Independent expert panel set up to audit Maha public health system

MUMBAI: To strengthen Maharashtra’s public healthcare system, the state government has set up an independent Health Services Evaluation Committee to audit services across all districts. The decision was announced through a government resolution (GR) issued on April 29 by the department of public health.

The expert-led panel will comprise professionals from public health, epidemiology, social sciences and health systems management, tasked with conducting an independent, evidence-based assessment of Maharashtra’s healthcare infrastructure. Free from administrative influence, it will assess gaps in infrastructure, staffing, medicine supply and programme delivery in rural sub-centres, primary health centres (PHCs), district hospitals, and urban facilities. Officials say its evidence-based findings will replace anecdotal complaints and serve as the foundation for future health policy. The committee will engage stakeholders across 36 districts and major municipal bodies.

“This committee will help us move beyond anecdotal complaints and provide a structured, evidence-based understanding of our public health system. It’s not about fault-finding—it’s about knowing where we stand and how to improve,” said a senior officer from the Directorate of Health Service.

A senior health department official involved in the planning, speaking on condition of anonymity, added, “We need to understand precisely where the system is faltering—whether it’s staffing shortages, infrastructure gaps, or weak programme delivery. This audit is designed to map those failures and initiate a course correction.”

The committee will independently define its methodology, tools and timelines. Before initiating field visits, it will conduct orientation sessions with district collectors, zilla parishad CEOs and municipal commissioners to explain its mandate and request logistical support.

The evaluation will take a deep dive into a range of service areas, including maternal and child health, communicable disease control, screening programmes, diagnostic services, drug availability and referral systems. It will also assess the reach and effectiveness of national and state-sponsored schemes, particularly in tribal and underserved regions.

Randomised field inspections will be carried out across a sample of rural sub-centres, PHCs, district hospitals and urban municipal facilities. Evaluation teams will interact with healthcare providers—doctors, nurses, ASHA workers, lab technicians—as well as patients and local leaders. They will review infrastructure conditions, assess equipment functionality and audit medicine stocks and supply chains.

Civil society organisations and community members will also be consulted to gather feedback on access, reliability and responsiveness of public health services. District administrations and municipal bodies will facilitate logistics such as transport, accommodation and access to records. Government officials on the evaluation team will be entitled to allowances as per standard rules.

Draft reports will be compiled for each district and shared with relevant administrative heads for feedback before finalisation. Separate reports will be prepared for municipal corporations and submitted to the public health department. The GR mandates that any identified deficiencies must be addressed through corrective action by district collectors, zilla parishad CEOs and municipal commissioners, with overseeing from the health department.

Experts have welcomed the move, citing the urgent need for a system-wide review. Dr Reema Kulkarni, a Pune-based public health researcher, said, “This is a much-needed structural review. Maharashtra’s health system has grown more complex post-pandemic. But unless the government acts on the committee’s recommendations, this risks becoming just another diagnostic report with no follow-up.”

The initiative comes on the heels of a scathing audit by the Comptroller and Auditor General (CAG) of India, tabled in the Maharashtra assembly last December. The report flagged acute shortages in human resources, with 27% vacancies among doctors, 35% among nurses and 31% among paramedical staff. Many health facilities were found to be overstretched, catering to a population far above the norms prescribed under Indian public health standards.

The CAG also criticised the severe shortfall in drug supplies—between 2017-18 and 2021-22, over 70% of medicines demanded by hospitals were not supplied by Haffkine Bio-Pharmaceutical Corporation Ltd, leading to ₹2,052 crore in unutilised funds. Moreover, Maharashtra’s health spending remained low, accounting for just 4.91% of the total budget in 2021-22. A large chunk of central assistance under the National Health Mission also went unused—76% in 2016-17 and 18% in 2021-22.