Performance Audit of State Health Systems Development Project in Karnataka

Abstract

The Karnataka Health Systems Development Project (Project) was launched in April 1996 with the assistance of World Bank at an estimated cost of Rs.546 crore to strengthen the secondary level of health care by providing in-patient and out-patient care with diagnostic and treatment facilities that were not available at the primary level. The project was to become operational by the end of 2001-02. Due to slow progress, however, the implementation of the project was extended by two years. The project is expected to be completed by March 2004. The performance audit of the implementation of the Karnataka Health Systems Development Project covering the period 1996-97 to 2002-03 revealed that lack of planning in the execution of civil works resulted not only in cost and time overrun but also reallocation of funds for civil works at the cost of other components of the project. Deviations to original plan of procurement, distribution and poor utilisation of equipment coupled with non/short procurement of drugs and deficiencies in deployment of doctors affected adversely the delivery of health care services. Ineffective functioning of referral system in the first referral hospitals and non-implementation of IEC strategy also affected adversely the delivery of medical services and achieving the envisaged objective of the project.