National Health Profile 2018

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Union Minister of Health and Family Welfare released the National Health Profile (NHP)-2018 prepared by the Central Bureau of Health Intelligence (CBHI).

The National Health Profile covers demographic, socio-economic, health status and health finance indicators, along with comprehensive information on health infrastructure and human resources in health.

He also launched the National Health Resource Repository (NHRR) – Country’s first ever national healthcare facility registry of authentic, standardized and updated geo-spatial data of all public and private healthcare establishments.

Health Profile is a very important tool as it has helped in designing various programmes.

India has shown impressive gains with 22% reduction in Maternal Mortality since 2013.

Uttar Pradesh with 30% decline has topped the chart in the reduction of Maternal Deaths.

Ayushman Bharat will provide comprehensive healthcare to the people as 1,50,000 sub-centres will be converted into Health and Wellness Centres (HWCs). The H&WC would provide preventive, promotive, and curative care for non-communicable diseases, dental, mental, geriatric care, palliative care, etc.

He further stated that the Government has initiated universal screening of common NCDs such as diabetes, hypertension and common cancers along with Tuberculosis and Leprosy, which will eventually help in reducing the disease burden of the country. This will again change the Health Profile of the people in future.

Under the Collection of Statistics Act 2008, over 20 lakh healthcare establishments like hospitals, doctors, clinics, diagnostic labs, pharmacies and nursing homes would be enumerated under this census capturing data on over 1,400 variables.

The Central Bureau of Health Intelligence (CBHI) has actively engaged with key stakeholders including leading Associations, Allied Ministries, and several private healthcare service providers.

National Health Profile 2018 – Complete List of Facts :

In the Budget this year, the government allocated only 1.3 percent of the GDP for public healthcare, which is much lower than the global average of 6 percent. This, even as the country continues to deal with a severe scarcity of doctors in basic healthcare facilities, rendering helpless citizens without any options but to pay more in the rural and urban private hospitals.

In India, there is only one allopathic government doctor for every 11,082 people, which is 11 times more than the WHO recommended a doctor-population ratio of 1:1000. The situation is grim in Bihar where the population per government doctor is 28,391. It is followed by Uttar Pradesh where there are 19,962 patients per doctor, followed closely by Jharkhand, Madhya Pradesh, Chhattisgarh and Karnataka.

The national capital is better in terms of doctor-patient ration, with 2203 patients per doctor, but is still twice that of the WHO average.

The report also stated that the government is spending just Rs 1,112 per capita, for health care, which means only Rs 3 per day is spent per day for the healthcare of an average Indian. This puts India even lower than nations like Bhutan, Sri Lanka and Nepal who spend 2.5, 1.6 and 1.1 percent of their GDP on health care.

However, the figures are not dismal throughout. The country has recorded a marked decrease in infant and maternal mortality rate. From 74 deaths per 1000 live births in 1994 to 34 in 2016, infant mortality rate stands at its lowest right now. Even maternal mortality rate saw a decrease by 11 points in the past years. The national MMR stands at a rate of 167 per 1,000,000 births.

The report also claims rabies to be the most fatal communicable disease. It reportedly had a 100 percent fatality rate in 2017, with the highest number of deaths reported from West Bengal (26) and Karnataka (15). Swine flu (H1N1) virus also saw an increase in casualty, from 1786 in 2016 to 2266 in 2017. The report also stated that dengue cases also saw a rise in the country, up from 1,29,166 in 2016 to 1,57,996 in 2017.

Delhi is better in terms of doctor-population ratio amongst other states, where the ratio stands at 1:2203, which is still twice the recommended ratio by WHO.

The NHP report reflects the consistent indifferent approach of the government in terms of public health spending. The report states the country spent only 1.02 per cent of its GDP on healthcare in the financial year 2015-16.

It also says that the per capita public expenditure by the government on health stands at Rs 1,112 that comes to Rs 3 per day.

This dismal figure puts India below other low-income nations like Maldives (9.4), Bhutan (2.5), Sri Lanka (1.6) and Nepal (1.1). Globally, Sweden spends the largest chunk on public healthcare by dedicating 9.2 per cent of its GDP.

Along with the life expectancy rate, there is noteworthy progress in health indicators such as the infant mortality rate and maternal mortality rate (MMR) in the country.

The infant mortality rate at the national level stands at its lowest i.e. 34 per 1,000 live births, however, the gap between rural (38) and urban (23) mortality rate is still high.

With an 11-point decrease between 2010-12 and 2011-13, the national MMR stands at a rate of 167 per 1,000,000 births. The state of Assam (300) has the highest MMR, while Kerala the lowest (61).

With rabies having a 100 per cent fatality rate amongst 97 cases reported in the year, it remained one of the most lethal communicable diseases in the country for the year. The highest figure of deaths due to rabies was reported from West Bengal (26) and Karnataka (15).

According to the report, the cases of Influenza A H1N1 (Swine flu) witnessed a 21-time increase, as 38,811 number of cases were reported leading to a casualty of 2,266 in comparison with 1,786 that were reported in 2016.

Japanese Encephalitis (JE), a kind of an infection of the brain caused by the JE virus, continues to claim lives with 12 per cent mortality rate amongst 2,180 cases. The maximum number of cases (693) of JE and death (93) were reported from Uttar Pradesh, the highest since 2013.

The figure of dengue cases also saw a rise as the cases went up from 1,29,166 in 2016 to 1,57,996 in 2017.

According to 2011 Census, the overall literacy rate of India is 73%. At the time of Independence the country’s literacy rate was abysmally low, 14%. Over the years literacy rate has been increasing but with varied rates in different states with some states like Kerala (94%) and Mizoram (91.3%) are well above the national average while states like Bihar has a dismal rate of 61.8%. There is also a concern for female literacy rate (64.6%) which is much below the male literacy rate (80.9%).

At the national level, the mean age at effective marriage for female in the year 2016 is 22.2 years and varies from 21.7 years in rural areas to 23.1 years in urban areas. Among the bigger States/UTs, the mean age varies from 21.2 years in West Bengal to 24.7 years in Jammu & Kashmir.

Before 2005, the official measure of poverty line was based primarily on food security. It was defined as the per capita expenditure needed for a person to consume enough calories and be able to pay for associated essentials to survive. Since 2005, the Government adopted Tendulkar methodology which moved away from calorie anchor to a basket of goods. Using the Tendulkar methodology, NITI Aayog estimates that during the year 2011-12, 25.7% of population in rural areas and 13.7% in urban areas live below the poverty line.

The second advance estimates for Per Capita Net National Income for the year 2017-18, at current prices is Rs. 112764 crore and Rs. 86689 crore at constant price (base year 2011-12).

Safe drinking water is essential for good health. As on 01.04.2017, 13,25,302 habitations were provided with safe drinking water under National Rural Drinking Water Programme.

As on 01.04.2017, The habitations identified as affected from flouride and arsenic were 13,492 and 18,258 respectively in the country.

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 overall prevalence of the disease has diminished in 2012 and 2013 however there is a slight increase in 2014 and again started decreasing from 2015.

Kala-azar is the second largest parasitic killer in the world. In India Leishmania donovani is the only parasite that causes this disease. Bihar accounts for most of the cases by Kala-azar. Out of the overall cases reported in 2017, 72% of the cases have been reported in Bihar.

Dengue and Chikungunya transmitted by Aedes mosquitoes, are a cause of great concern to public health in India. Every year, thousands of individuals are affected and contribute to the burden of health care. Dengue outbreaks have continued since the 1950s but severity of disease has increased in the last two decades.

There has been considerable decrease in the number of swine flu cases/deaths in the year 2014 as compared with 2012 & 2013. However, the number of cases and deaths has been drastically increased in the year 2015.

Similarly, total of 63,679 cases of Chikungunya were reported in 2017 as compared with 64,057 cases in 2016.

Total number of cases and deaths due to Chicken Pox were 74,035 and 92 respectively in 2017. Kerala has 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.

Total number of Cases and Deaths due to Encephalitis were 12,485 and 626 in India during 2017 respectively. Assam has reported maximum numbers of Cases (5525) and Odisha has reported maximum number of deaths (246).

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 (1493) and maximum number of Deaths (33).

Total public expenditure on health for the year 2015-16 stood at Rs 1.4 lakh crores.

Per capita public expenditure on health in nominal terms has gone up from Rs 621 in 2009-10 to Rs 1112 in 2015-16.

Public expenditure on health as a percentage of GDP was 1.02% in 2015-16. There is no significant change in expenditure since 2009-10.

The Centre-State share in total public expenditure on health was 31:69 in 2015-16.

Total public expenditure on health (excluding other Central Ministries) in 2015-16 was Rs 140,054 crores, with Medical and Public Health comprising the major share (78.7%). The share of Family Welfare was 12.6%.

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

The North-Eastern states had the highest and EAG states (including Assam) had the lowest average per capita public expenditure on health in 2015-16 (excluding UTs).

The North Eastern states had the highest public health expenditure as a percentage of GSDP in 2015-16 (2.76%). The value was 1.36% for EAG (including Assam) and 0.76% for major non-EAG states.

Based on Health Survey (71st round) conducted by NSSO, Average medical expenditure incurred during stay at hospital from Jan 2013 – Jun 2014 was Rs. 14,935 for rural and Rs. 24,436 for urban in India.

Average total medical expenditure per child birth as in patient over last 365 days (survey conducted from Jan to Jun 2014) in a public hospital in rural area is Rs. 1,587 and in urban area is Rs. 2,117.

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

Overall, 80% 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.

There has been a marked improvement in the Dentist to population Ratio. Number of Dental Surgeon registered with Central/State Dental Councils of India up to 31.12.2017 were 2,51,207.

There is a steady rise in total number of registered AYUSH Doctors in India from 7, 71,468 in 2016 to 773668 in 2017.

AYUSH has maximum number of registered Ayurvedic doctors (55.44%), followed by registered Homeopathy Doctors (36.77%) in India.

There is an increase in the availability of Allopathic Medical Practitioners, Dental Surgeon and Nurses per lakh population over the years.

Auxiliary Nurse Midwife (ANM) plays very crucial role in providing healthcare services pertaining to maternal and child health. They are having wider linkages with ASHA workers, Anganwadi workers of ICDS and other development sectors like education, water supply and sanitation. There are total of 8,41,279 ANMs serving in the country as on 31.12.2016.

There are 19,80,536 Registered Nurses and Registered Midwives (RN & RM) and 56,367 Lady Heath Visitors serving in the country as on 31.12.2016.

The India has 476 medical colleges, 313 Dental Colleges for BDS & 249 Dental Colleges for MDS. There has been a total admission of 52,646 in 462 Medical Colleges and 27,060 in BDS and 6,233 in MDS during 2017-18.

India has 3,215 Institutions producing 1,29,926 General Nurse Midwives annually and 777 colleges for Pharmacy (Diploma) with an intake capacity of 46795 as on 31st October, 2017.

There are 23,582 hospitals having 7,10,761 beds in the country. 19,810 hospitals are in rural area with 2,79,588 beds and 3,772 hospital are in Urban area with 43,1,173 beds.

Medical care facilities under AYUSH by management status i.e. dispensaries & hospitals are 27,698 and 3,943 respectively as on 1.4.2017.

Health-care is the right of every individual. 60% of population of India is rural population. A majority of 700 million people lives in rural areas and to cater their health needs, there are 1,56,231 Sub Centres, 25,650 Primary Health Centres and 5,624 Community Health Centres in India as on 31st March 2017.

Total no. of licensed Blood Banks in the Country as on June, 2017 is 2903.

The Central Government Health Scheme (CGHS) was started under the Ministry of Health and Family Welfare in 1954 with the objective of providing comprehensive medical care facilities to Central Government employees, pensioners and their dependents residing in CGHS covered cities. At present, CGHS has health facilities in 37 cities having 287 Allopathic Dispensaries and 85 AYUSH Dispensaries in the Country with 10,82,913 registered cards/ families.

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.

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