Karnataka must raise health spending, fill vacancies and expand facilities, says report on assessment of public health facilities

A preliminary assessment of public health facilities in Karnataka has called for higher budgetary allocation, filling of vacant posts and expansion of infrastructure in underserved districts.

The report, prepared by Health for All Forum – Karnataka using data obtained under the Right to Information Act, 2005, reviews the status of health sub-centres (HSCs), primary health centres (PHCs), community health centres (CHCs) and general hospitals in selected districts.

Key recommendations

The report has urged the State government to increase health expenditure to 10% of the total Budget, strengthen primary healthcare and sanction new facilities based on Indian Public Health Standards (IPHS) norms and updated population estimates.

It has recommended a Statewide recruitment drive to fill all sanctioned posts on a permanent basis and reduce reliance on contractual appointments.

The recommendations are placed in the context of the Karnataka State Integrated Health Policy, which envisaged higher public spending and equitable access to quality healthcare.

Growing disease burden

Pointing to a rise in both communicable and non-communicable diseases in recent years, the assessment stated that in Yadgir district, hypertension cases treated at public facilities more than doubled between 2021-22 and 2024-25. Diabetes cases rose by over 50% during the same period.

Citing data from the National Family Health Survey (2019-20), the report stated that 14.8% of women and 17.2% of men in Karnataka had mildly elevated blood pressure, higher than the national average.

Infrastructure gaps

Based on IPHS norms, the assessment identified infrastructure shortfalls across districts.

For instance, only 53.4% of the sub-centres reviewed were functioning in their own buildings, with the rest operating from rented or other premises. Shortages were also noted in PHCs and CHCs.

Vacancies and rising workload

Vacancies were reported across levels. In 12 general hospitals examined, 45.6% of posts were vacant in 2024-25. In 12 CHCs, 42.6% of posts were unfilled. Across 49 PHCs, 30.4% of sanctioned posts remained vacant.

More than half of the PHCs studied did not have a medical officer, and over 41% lacked nursing staff. At the sub-centre level, 5.5% of centres had no personnel.

Budget trends

The report stated that the highest health allocation between 2013-14 and 2023-24 was 5.78% of the total State Budget in 2021-22, below the level indicated in the Karnataka State Integrated Health Policy.

It also noted that a growing share of the health budget is being spent on government-subsidised insurance schemes, limiting the scope for expanding public infrastructure.