Odisha, as per the 2023–24 economic survey, lags slightly behind the national average, with a life expectancy of 69.3 years
Tejeswar Patnaik
‘Health is wealth’ is a timeless saying that underscores the importance of well-being in every individual’s life. Health encompasses both physical and mental wellness. Ancient Indian practices such as yoga, pranayama, and meditation have garnered global recognition for their contribution to overall well-being.
At the time of India’s Independence, the average life expectancy was just 32 years. Over the last seven decades, significant advancements in healthcare have increased the average lifespan to 70 years—a rise of over 100%. Among all Indian states, Kerala is recognized as having the best public healthcare system, according to NITI Aayog’s Health Index and other sources.
However, Odisha, as per the 2023–24 Economic Survey, lags slightly behind the national average, with a life expectancy of 69.3 years. This highlights the pressing need to improve its healthcare infrastructure. While the state has made progress in certain health indicators, Odisha’s public healthcare system continues to face numerous challenges, as revealed in the recent Comptroller and Auditor General (CAG) report tabled in the Odisha Assembly.
The CAG report indicates that Odisha faces a severe shortage of hospital beds in government facilities—nearly 64% below the threshold prescribed under the National Health Policy. Additionally, the state grapples with acute shortages in medical human resources. Specialist doctor positions have a vacancy rate of 49%, while 40% of medical officer posts and 30% of nursing staff positions remain unfilled. Many government hospitals also lack basic amenities such as seating chairs and toilets for outpatients, further inconveniencing the public.
Systemic Inefficiency
The report also flagged inadequacies in emergency and diagnostic services. Essential facilities such as mobile X-rays, ambulances, operating theatres, emergency beds, and oxygen supplies are either insufficient or absent. Moreover, the lack of adequate diagnostic equipment and the non-utilization of funds earmarked for public health infrastructure continue to impede progress. These systemic inefficiencies directly impact Odisha’s ranking in the Multidimensional Poverty Index, as indicators like infant and maternal mortality are key components of comprehensive healthcare assessments.
The erstwhile BJD government claimed significant strides in public healthcare through initiatives such as the Biju Swasthya Kalyan Yojana (BSKY), a flagship scheme to cover hospitalization expenses for eligible beneficiaries. However, the current BJP government has phased out this scheme and has implemented the Central Government’s Ayushman Bharat initiative instead.
Despite these challenges, Odisha has significantly improved health outcomes over the past two decades. The state has achieved a decline in infant and maternal mortality rates, alongside progress in controlling diseases such as malaria, tuberculosis, and polio. However, it still lags behind other states in terms of public healthcare infrastructure and service delivery.
Further, the CAG report highlighted gaps in medical education, with 27% of teaching posts in government-run medical colleges remaining vacant. This shortage hampers students from acquiring essential domain knowledge and skills, ultimately affecting the quality of healthcare delivery in the state.
The health sector received ₹21,200 crore in the BJP government’s maiden budget for 2024–25, which constitutes about 8% of the total budget outlay of ₹2.65 lakh crore. However, experts believe this allocation is insufficient to address the state’s critical healthcare challenges. Increasing this share to at least 13% over the next four years could significantly improve healthcare infrastructure, reduce infant and maternal mortality rates, and address systemic inefficiencies. Odisha’s infant mortality rate (36.3 per 1,000 live births) and maternal mortality rate (119 per 100,000 live births) remain higher than the national averages, reflecting the urgency of focused interventions and increased investment.
Doctors and specialist medical professionals are often reluctant to serve in rural and semi-urban areas specifically in backward tribal areas due to inadequate infrastructure, lack of incentives, and poor working conditions. The absence of proper amenities in block and sub-divisional hospitals exacerbates this issue, leaving large sections of the population underserved. Doctors frequently face public ire for the shortcomings of the healthcare system, despite having limited control over these conditions. Transformational changes in infrastructure, incentives, and better working conditions are essential to attract and retain medical professionals in these regions.
Underutilization of Funds
Another major issue is the underutilization of allocated funds for public health infrastructure. Accountability must be fixed at various administrative levels to ensure the effective implementation of government guidelines. Hospital management should strive for a clean and patient-friendly environment to enhance trust and accessibility. Periodic reviews and evaluations of healthcare indicators can help identify and address gaps in the system. A target-driven approach with measurable outcomes can bring about tangible improvements in public healthcare. Health sector experts may analyze the reasons behind Kerala’s success in public healthcare and suggest strategies to emulate its model.
Odisha’s public healthcare system stands at a critical juncture. While some progress has been made, substantial improvements are necessary to meet the population’s needs, especially for those unable to afford private healthcare. By increasing budget allocations, addressing staff shortages, and fostering a culture of accountability, Odisha can transform its healthcare sector. The state is also in a position to spend more on public healthcare. Moreover, best practices from states like Kerala can be adopted to ensure quality healthcare for all. It is, therefore, time for the state government to proactively work towards achieving this goal.
(The writer is a former Dy General Manager of Bank of India. Views expressed are personal.)
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