complicated by conditions like diabetes, hypertension, malnutrition, and a rise in repeat Caesarean sections, the department emphasizes that this comprehensive restructuring is not just beneficial, but absolutely essential for the future of maternal and child health in Karnataka.