Healthcare Facilities

Public Health and hospitals being a State subject, the primary responsibility to provide accessible and quality health care services to the people in rural areas lies with State/UT Governments.  However, under the National Health Mission (NHM), financial and technical support is provided to States and UTs to supplement their efforts for improving the healthcare services, particularly in rural areas, based on requirements projected by the States in their Programme Implementation Plan.

As per Rural Health Statistics 2016, there are 1,87,771 healthcare facilities in the public sector (1,55,069 Sub Centres; 25,354 Primary Health Centres; 5,510 Community Health Centre; 1,065 Sub Divisional Hospital and 773 District Hospitals) to meet the health needs of the rural population.  However, there is some shortage in public health facilities, a statement of which is given below:

SHORTFALL IN HEALTH INFRASTRUCTURE AS PER 2011 POPULATION IN INDIA (As on 31st March, 2016)
S.No.	State/ UT	Total Population in Rural Areas	Tribal Population in Rural Areas	Sub Centres				PHCs				CHCs
				R	P	S	% Shortfall	R	P	S	% Shortfall	R	P	S	% Shortfall
1	Andhra Pradesh	34776389	2293102	7261	7659	*	*	1197	1075	122	10	299	193	106	35
2	Arunachal Pradesh	1066358	789846	318	304	14	4	48	143	*	*	12	63	*	*
3	Assam	26807034	3665405	5850	4621	1229	21	954	1014	*	*	238	151	87	37
4	Bihar	92341436	1270851	18637	9729	8908	48	3099	1802	1297	42	774	148	626	81
5	Chhattisgarh	19607961	7231082	4885	5186	*	*	774	790	*	*	193	155	38	20
6	Goa	551731	87639	122	212	*	*	19	22	*	*	4	4	0	0
7	Gujarat	34694609	8021848	8008	8801	*	*	1290	1314	*	*	322	322	0	0
8	Haryana	16509359	0	3301	2576	725	22	550	474	76	14	137	110	27	20
9	Himachal Pradesh	6176050	374392	1285	2071	*	*	212	518	*	*	53	79	*	*
10	Jammu & Kashmir	9108060	1406833	2009	2805	*	*	327	637	*	*	81	84	*	*
11	Jharkhand	25055073	7868150	6060	3953	2107	35	966	327	639	66	241	188	53	22
12	Karnataka	37469335	3429791	7951	9332	*	*	1306	2353	*	*	326	206	120	37
13	Kerala	17471135	433092	3551	4575	*	*	589	824	*	*	147	225	*	*
14	Madhya Pradesh	52557404	14276874	12415	9192	3223	26	1989	1171	818	41	497	334	163	33
15	Maharashtra	61556074	9006077	13512	10580	2932	22	2201	1811	390	18	550	360	190	35
16	Manipur	2021640	791126	509	421	88	17	80	85	*	*	20	17	3	15
17	Meghalaya	2371439	2136891	759	431	328	43	114	109	5	4	28	27	1	4
18	Mizoram	525435	507467	172	370	*	*	25	57	*	*	6	9	*	*
19	Nagaland	1407536	1306838	455	396	59	13	68	126	*	*	17	21	*	*
20	Odisha	34970562	8994967	8193	6688	1505	18	1315	1305	10	1	328	377	*	*
21	Punjab	17344192	0	3468	2951	517	15	578	427	151	26	144	150	*	*
22	Rajasthan	51500352	8693123	11459	14408	*	*	1861	2080	*	*	465	571	*	*
23	Sikkim	456999	167146	113	147	*	*	18	24	*	*	4	2	2	50
24	Tamil Nadu	37229590	660280	7533	8712	*	*	1251	1368	*	*	312	385	*	*
25	Telangana	21585313	2939027	4708	4863	*	*	768	668	100	13	192	114	78	41
26	Tripura	2712464	1117566	691	1033	*	*	109	94	15	14	27	20	7	26
27	Uttarakhand	7036954	264819	1442	1847	*	*	238	257	*	*	59	59	0	0
28	Uttar Pradesh	155317278	1031076	31200	20521	10679	34	5194	3497	1697	33	1298	773	525	40
29	West Bengal	62183113	4855115	13083	10369	2714	21	2153	909	1244	58	538	349	189	35
30	A & N Islands	237093	26715	50	123	*	*	8	22	*	*	2	4	*	*
31	Chandigarh	28991	0	5	17	*	*	0	3	*	*	0	2	*	*
32	Dadra & Nagar Haveli	183114	150944	56	56	0	0	8	11	*	*	2	0	2	100
33	Daman & Diu	60396	7617	13	26	*	*	2	4	*	*	0	2	*	*
34	Delhi	419042	0	83	26	57	69	13	5	8	62	3	0	3	100
35	Lakshadweep	14141	13463	4	14	*	*	0	4	*	*	0	3	*	*
36	Puducherry	395200	0	79	54	25	32	13	24	*	*	3	3	*	*
	All India/ Total	833748852	93819162	179240	155069	35110	20	29337	25354	6572	22	7322	5510	2220	30

Notes: The requirement is calculated using the prescribed norms on the basis of rural population from Census, 2011.  All India shortfall is derived by adding state-wise figures of shortfall ignoring the existing surplus in some of the states.

R: Required; P: In Position; S: Shortfall;     *: Surplus

According to the NSSO health and morbidity survey analysis  held in 2014, of ill persons in rural areas 28% sought out patient services from government facilities and of the total hospitalized, 42% were hospitalized in government facilities. As regards child birth, 56% of child births in rural areas took place in public hospitals and 24% in private hospitals. It may be pointed out that in rural areas the cost of care for hospitalized patient was much higher in private hospitals (Rs 21726 ) than in public hospital (Rs 5636) in the rural area.

Some of the key recent measures undertaken by the Government to improve health care services in the rural areas are:-

(i)                 The Government of India has recently approved the National Health Policy (NHP) which provides detailed framework and policy thrust areas to improve healthcare sector in a time bound manner.

(ii)               Over the period of 2005-2016 there has been an addition of 9043 Sub Health Centres (SHCs), 2118 Public Health Centres (PHCs) and 2164 Community Health Centres (CHCs).

(iii)             Transformation of Sub-Health Centres into Health and Wellness Centres has been rolled out to strengthen the delivery of comprehensive primary care.

(iv)              Operational Guidelines for NHM Free Drugs Service Initiative and Free Diagnostics Service Initiative have been shared with states. The objective is to ensure availability of essential drugs and necessary diagnostic services free of cost in public health facilities.

(v)               Bridge Programme in Community Health - for Nurses and for Ayurveda Practitioners- have been finalized and MoU in this regard has been signed with IGNOU. The trained personnel are proposed to be posted at Sub-Centres (SCs) as Community Health Officers – to lead the team at SCs for providing comprehensive promotive and preventive and curative healthcare services.

(vi)             Kayakalp awards have been launched to promote cleanliness, hygiene and infection control practices in public health facilities. Additionally, NQAS quality certification of public hospitals is being undertaken.

(vii)           Pradhan Mantri Shurakshit Matritva  Abhiyan (to improve access to specialist maternal care through voluntary participation of private providers).

(viii)         Pradhan Mantri National Dialysis Program to enable free Dialysis treatment to poor patients with end stage renal diseases.

(ix)             Universal screening of individuals over thirty for early detection and treatment of common non communicable diseases.

The Minister of State (Health and Family Welfare), Sh Faggan Singh Kulaste stated this in a written reply in the Lok Sabha here today.

Courtesy: pib.nic.in