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Health Care Facilities in Rural Areas

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 4TH JANUARY, 2019 

HEALTHCARE FACILITIES IN RURAL AREAS 

356. DR. HEENA VIJAYKUMAR GAVIT
        SHRIMATI SUPRIYA SULE 

state: Will the Minister of HEALTH AND FAMILY WELFARE be pleased to 
  • (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? 
Health+Care+Facilities+in+Rural+Areas
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 under served 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. 
Annexure
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
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
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
34
Delhi
0
109
109
0
24383
24383
35
Lakshadweep
9
0
9
300
0
300
36
Puducherry
3
11
14
96
3473
3569
*****

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