Lok Sabha Question No. 356 (STARRED), answered on 2019-01-04
Subject: Healthcare Facilities in Rural Areas
Ministry: HEALTH AND FAMILY WELFARE
Asked by: HEENA VIJAYKUMAR GAVIT, SUPRIYA SADANAND SULE

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA STARRED QUESTION NO. 356 TO BE ANSWERED ON THE 4 TH JANUARY ,2019 HEALTHCARE FACILITIE S IN RURAL AREAS

## *356. DR. HEENA VIJAYKUMAR GAVIT: SHRIMATI SUPRIYA SULE:

Will  the  Minister  of  HEALTH  AND  FAMILY  WELFARE  be  pleased  to state:

- (a) whether healthcare in the rural areas of the country is a major concern, details thereof and the reasons therefor;
- (b)  the  details  of  availabili ty  of  healthcare  facilities/infrastructure  includ manpower and affordability of facilities to the rural people vis - a- vis urban people;
- (c) the details of steps taken to address the problems of rural health both a and micro levels and to improve the healthcare sector in rural areas of the and
- (d) whether there is any proposal to draw a long term perspective plan to the p revailing inequalities in the rural health sector and if so, the detai indicating the programmes/schemes being implemented/proposed to be implemented  by  the  Government  to  reduce  rural - urban  gap  in  access  to  quality healthcare and advanced treatme nt and diagnostic facilities in the country?

## THE MINISTER OF HEALTH AND FAMILY WELFARE

## ANSWER (SHRI JAGAT PRAKASH NADDA)

- (a)to ( d) : A Statement is laid on the Table of the House.

## STATEMENT REFERRED TO IN REPLY TO LOK SABHA STARRED QUESTION NO. 356* FOR 4 TH JANUARY , 20 19

(a)& (b) The key health indicators such as Infant Mortality Rate (IMR), Un Mortality  Rate  (U5MR),  Total  Fertility  Rate  (TFR),  proportion  of  institu deliveries etc and availability of health human resources & health infrastructure are poor in rural areas as compared to urban areas.

As  per  National  Health  Profile  2018,  there  are  19810  Rural  Gov ernment Hospitals with 279588 beds & 3772 Urban Government hospitals with 431173 bed in India. The state wise details are at A nnexure.

As  per  Health  Management  Information  System  (HMIS),  there  are  86342 doctors in rural areas (including doctors in District Hospitals) and 15964 d urban areas.

As per Health and Morbidity Survey 2014 of National Sample Survey Offic (NSSO),  Ministry  of  Statistics  and  Program  Implementation,  Out  of  Poc Expenditure (OOPE) per hospitalized case (excluding child birth) in Public Facilities is Rs 5369 for Ru ral and Rs 7189 for Urban areas. The OOPE in public health facilities is much lower than the private sector.

(c) &  (d) 'Public  Health  &  Hospital'  being  a  State  subject,  the  primary responsibility to provide healthcare to its citizens lies with the State G overnments. To address the healthcare challenges, particularly in rural areas, the Natio Health Mission (NRHM) was launched in 2005 to supplement the efforts of t State/UT governments to provide accessible, affordable and quality healthca all those who access public health facilities. Currently, NRHM is a sub - mission of National Health Mission.

This support under NHM includes provision of a host of free services such as  maternal  health,  child  health,  adolescent  health,  family  planning,  un rsal immunisation  programme,  and  for  major  diseases  such  as  Tuberculosis,  HIV AIDS, vector borne diseases such as Malaria, Dengue and Kala Azar, Leprosy et

Other major initiatives for which states are being supported include Janani Suraksha Ka ryakram (JSSK)(under which free drugs, free diagnostics, free blo and diet, free transport from home to institution, between facilities in referral  and  drop  back  home  is  provided),  Rashtriya  Bal  Swasthya Karyakram (RBSK),  Rashtriya  Kishor  Swast hya  Karyakram  (RKSK),  implementation  of NHM Free Drugs and Free Diagnostics Service Initiatives, PM National Dialys Programme and implementation of National Quality Assurance Framework.

Mobile Medical Units (MMUs) & Telemedicine are also being implement ed with NHM support to improve healthcare access particularly in rural areas.

As  part  of  Ayushman  Bharat,  the  Government  is  supporting  the  States  f strengthening  Sub  Centres  and  Primary  Health  Centres  as  Health  and  Wellne Centres  for  provision  of  compr ehensive  primary  health  care  that  includes preventive and health promotion at the community level with continuum of care approach.  Further,  the  Government  has  launched  Pradhan  Mantri  Jan  Arogya Yojana (PMJAY) under Ayushman Bharat to provide affordable qua lity inpatient care.

To  improve  availability  of  doctors  &  specialists  in  underserved  area Government  is  upgrading  District  Hospitals  to  Medical  Colleges  in  82  dis which  do  not  have  any  Medical  College  thereby  providing  at  least  one  Med Coll ege for every three contiguous Parliamentary Constituencies.

## A nnexure

| S.No.   | State/UT/Division        |   Rural Hospitals (Govt.) No. |   Urban Hospitals (Govt.) No. |   Total Hospitals (Govt.) No. |   Rural Hospitals (Govt.) Beds |   Urban Hospitals (Govt.) Beds |   Total Hospitals (Govt.) Beds |
|---------|--------------------------|-------------------------------|-------------------------------|-------------------------------|--------------------------------|--------------------------------|--------------------------------|
|         | India                    |                         19810 |                          3772 |                         23582 |                         279588 |                         431173 |                         710761 |
| 1       | Andhra Pradesh           |                           193 |                            65 |                           258 |                           6480 |                          16658 |                          23138 |
| 2       | Arunachal                |                           208 |                            10 |                           218 |                           2136 |                            268 |                           2404 |
| 3       | Pradesh* Assam *         |                          1176 |                            50 |                          1226 |                          10944 |                           6198 |                          17142 |
| 4       | Bihar                    |                           930 |                           103 |                          1033 |                           6083 |                           5936 |                          12019 |
| 5       | Chhattisgarh             |                           169 |                            45 |                           214 |                           5070 |                           4342 |                           9412 |
| 6       | Goa*                     |                            17 |                            25 |                            42 |                           1405 |                           1608 |                           3013 |
| 7       | Gujarat                  |                           364 |                           122 |                           486 |                          11715 |                          20565 |                          32280 |
| 8       | Haryana*                 |                           609 |                            59 |                           668 |                           6690 |                           4550 |                          11240 |
| 9       | Himachal                 |                           705 |                            96 |                           801 |                           5665 |                           6734 |                          12399 |
| 10      | Pradesh* Jammu & Kashmir |                            56 |                            76 |                           132 |                           7234 |                           4417 |                          11651 |
| 11      | Jharkhand                |                           519 |                            36 |                           555 |                           5842 |                           4942 |                          10784 |
| 12      | Karnataka*               |                          2471 |                           374 |                          2845 |                          21072 |                          49093 |                          70165 |
| 13      | Kerala                   |                           981 |                           299 |                          1280 |                          16865 |                          21139 |                          38004 |
| 14      | Madhya Pradesh           |                           334 |                           117 |                           451 |                          10020 |                          18819 |                          28839 |
| 15      | Maharashtra              |                           273 |                           438 |                           711 |                          12398 |                          39048 |                          51446 |
| 16      | Manipur                  |                            23 |                             7 |                            30 |                            730 |                            697 |                           1427 |
| 17      | Meghalaya*               |                           143 |                            14 |                           157 |                           1970 |                           2487 |                           4457 |
| 18      | Mizoram*                 |                            56 |                            34 |                            90 |                            604 |                           1393 |                           1997 |
| 19      | Nagaland                 |                            21 |                            15 |                            36 |                            630 |                           1250 |                           1880 |
| 20      | Odisha*                  |                          1655 |                           149 |                          1804 |                           6339 |                          12180 |                          18519 |
| 21      | Punjab*                  |                           510 |                           172 |                           682 |                           5805 |                          12128 |                          17933 |
| 22      | Rajasthan                |                           602 |                           150 |                           752 |                          21088 |                          10760 |                          31848 |
| 23      | Sikkim*                  |                            24 |                             9 |                            33 |                            260 |                           1300 |                           1560 |
| 24      | Tamil Nadu*              |                           692 |                           525 |                          1217 |                          40179 |                          37353 |                          77532 |
| 25      | Telangana*               |                           802 |                            61 |                           863 |                           7668 |                          13315 |                          20983 |
| 26      | Tripura*                 |                            99 |                            56 |                           155 |                           1140 |                           3277 |                           4417 |
| 27      | Uttar Pradesh*           |                          4442 |                           193 |                          4635 |                          39104 |                          37156 |                          76260 |
| 28      | Uttarakhand              |                           410 |                            50 |                           460 |                           3284 |                           5228 |                           8512 |
| 29      | West Bengal              |                          1272 |                           294 |                          1566 |                          19684 |                          58882 |                          78566 |
| 30      | A&N Island               |                            27 |                             3 |                            30 |                            575 |                            500 |                           1075 |
| 31      | Chandigarh               |                             0 |                             4 |                             4 |                              0 |                            778 |                            778 |
| 32      | D&N Haveli*              |                            10 |                             1 |                            11 |                            273 |                            316 |                            589 |
| 33      | Daman & Diu              |                             5 |                             0 |                             5 |                            240 |                              0 |                            240 |

Notes: Government hospitals includes central government, state government and local govt. bodies #Projected population is taken from Report of the Technical Group on Population Projections May 2006, National Commission on Population, Registrar General of India

Source: Director General of State Health Services

*States/Uts provided information for the year 2017 and PHCs are also included in the number of hospitals.