The World Bank funded Karnataka Health Systems Development Project (KHSDP) will come to a close on March 31, 2004 after the last eight hospitals out of a total of 204 medical centres are handed over to the state directorate of health and family welfare. However, the 44 trauma centres identified in the 27 districts, which is a crucial part of the project, can only offer simple first-aid for accident victims unlike its earlier plan of handling all highway trauma and accident cases. KHSDP has not been able to include purchase of the state-of-the-art trauma equipment for neurosurgery and serious orthopaedic injuries.

The World Bank will constitute a committee to review and assess the implementation of the 8-year-old project in mid-April 2004. It will analyse whether the project objectives have been achieved, indicate the shortfalls and take into account the reasons for the same, KH Gopala Krishna Gowda, project administrator and special secretary to the government of Karnataka told Pharmabiz.com

"Trauma has been a vital focus of the project but the funding from World Bank loan of Rs. 652 crore has not been allocated towards purchase of equipments like a ventilator priced at around Rs. 1 crore or even hire a team of neurosurgeons to man the centres. The state government took a decision to only provide the basic infrastructure which includes blood banks, in-patient beds, out patient emergencies and an operation theatre to handle simple orthopaedics and burns cases only," explained the project director.

The project's action plan included recruitment of doctors, equipment purchase, maintenance on contractual basis, introduction of telemedicine to the 44 trauma centres and installation of the geographical information systems. "The World Bank aid has helped to create infrastructure but induction of human resources has been a complicated situation following the government orders to freeze recruitment, informed the project director.

Out of the total 204 medical centres that cover community health centres, taluk level hospitals and district hospitals, 196 have already been handed over to the state directorate of health and family welfare. The eight hospitals located in Chikmagalur, Mangalore, Hubli and Virajpet will be handed over before March 31, 2004.

The KHSDP, which commenced its activities in June 1996, was initially a 5-year project under the World Bank aid for Karnataka which was extended because much of the civil works could not be completed and around two years were lost in procedural formalities, said the project director.

A total of 251 hospitals were identified for under the World Bank loan and KFW-German grant project. Out of these 200 medical centres received the World Bank loan of Rs.652 crore and the remaining 51 are under KFW-German project for the Gulbarga division of the state that has upgraded 47 medical centres. Currently Rs.605 crore out of the Rs.652 crore has been utilised for civil works, purchase of equipment and hiring of manpower.

Through the project Rs.12 crore has been collected as user-charges (exempted for those below the poverty line) in the last three years and out this Rs.6 crore has been used for the maintenance of the facilities.

The Finance Commission will now disburse Rs.21 crore for purchase CT Scans for the seven Regional Diagnostic Labs located in Bidar, Bellary, Hubli, Mandya, Tumkur, Chitradurga and Bagalkot. Out the Rs.21 crore Rs.5 crore is for the infrastructure and the remaining Rs.16 crore is for purchase of equipment. The purchase of CT Scans is pending government clearance.

The remaining amount of Rs.26 crore will be utilised for maintenance and purchase of drugs and medical supplies. The state government has been apprised about the budget allocation for the 204 hospitals for the next financial year.