Public Health

Public Health


According to the National Health Profile 2018, 13th Issue, Central Bureau of Health Intelligence, Ministry of Health & Family Welfare (please click here to access):

Demographic Indicators

• The Infant Mortality Rate (IMR) per 1,000 live births has declined considerably from 74 infant deaths in 1994 to 34 infant deaths in 2016. There is a huge gap between IMR in rural areas (38 infant deaths per 1,000 live births) and urban areas (23 infant deaths per 1000 live births).

• Among the states, the lowest IMR per 1,000 live births in 2016 was found in both Goa (8), followed by Kerala (10) and Manipur (11). The highest IMR per 1,000 live births in 2015 was found in Madhya Pradesh (47), followed by both Assam and Odisha (44 each).

 

• The life expectancy of life at birth has increased from 49.7 years in 1970-75 to 68.3 years in 2011-15. In the period 2011-15, the life expectancy for females is 70.0 years and 66.9 years for males.

• In the period 2011-15, the life expectancy in the rural areas is 67.1 years and in the urban areas it is 71.9 years.

• The Maternal Mortality Ratio (MMRatio) per 1,00,000 livebirths has decreased from 178 maternal deaths during 2010-12 to 167 maternal deaths during 2011-13. In 2011-13, the MMRatio per 1,00,000 livebirths is highest in Assam i.e. 300 maternal deaths and lowest in Kerala i.e. 61 maternal deaths.

• The country's birth rate per 1,000 estimated mid-year population has fallen from 29.5 livebirths in 1991 to 20.4 livebirths in 2016. Birth rate per 1,000 estimated mid-year population in rural areas was 22.1 livebirths and in urban areas it was 17.0 livebirths in 2016.

• India's natural growth rate per 1,000 mid-year population has declined from 19.7 in 1991 to 14.0 in 2016.

• The proportion of urban population to India's total population has increased from 25.7 percent in 1991 to 27.81 percent in 2001, and further increased to 31.14 in 2011.

• The country's population density has increased from 267 persons per square kilometer in 1991 to 325 persons per square kilometer in 2001, and further rose to 382 persons per square kilometer in 2011.

• The decadal growth rate of India's population has fallen from 23.87 percent in 1981-1991 to 21.54 percent in 1991-2001, and further declined to 17.7 percent in 2001-2011.

Health Status Indicators

• In 2017, maximum number of malaria cases have been reported in Odisha (3,52,140 cases) and maximum number of deaths have been reported in West Bengal (29 deaths).

• The total number of cases of malaria has changed from 8,81,730 in 2013 to 8,42,095 in 2017. The total number of deaths due to malaria has changed from 440 in 2013 to 104 in 2017.

• Out of the overall cases of Kala-azar reported in 2017, 72 percent of the cases have been reported in Bihar. The total number of cases of Kala-azar has fallen from 13,869 in 2013 to 5,758 in 2017. Likewise, the total number of deaths from Kala-azar has fallen from 20 in 2013 to zero in 2017.

• There has been a considerable fall in the number of swine flu cases/ deaths in the year 2014 (viz. 937) as compared with 2012 (viz. 5,044) & 2013 (viz. 5,253). However, the number of cases (42,592) and deaths (2,990) has drastically increased in the year 2015. In 2016, the cases have been decreased to 1786 and again increased to 38,811 in 2017.

• A total of 63,679 cases of chikungunya were reported in 2017 as compared with 64,057 cases in 2016. Most chikungunya cases in 2017 were reported from Karnataka (32,170), followed by Gujarat (7,807) and Maharashtra (7,639).

• The total number of cases and deaths due to chicken pox were 74,035 and 92, respectively in 2017. Kerala accounted for maximum number of cases (30,941) and West Bengal has accounted for maximum number of deaths (53) due to chicken pox in 2017.   

• The total number of cases of Acute Encephalitis Syndrome has increased from 7,825 in 2013 to 13,036 in 2017. The total number of deaths due to Acute Encephalitis Syndrome has decreased from 1,273 in 2013 to 1,010 in 2017. Uttar Pradesh reported maximum numbers of cases (4,749) and maximum number of deaths (593) in 2017.

• The total number of cases of Japanese Encephalitis has almost doubled from 1,086 in 2013 to 2,180 in 2017. The total number of deaths due to Japanese Encephalitis has increased from 202 in 2013 to 252 in 2017. Uttar Pradesh reported maximum numbers of cases (693) and maximum number of deaths (93) in 2017.

• The total number of cases and deaths due to encephalitis were 12,485 and 626, respectively in 2017. Assam accounted for maximum number of cases (5,525) and Uttar Pradesh accounted for maximum number of deaths (246) due to chicken pox in 2017.

• The total number of cases and deaths due to viral meningitis were 7,559 and 121, respectively in 2017. Andhra Pradesh accounted for maximum number of cases (1,493) and maximum number of deaths (33) due to viral meningitis in 2017.

• The total number of cases of dengue has almost doubled from 75,808 in 2013 to 1,57,996 in 2017. The total number of deaths due to dengue has increased from 193 in 2013 to 253 in 2017. Tamil Nadu reported maximum numbers of cases (23,294) and maximum number of deaths (65) in 2017.

• As per the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS), out of 3,57,23,660 patients who attended non-communicable disease (NCD) clinics in 2017, 8.41 percent people are diagnosed with diabetes, 10.22 percent are diagnosed with hypertension (high blood pressure), 0.37% are diagnosed with cardiovascular diseases (CVDs), 0.13 percent are diagnosed with stroke and 0.11 percent are diagnosed with common cancers (including oral, cervical and breast cancer).

• During the year 2015, the lives of 4,13,457 and 1,33,623 people are cut short as a result of accidental and suicide cases, respectively. Many more people suffer non-fatal injuries, with many incurring a disability as a result of their injury.

• Suicide rates are increasing significantly for young adults including male, female & transgender in a wider population. The maximum number of suicide cases (44,593) is reported between the age-group 30-45 years.   

• The total number of disabled persons in India is 26,814,994 as per the Census 2011.

• The total number of cases and deaths due to snake bite are 1,42,366 and 948 respectively in 2017.

Health Financing in India

• The total public expenditure on health for the year 2015-16 stood at Rs 1.4 lakh crores (actual).

• The per capita public expenditure (actual) on health in nominal terms has gone up from Rs. 621 in 2009-10 to Rs. 1,112 in 2015-16.

• Public expenditure on health (includes health sector expenditure by Centre and States/UTs) as a percentage of GDP was 1.02 percent in 2015-16. There is no significant change in public expenditure on health as a percentage of GDP since 2009-10.

• The Centre-State share in total public expenditure on health was 31:69 in 2015-16, which used to be 36:64 in 2009-10.

• The total public expenditure on health (excluding other Central Ministries) in 2015-16 was Rs. 1,40,054 crores, with Medical and Public Health comprising the major share (78.7 percent). The share of Family Welfare was 12.6 percent.

• Urban and rural health services constituted 71 percent of the public expenditure on medical and public health in 2015-16.

• The North-Eastern states had the highest (viz. Rs. 2,878 per capita) and Empowered Action Group (EAG) states (including Assam) had the lowest (viz. Rs. 871 per capita) average per capita public expenditure on health in 2015-16 (excluding UTs). For example, in Mizoram the per capita health expenditure was Rs. 5862 (actual) in 2015-16. However, in Bihar, the per capita health expenditure was Rs. 491 (actual) in 2015-16.

• The North-Eastern states had the highest public health expenditure as a percentage of Gross State Domestic Product (GSDP) in 2015-16 (2.76 percent). Public health expenditure as a percentage of GSDP stood at 1.36 percent for EAG states (including Assam) and 0.76 percent for major non-EAG states.

• Based on the Health Survey (71st round) conducted by National Sample Service Office (NSSO), the average medical expenditure incurred during stay at hospital between January, 2013 and June, 2014 was Rs. 14,935 for rural and Rs. 24,436 for urban India.

• The average total medical expenditure per child birth as in-patient over the last 365 days (survey conducted from January to June 2014) in a public hospital in rural areas is Rs. 1,587 and in urban areas is Rs. 2,117.

• Around 43 crore individuals were covered under any health insurance in the year 2016-17. This amounts to 34 percent of the total population of India. Almost 79 percent of them were covered by public insurance companies.   

• Overall, 77 percent of all persons covered with insurance fall under Government-sponsored schemes.

• Public insurance companies had a higher share of coverage and premium for all types of health insurance policies, except family floater policies including individual policies.

• Compared to countries that have either Universal Health Coverage or moving towards it, India’s per capita public spending on health is low.

Human Resources in Health Sector

• The number of registered allopathic doctors possessing recognized medical qualifications (under Indian Medical Council Act) and registered with state medical council for the years 2016 and 2017 were 25,282 and 17,982, respectively. Upto 2017, the total number of doctors possessing recognised medical qualifications (under the IMC Act) registered with the State Medical Councils/ Medical Council of India is 10,41,395. 

• In 2017, the average population served per government allopathic doctor is 11,082. The state having the highest average population served per government allopathic doctor in 2017 is Bihar (28,391), followed by Uttar Pradesh (19,962) and Jharkhand (18,518). 

• In 2017, the average population served per government dental surgeon is 1,76,004. The state having the highest average population served per government dental surgeon in 2017 is Chhattisgarh (25,87,900), followed by Maharashtra (14,83,150) and Uttar Pradesh (11,41,869).

• The number of dental surgeon registered with Central/ State Dental Councils of India has increased from 93,332 in 2008 to 2,51,207 as on 31st December, 2017.

• Over the years with gaining popularity, there is a steady rise in total number of registered AYUSH doctors in India from 7,71,468 in 2016 to 7,73,668 in 2017.

• There are total of 8,41,279 Auxilliary Nurse Midwives (ANMs) serving in the country as on 31st December, 2016.

• As on 31st December, 2016, the highest number of registered ANMs among the states were found in Andhra Pradesh (1,38,435), followed by Rajasthan (1,08,688) and Odisha (62,159).

• There are 19,80,536 Registered Nurses and Registered Midwives (RN & RM) and 56,367 Lady Health Visitors (LHV) serving in the country as on 31st December, 2016.

• As on 31st December, 2016, the highest number of registered RN & RM among the states were found in Tamil Nadu (2,62,718), followed by Kerala (2,46,161) and Andhra Pradesh (2,32,621).

• As on 13th November, 2017, the total number of registered pharmacists operating in the country is 9,07,132.

• As on 13th November, 2017, the highest number of registered pharmacists among the states were found in Maharashtra (2,03,089), followed by Gujarat (1,19,445) and Andhra Pradesh (1,15,754).

• In rural areas, the total number of allopathic doctors at primary health centres (PHCs) is 27,124 as on 31st March, 2017.

• As on 31st March, 2017, among the states, the highest number of allopathic doctors at PHCs is found in Maharashtra (2,929), followed by Tamil Nadu (2,759) and Rajasthan (2,382).

• In rural areas, the total number of specialists at community health centres (CHCs) is 4,156 as on 31st March, 2017.

• As on 31st March, 2017, among the states, the highest number of specialists at CHCs is found in Maharashtra (508), followed by Karnataka (498) and Rajasthan (497).

Health Infrastructure

• Medical education infrastructures in the country have shown rapid growth during the last 26 years. The country has 476 medical colleges, 313 dental colleges for Bachelor of Dental Surgery (BDS) & 249 dental colleges for Master of Dental Surgery (MDS). There has been a total admission of 52,646 in 476 Medical Colleges and 27,060 in BDS and 6,233 in MDS during 2017-18.

• The total number of dental colleges for BDS has increased from 77 in 1994-95 to 313 in 2017-18 viz. by 4.1 times. The total number of dental colleges for MDS has increased from 32 in 1994-95 to 249 in 2017-18 viz. by 7.8 times.

• The total number of admission in dental colleges for BDS has risen from 1,987 in 1994-95 to 27,060 in 2017-18 viz. by 13.6 times. The total number of admission in dental colleges for MDS has risen from 225 in 1994-95 to 6,233 in 2017-18 viz. 27.7 times.

• The total number of medical colleges in India has increased from 146 in 1991-92 to 476 in 2017-18 viz. by 3.3 times.

• The total number of male students taking admissions in medical colleges has gone up from 7,468 in 1991-92 to 26,082 in 2017-18 viz. by 3.5 times. The total number of female students taking admissions in medical colleges has gone up from 4,731 in 1991-92 to 26,564 in 2017-18 viz. by 5.6 times.

• India has 3,215 institutions producing 1,29,926 General Nurse Midwives annually and 777 colleges for Pharmacy (Diploma) with an intake capacity of 46,795 as on 31st October, 2017.

• There are 23,582 government hospitals having 7,10,761 beds in the country. It means that there is just one bed for 1,826 Indians in government hospitals, assuming that the projected population in 2018 being 129,80,41,000 as on 1st March, 2018.

• Around 19,810 government hospitals are in rural areas with 2,79,588 beds and 3,772 government hospitals are in urban areas with 4,31,173 beds.

• As on 31st March, 2017, there are 1,56,231 sub-centres, 25,650 primary health centres (PHCs) and 5,624 community health centres (CHCs).

• As on 31st March, 2017, most sub-centres are found in Uttar Pradesh (20,521), followed by Rajasthan (14,406) and Maharashtra (10,580). 

• As on 31st March, 2017, most PHCs are found in Uttar Pradesh (3,621), followed by Karnataka (2,359) and Rajasthan (2,079). 

• As on 31st March, 2017, most CHCs are found in Uttar Pradesh (822), followed by Rajasthan (579) and Tamil Nadu (385).

• Medical care facilities under AYUSH by management status i.e. dispensaries & hospitals are 27,698 and 3,943 respectively, as on 1st April, 2017.

• The total number of licensed blood banks in the country till June, 2017 is 2,903. The highest number of blood banks are found in Maharashtra (328), followed by Uttar Pradesh (294) and Tamil Nadu (291).  

• In total, there are 469 eye banks (362 privately run and 107 government run) in the country as on 4th January, 2018. Most eye banks are found in Maharashtra (166), followed by Karnataka (39) and Madhya Pradesh (36).

Achievement of health-related SDGs targets

• On most targets pertaining to health-related Sustainable Development Goals (SDGs), India lags behind the target. For example, although the target for coverage of essential health services is 100 percent (indicator no. 3.8.1), in our country only 57 percent of the population is covered by such services. Similarly, although the target for Maternal Mortality Ratio (per 1,00,000 live births) is 70 by 2030 (indicator no. 3.1.1), MMRatio in India presently is 174.

• The target for Under-five mortality rate (per 1000 live births) is 25 by 2030 (indicator no. 3.2.1). However, U5MR in the country is 47.7.

• In case of many SDG-related indicators such as Suicide mortality rate (per 100,000 population) (indicator no. 3.4.2) or say Adolescent birth rate (per 1000 women aged 15-19 years) (indicator no. 3.7.2), the SDG target is yet to be determined.

• For many SDG-related indicators such as Hepatitis B incidence (indicator no. 3.3.4) or say Proportion of the population with access to affordable medicines and vaccines on a sustainable basis (indicator no. 3.b.1), the data for India is either not provided or remain unavailable.

Table: Current Status of Health-related Sustainable Development Goals (SDGs) Target - Indian Scenario

SDGs

Source: Monitoring Health in the Sustainable Development Goals: 2017, World Health Organization, Regional Office for South East Asia, as quoted in the National Health Profile 2018, please click here to access, page no. 288

Report of the Inter-Agency and Expert Group on Sustainable Development Goal Indicators (E/CN.3/2016/2/Rev.1), please click here to access


 




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