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.
*****
MV/LK