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The Hindu
6 days ago
- Health
- The Hindu
Rise in C-section deliveries: Audit finds lack of confidence among specialists and sub-optimal capacity of labour room staff main contributing factors
An audit of caesarean section (C-section) deliveries in Karnataka by a team of experts from the Health Department has found lack of confidence among specialists to take trials in moderate cases for fear of newborn morbidity and mortality and sub-optimal capacity of the labour room doctors and nurses to be the main contributing factors for a rise in the surgical deliveries. In Karnataka, nearly one in every three deliveries is conducted through a C-section. Over the past 15 years, the C-section rate has doubled, indicating a significant shift in obstetric practices. While cesarean delivery is a lifesaving intervention when medically indicated, excessively high rates are associated with increased surgical risks, higher healthcare costs, and unnecessary strain on the health system. Review by committee To address this growing concern and to bring down C-section rates, the Health Department initiated a comprehensive review of C-section practices and an audit of such deliveries at the Tumkuru district hospital, where the rate is the highest in the State. The findings of the review and audit — conducted by a multi-stakeholder committee in January 2025 — were reviewed by the State Technical Committee on June 17, 2025. According to the committee's report, every second cesarean was a repeat C-section, without trial for vaginal birth after cesarean (VBAC). Besides, non-standardised induction practices leading to poor labour progression, high referrals from taluk hospitals to the district hospital and a demand by patients and their relatives have contributed to higher C-section rates. Harsh Gupta, principal secretary, Health and Family Welfare, told The Hindu on Thursday that regular audits of C-section cases in randomly selected public facilities will henceforth be done by the State Technical Committee.. Corrective measures 'While this audit is for Tumkuru district hospital, the contributing factors are by and large the same in all districts. Based on the findings, we have initiated corrective measures and are conducting orientation programmes for obstetricians and gynaecologists on the safety and feasibility of VBAC. Of late, C-section has become a trend with many women themselves opting for it,' he said. 'While optimisation of quality antenatal care (ANC) checks is being taken up by introducing newer tools such as 'Gestosis scoring' used to assess the risk of preeclampsia and 'Pregnancy wheels' used to calculate gestational age and estimated delivery date, the consent form for the C-section has been revised by incorporating side effects of procedure,' Mr. Gupta said. To encourage vaginal births under the Ayushman Bharat Arogya Karnataka (AB-ArK) scheme, the department is considering a proposal for inclusion of incentives for normal delivery services at primary and secondary health care facilities. 'Apart from this, a proposal for withdrawal of team-based incentives for conducting C-sections to discourage unnecessary procedures is also under consideration,' he said. Recommendations To ensure evidence-based practices and reduce unnecessary cesarean sections, the committee has recommended development of State-specific guidelines for labour induction. 'Strengthening the taluk hospitals by rationalisation of posting specialists to provide assured comprehensive emergency obstetric and newborn care services round-the-clock; refresher trainings on evidence-based labour management for obstetric care teams and regular online capacity building of skills required for labour room process have also been recommended,' he said. 'Capacity building of the nursing teams incorporating the principles of midwifery initiatives such as alternative birthing positions, exercise in the antenatal period, respectful maternity care involving counselling on the labour process has also been recommended. Besides, early identification of risk factors such as anemia, uncontrolled hypertension and diabetes, Urinary tract infections in the pregnant women and early intervention and community-level awareness campaigns on the risks of unnecessary C-sections and the benefits of vaginal birth are among the other recommendations,' Mr. Gupta added.
The Hindu
18-06-2025
- Health
- The Hindu
Free treatment under Vay Vandana scheme for senior citizens aged 70 and above still elusive in Karnataka
Free treatment for senior citizens aged 70 and above, under the Ayushman Bharat Vay Vandana (ABVV) scheme, is still elusive in Karnataka. This is because the State's Finance Department has not agreed to the Centre's assurance that the modalities for release of grants for the scheme will be finalised soon. Responding to the State's letter seeking adequate support to implement the Vay Vandana scheme, which is an extended part of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY), the Centre has requested Karnataka to start providing the services and that the payment modalities for additional cost will be worked out soon. Sharing ratio Expressing the State's inability to start the Vay Vandana scheme without any clarity on the fund release, Karnataka's Principal Secretary (Health) Harsh Gupta had written to the Union Health Secretary pointing out that the State is entitled to get ₹36.58 crore from the Centre for the scheme as per the 60:40 sharing ratio of Ayushman Bharat Arogya Karnataka (AB-ArK) scheme. 'Although the sharing ratio for the health scheme between the Centre and State should be 60:40, it is actually 25:75 as the State bears expenditure for around 1.12 crore families while the Centre is only funding the expenses of 69 lakh families as listed under the Socio Economic and Caste Census (SECC) 2011 data,' he said in the letter. Of the total AB-ArK beneficiaries, the State has around 15.12 lakh families with senior citizens as members. Of these, 9.22 lakh are SECC-identified families (tagged families), and the remaining are over and above the SECC-identified families (untagged families). 'The Centre will provide the State with additional support at the rate of a mere ₹75.7 per family per annum for tagged families and ₹1,052 per family per annum for the untagged families. However, additional support to the untagged families will be provided only after the 69 lakh families out of 1.12 crore total families are tagged,' the letter stated. NHA's letter In response to this, L.S. Changsan, Chief Executive Officer of the National Health Authority (NHA) that is the implementing agency for AB PM-JAY, said the additional premium for existing beneficiary families determined at ₹75.7 per family per annum covers the additional top-up wallet of ₹5 lakh, which is utilised only after the primary wallet of the family is exhausted. For new beneficiary families, the annual premium of ₹1,052 per family aligns with the existing premium structure under AB PM-JAY, the NHA CEO's letter stated. 'Based on the consultations with States in July 2024 and the inputs received subsequently, the principles for tagging are being finalised. The identification of existing families and new families will be done based on these principles. However, the State may start providing the services to the Ayushman Vay Vandana card holders and tagging activity will be completed before fund release proposals for the ABVV are due,' the letter said. No definitive mechanism However, Karnataka's Finance Department has not agreed to this. 'In the absence of any definite mechanism to link the AB-ArK beneficiaries with the actual SECC data, as per the next best approximation worked out by the State Health Department, Karnataka will require a total of ₹68.98 crore per annum for the senior citizens scheme. As the Centre has to provide 60% of this amount to the State, Karnataka is entitled to get ₹36.58 crore from the Centre. We are now planning to place this issue before the State Cabinet for further discussion,' Mr. Harsh Gupta told The Hindu.
Time of India
17-06-2025
- Health
- Time of India
Dharwad Dist Hosp gets chemotherapy centre
Dharwad: Labour minister Santosh Lad inaugurated Day Care Chemotherapy Centre at Dharwad District Hospital on Monday evening. The chemotherapy centre has been set up in association with HCG Hospital, Hubballi, under AB-ArK (Ayushman Bharat-Arogya Karnataka) scheme, he said. Tired of too many ads? go ad free now For every patient who has undergone the 1st cycle of treatment, the next cycle will be treated as per the advice of an oncologist. Every Wednesday, the patients will be examined by a cancer specialist at the hospital. Getting treatment here will benefit the patients from distant places, Lad said. A total of 242 patients have been sent for cancer treatment from the hospital in 2024-2025. District surgeon Dr Sangappa Gabi, resident medical officer Dr Girijatai GH, senior specialists Dr Mayura Kadam and Dr SM Sambrani, nursing superintendent Vijayakumar Malagi, office superintendent VH Banasode and other staff were present.
Time of India
10-06-2025
- Health
- Time of India
Approvals for oncology procedures rise under Ayushman Bharat Arogya Karnataka scheme
Bengaluru: Access to cancer care under the Ayushman Bharat Arogya Karnataka (AB-ArK) scheme has expanded, with approvals for oncology procedures rising six-fold over seven years, from 9,328 in 2018-19 to 60,301 in 2024-25, according to health department data. In 2024-25, the scheme pre-authorised 60,301 oncology procedures at A cost of Rs 271.7 crore. Of these, 56% were for medical oncology (primarily chemotherapy), 25% for radiation oncology, and 19% involved surgical oncology. The scheme benefited approximately 59,000 priority household (PHH) beneficiaries and 1,212 non-PHH individuals. Data sourced by TOI indicated a heavier reliance on private hospitals, which handled 56% of the total procedures, accounting for 67% of the expenditure, while govt hospitals handled 44% of the caseload. As per the population-based cancer registry at Kidwai Memorial Institute of Oncology, Karnataka faces a high cancer burden, with an estimated 1 lakh new cases and a prevalence of 2.3 lakh existing cases annually. A senior health department official said, "In Karnataka, the lifetime risk of developing cancer is one in seven among men and one in six for women. However, 77% of breast cancer cases and 91% of cervical cancer cases are detected in the early stages. Sponsored Links Sponsored Links Promoted Links Promoted Links You May Like 5 Books Warren Buffett Wants You to Read In 2025 Blinkist: Warren Buffett's Reading List Undo " The state currently offers tertiary-level cancer care through the scheme, aiming to improve accessibility through Karnataka. A total of 109 hospitals — 13 govt and 96 private — are empanelled under the Suvarna Arogya Suraksha Trust. The network includes eight govt medical colleges and 22 private medical colleges offering specialised oncology services. Since 2022-23, Kidwai institute alone has conducted 51,418 oncology procedures — the highest among govt institutions. It is followed by Mysore Medical College and Research Institute (5,123), VTSM Peripheral Cancer Centre in Kalaburagi (4,690), Karnataka Institute of Medical Sciences in Hubballi (4,189), and Vijayanagar Institute of Medical Sciences in Ballari (836). Among private hospitals, Bharat Hospital and Institute of Oncology in Mysuru leads with 6,204 procedures. Box 1 Districts sans oncology coverage under scheme - Bidar - Yadgir - Vijayanagara - Koppal - Chitradurga - Chikkaballapur - Ramanagara - Kodagu - Chamarajanagar - Chikkamangaluru BOX 2 Utilisation of oncology procedures Year Procedure count Approved amount 2018-19 9,328 Rs 52 lakh 2019-20 31,715 Rs 1.7cr 2020-21 29,862 Rs 1.5cr 2021-22 34,627 Rs 1.8cr 2022-23 43,356 Rs 2.1cr 2023-24 52,547 Rs 2.4cr 2024-25 60,301 Rs 2.7cr BOX 3 Utilisation by oncology type Year Medical Radiation Surgical Total cases Approved amount 2022-23 21,472 12,881 9,003 43,356 Rs 2.1cr 2023-24 28,565 14,159 9,823 52,547 Rs 2.4cr 2024-25 33,893 15,341 11,067 60,301 Rs 2.7cr — Source: Health department
The Hindu
28-05-2025
- Health
- The Hindu
Utilisation of oncology procedures under AB-ArK see over a six-fold rise in last six years
Utilisation of oncology procedures under the Ayushman Bharat Arogya Karnataka (AB-ArK) has seen over a six-fold rise in the last six years. From 9,328 pre-authorisations approved under the flagship health scheme in 2018-2019, the number has shot up to 60,301 in 2024-2025, according to data from the Health Department. Karnataka has a high cancer burden with around one lakh new cases reported every year. The State has an estimated cancer prevalence of around 2.35 lakh cases, according to the Population Based Cancer Registry at the State-run Kidwai Memorial Institute of Oncology in Bengaluru. The cumulative risk for developing cancer in their lifetime is one in seven for men and one in six for women in Karnataka, according to doctors.. The State is providing tertiary care for oncology procedures under the health scheme and a total of 109 hospitals, including 96 private hospitals, are empanelled under Suvarna Arogya Suraksha Trust (SAST), the nodal agency that is implementing AB-ArK. As many as eight government medical colleges and 22 private medical colleges are also empanelled for oncology specialty under SAST. However, empanelled hospitals for oncology are present only in 21 districts and people from Bidar, Yadgiri, Vijayanagara Koppal, Chitradurga, Chickballapura, Ramanagara, Kodagu, Chamarajanagar and Chikkamagaluru have to travel to other districts for cancer treatment. Pre-authorisations A total of 2.61 lakh pre-authorisations have been approved under the scheme for an amount of ₹1,301.92 crore from 2018-2019 when the scheme was launched. In 2024-2025, a total of 60,301 pre-authorisations for an amount of ₹271.72 crore have been expended under the scheme. Among the procedures covered under the scheme, 56% are medical oncology procedures (chemotherapy), 25% are radiation oncology procedures and 19% surgical oncology cases, according to data. Apart from Kidwai, Mysuru Medical College and Research Institute, VTSM Peripheral Cancer Centre in Kalaburgi, Karnataka Institute of Medical Sciences in Hubballi and Vijaynagar Institute of Medical Sciences in Ballari are the top five public health facilities with highest utilisation of oncology procedures. Since 2022-2023, in the category of government hospitals, Kidwai institute has done the highest procedures under the scheme (51,418). Among private empanelled hospitals, Bharat Hospital and Institute of Oncology in Mysuru has done the highest procedures at 6,204, according to data. Female cancers high in Bengaluru In Bengaluru, of the estimated 15,603 cases registered annually, 8,723 are female cancers. Of the 6,880 male cancers reported, lung cancer continues to be the most predominant site (9.7% of the total male cancers). Lung cancer is followed by cancers of the prostate (6.9%), stomach (6.5%), and mouth (6.4%). Among females, breast cancer is the most common constituting 31.5% of the total female cancers followed by cancer of the cervix (9.1%), ovary (6.4%), mouth (4.3%), and corpus uteri (4.2%), according to data.
