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This past week Union Minister of Health and Family Welfare JP Nadda released the National Health Profile (NHP)-2018. The report published annually since 2005, was prepared by the Central Bureau of Health Intelligence (CBHI). It covers demographic, socio-economic, health status and health finance indicators, along with comprehensive information on health infrastructure and human resources in health. Here are some highlights of the report.
Declining Total Fertility Rate (TFR)
The TFR for India as a whole was 2.3 whereas in rural areas it was 2.5. In urban areas, it was even lower at 1.8.
TFR refers to number of children that would be born per woman, assuming no female mortality at childbearing age and the age-specific fertility rates of a specified country and reference period.
The NHP mentions that as per the SRS Statistical Report of 2016 by the Registrar General of India, the TFR in 12 Indian states has fallen below two children per woman. These states include Andhra Pradesh, Delhi, Himachal Pradesh, Jammu and Kashmir, Karnataka, Kerala, Maharashtra, Punjab, Tamil Nadu, Telangana, Uttarakhand and West Bengal.
Also as per the 2016 report, TFR in nine states has reached replacement levels of 2.1 and above. These include Assam, Chhattisgarh, Gujarat, Haryana, Jharkhand, Madhya Pradesh, Odisha and Rajasthan.
Delhi, Tamil Nadu and West Bengal have the lowest fertility as per the report. However, the two big states of Uttar Pradesh and Bihar are still to reach replacement levels. The TFR for Bihar in 2016 was 3.3, while for Uttar Pradesh was 3.1.
Health spending
India spent 1.02 percent of its GDP (2015-16) as public expenditure on health, lower than Bhutan and Sri Lanka and higher than Bangladesh.
Per capita public expenditure on health in nominal terms has gone up from Rs 621 in 2009-10 to Rs 1,112 in 2015-16.
The cost of treatment has been on the rise in India and has led to inequity in access to health care services.
The Centre:State share in total public expenditure on health was 31:69 in 2015-16. The share of Centre in total public expenditure on health has been declining steadily over the years except in 2017-18.
Health insurance in India is a growing segment. 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. Around 79 percent of them were covered by public insurance companies. Overall, 80 percent of all persons covered with insurance fall under government sponsored schemes.
Health infrastructure
The country has 476 medical colleges, 313 Colleges for BDS (dental) courses and 249 colleges which conduct MDS courses. There has been a total admission of 52,646 in 476 Medical Colleges and 27,060 in BDS and 6,233 in MDS in 2017-18.
At present, average population served per government allopathy doctor is 11,039. This figure is 10 times worse than the WHO prescribed ratio of 1:1000.
Maharashtra (1,53,513), Tamil Nadu (1,26,399), Karnataka (1,04,794) are top three states having the highest number of registered allopathy doctors.
There are 3,215 Institutions for General Nurse Midwives with admission capacity of 129,926 and 777 colleges for Pharmacy (Diploma) with an intake capacity of 46,795 as of October 31, 2017.
There are 23,582 government hospitals having 7,10,761 beds in the country. 19,810 hospitals are in rural area with 2,79,588 beds and 3,772 hospitals are in urban area with 431,173 beds.
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