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By:

Rajendra Joshi

3 December 2024 at 3:50:26 am

Procurement first, infrastructure later

Procurement at multiples of market price; equipment before infrastructure; no accountability Kolhapur: Maharashtra’s Medical Education and Public Health Departments have been on an aggressive drive to expand public healthcare infrastructure. Daily announcements of new centres, advanced equipment and expanded services have reassured citizens long denied dependable public healthcare. Procurement of medical equipment, medicines and surgical supplies is reportedly being undertaken at rates two to...

Procurement first, infrastructure later

Procurement at multiples of market price; equipment before infrastructure; no accountability Kolhapur: Maharashtra’s Medical Education and Public Health Departments have been on an aggressive drive to expand public healthcare infrastructure. Daily announcements of new centres, advanced equipment and expanded services have reassured citizens long denied dependable public healthcare. Procurement of medical equipment, medicines and surgical supplies is reportedly being undertaken at rates two to ten times higher than prevailing market prices. Basic economics dictates that bulk government procurement ought to secure better rates than private buyers, not worse. During the Covid-19 pandemic, equipment and consumables were procured at five to ten times the market rate, with government audit reports formally flagging these irregularities. Yet accountability has remained elusive. The pattern is illustrated vividly in Kolhapur. The Dean of Rajarshi Shahu Government Medical College announced that a PET scan machine worth Rs 35 crore would soon be installed at Chhatrapati Pramilaraje (CPR) Government Hospital for cancer diagnosis. But a comparable machine is available in the market for around Rs 6.5 crore. A senior cancer surgeon at a major cancer hospital in western Maharashtra, where a similar machine was recently installed, remarked that the gap between what his hospital paid and what the government is reportedly paying was enough to make one ‘feel dizzy’. The label of a ‘turnkey project’ does not adequately explain a price differential of this magnitude. High Costs CPR Hospital recently had a state-of-the-art IVF centre approved at a sanctioned cost of Rs 7.20 crore. Senior fertility specialists across Maharashtra note that even a modern IVF centre with advanced reproductive technology equipment typically costs between Rs 2.5 crore and Rs 3 crore. The state’s outlay is reportedly approaching Rs 15 crore. Equipment arrived in June 2025 and lay idle for months owing to indecision about the site. Similarly, digital X-ray machines approved for CPR Hospital and a government hospital in Nanded; available in the market for roughly Rs 1.5 crore; were reportedly procured at Rs 9.98 crore per unit. Doctors in CPR’s radiology department, apprehensive about being drawn into potential inquiries, reportedly resisted accepting the equipment. One departmental head was transferred amid disagreements over signing off on the proposal. What’s Wrong These cases point to a deeper structural failure: Maharashtra has perfected what might be called the ‘equipment first, infrastructure later’ model. In any public hospital, the administrative sequence ought to be: identify space, create infrastructure, sanction specialist posts, and only then procure equipment. Compounding the procurement paradox is a parallel policy decision. On 20 December 2025, the state government decided to introduce radiology diagnostic services through a Public-Private Partnership model (PPP). Following this, an order issued on 6 February 2026 authorised private operators to provide PET scan, MRI and CT scan services at six government medical college hospitals: in Pune, Kolhapur, Miraj, Sangli, Mumbai and Baramati. CPR already has a 126-slice CT scan machine and a 3 Tesla MRI scanner, with another CT scan proposed. If the PPP arrangement proceeds, the hospital could simultaneously run one PET scan machine, two MRI scanners and three CT scan machines. Medical experts warn this could lead to unnecessary diagnostic testing simply to keep machines occupied, thus exposing patients to excess radiation while government-owned equipment gathers dust. A similar pattern was seen during the pandemic, when the Medical Education Department spent hundreds of crores on RT-PCR machines, only to award swab-testing contracts to a private company. Many of those machines remain unused today.

AI in Sperm Sorting: An Unbiased Decision for A Better Outcome

Artificial Intelligence or AI is revolutionising fertility treatments of the future. The inclusion of AI enhances the accuracy, efficiency, and objectivity of sperm selection, hence potentially improving fertility outcomes by leaps and bounds. Traditionally, sperm sorting through manual methods is subjective to judgments. Processes like centrifugation and swim-up methods are used to separate sperm based on motility and morphology. Although they are effective, they have their limitations, leading to human errors that affect the success rates of fertility treatment. For instance, studies have shown that traditional sperm sorting techniques can have variability in success rates, with reported live birth rates ranging between 15 per cent to 25 per cent per cycle depending on the method and quality of sperm. Hence the introduction of AI helps in maintaining consistency in evaluations of sperm, using the same data set for every sample which leads to better judgments.


Automation and Standardisation- Automation of sperm selection and also introduction of AI in the process have improved the results in ART. AI-assisted sperm selection improves the accuracy in choosing high-quality sperm for fertilisation purposes, and also, pregnancy and live birth rates might be improved. Technologies like Intracytoplasmic Morphologically Selected Sperm Injection along with AI ensure the chances of pregnancies increase by about 10-20 per cent compared to the standard procedures. AI and Automation will decrease time taken to analyze sperm and increase opportunities to select better sperm with DNA integrity for better development and higher success rates in embryo selection. These processes ensure that the sperm selection process follows consistent criteria, reducing variability in outcomes caused by human error.


Analysing Complex Data for Better Outcomes- AI plays a crucial in improving IVF outcomes by analysing complex data and providing tailored recommendations. AI-driven tools and models such as those on SpOvum.ai point towards an opportunity to optimise ovarian stimulation decisions by assessing patient characteristics and follicle growth patterns. A study revealed that the use of AI in IVF improved egg yield and reduced medication costs. AI enables fertility specialists to make data-driven choices, improving overall IVF success rates and streamlining treatment processes.


Reducing Human Error- AI models can continuously learn and refine their performance by being trained on newer data. This adaptability ensures the technology remains unbiased and up-to-date with the latest scientific insights into sperm quality and fertility success rates. Studies have shown that AI-driven sperm sorting can decrease human-related errors by up to 25 per cent, improving sperm selection quality in terms of morphology and motility.


Reduction of Sperm Damage- The new AI-driven sperm sorting techniques also include microfluidic systems that are known to exhibit several advantages over the most commonly used conventional method, which is centrifugation. Traditional centrifugation methods, such as density gradient centrifugation, also cause severe oxidative stress and DNA fragmentation of the sperm because of the very high mechanical forces involved. The AI-infused microfluidic sorting minimises this damage significantly by involving gentler processes that mimic the natural pathway of sperm selection. The studies show that the process of microfluidic sorting decreases DNA fragmentation in sperm, which gives improved opportunities for success for IVF. For example, DNA fragmentation is 20 percent lower in sperm sorted using microfluidic processes than in traditional processing methods.


AI is bound to play an increasingly definitive role in fertility treatments, which will improve the outcomes for couples experiencing infertility.


(The author is a Co-Founder & CEO at SpOvum® Technologies. Views personal.)

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