Question : Healthcare Facilities in Rural Areas

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, if so, the details thereof and the reasons therefor;

(b) the details of availability of healthcare facilities/infrastructure including 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 at macro and micro levels and to improve the healthcare sector in rural areas of the country; and

(d) whether there is any proposal to draw a long term perspective plan to address the prevailing inequalities in the rural health sector and if so, the details thereof 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 treatment and diagnostic facilities in the country?

ANSWER
THE MINISTER OF HEALTH AND FAMILY WELFARE
(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 4TH JANUARY, 2019

(a) & (b) The key health indicators such as Infant Mortality Rate (IMR), Under 5 Mortality Rate (U5MR), Total Fertility Rate (TFR), proportion of institutional 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 Government Hospitals with 279588 beds & 3772 Urban Government hospitals with 431173 beds in India. The state wise details are at Annexure.
As per Health Management Information System (HMIS), there are 86342 doctors in rural areas (including doctors in District Hospitals) and 15964 doctors in urban areas.
As per Health and Morbidity Survey 2014 of National Sample Survey Office (NSSO), Ministry of Statistics and Program Implementation, Out of Pocket Expenditure (OOPE) per hospitalized case (excluding child birth) in Public Health Facilities is Rs 5369 for Rural 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 Governments. To address the healthcare challenges, particularly in rural areas, the National Rural Health Mission (NRHM) was launched in 2005 to supplement the efforts of the State/UT governments to provide accessible, affordable and quality healthcare to 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, universal immunisation programme, and for major diseases such as Tuberculosis, HIV/ AIDS, vector borne diseases such as Malaria, Dengue and Kala Azar, Leprosy etc.


Other major initiatives for which states are being supported include Janani Shishu Suraksha Karyakram (JSSK)(under which free drugs, free diagnostics, free blood and diet, free transport from home to institution, between facilities in case of a referral and drop back home is provided), Rashtriya Bal Swasthya Karyakram (RBSK), Rashtriya Kishor Swasthya Karyakram (RKSK), implementation of NHM Free Drugs and Free Diagnostics Service Initiatives, PM National Dialysis Programme and implementation of National Quality Assurance Framework.
Mobile Medical Units (MMUs) & Telemedicine are also being implemented with NHM support to improve healthcare access particularly in rural areas.
As part of Ayushman Bharat, the Government is supporting the States for strengthening Sub Centres and Primary Health Centres as Health and Wellness Centres for provision of comprehensive 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 quality inpatient care.
To improve availability of doctors & specialists in underserved areas, the Government is upgrading District Hospitals to Medical Colleges in 82 districts which do not have any Medical College thereby providing at least one Medical College for every three contiguous Parliamentary Constituencies.