Assessment of Availability and Achievements of the Public Health Care Services in Rural India

By : Shrikamal Sharma

Page No: 1-24

Abstract
Health is regarded as a fundamental dynamic force behind the growth and development of any country. At the apex of the development concept is Human Development that has defined (human) development as the process of enlarging people’s choices. The most critical ones are to lead a long and healthy life, to be educated and to enjoy a decent standard of living. Common health indicators used for the purpose are birth rate, fertility, death rate, infant mortality, life expectancy, nutrition etc. In this perspective, certain input (health institutions and availability of health personnel), certain outcomes (child vaccination services, fertility and mortality) and process indicators (institutional deliveries and antenatal care services) of public health services present in rural areas of the country are discussed. The number of public health institutions increased enormously. In 2019, there are more than 25.78 thousand hospitals, 5.69 thousand community health centres, 30.05 thousand primary health centres and 160.71 thousand health sub-centres working in the country, increasing the availability of health care services. At the same time, death rate, infant mortality rate (IMR) as well as birth rate and fertility rate have declined. The crude death rate per thousand declined from 25.1 in 1951 to 6.4 in 2017. Crude birth rate declined from 40.8 to 20.2 per thousand during the same period. Infant mortality rate came down from 148 in 1971 to less than 34 in 2017 and total fertility from 6.0 children in 1951 to 2.2 in 2017. But there is very wide spatial and societal variation in health achievements. Rural areas are still far behind the urban areas. For instance, infant mortality rate is 23 per thousand in urban areas as against 37 in rural areas. Similar is the case with CBR and TFR also. Recent trend is that despite of very high cost of health services more than half of the patients go to private health facilities. In this perspective, relative share of public and private sector in health services, particularly in rural areas, are analysed on state level, utilizing information published by the National Family Health Surveys and by annual publications of the Ministry of Health, Government of India.

Author :
Shrikamal Sharma
Formerly Professor & Head, Department of Geography and Director Population Research Centre, Dr. Harisingh Gour Vishwavidyalay, SAGAR (M.P) 470 003, India.
 

DOI: https://doi.org/10.32381/ATNAGI.2021.41.01.1