NEW DELHI:A two-year-old boy Samayan Singh Rathore injured himself while playing in an East Delhi locality last week. His panicked parents wanted to rush him to a nearby government dispensary but couldn’t find one. They took him to a government-aided hospital to consult a doctor. Despite paying `1,000, it took them over two hours to get their son’s X-ray done. Finally, they could only take the child to the doctor in the evening after collecting the report from the hospital.
Samayan Singh could be a lucky one. Not many are as fortunate as him, owing to the lack of health infrastructure. The national capital’s primary health infrastructure is abysmal, according to a data released by the Ministry of Health and Family Welfare. This puts enormous pressure on referral hospitals which have to meet the pressure of treating basic ailments. The union territory of Delhi has an area of 1,483 sq. km. and a population of 1.86 crore. In it are nine districts, 14 blocks and 165 villages.
There is an acute shortfall in the health infrastructure in Delhi when it comes to the required hospitals and the position of hospitals. The requirement is calculated using the prescribed norms on the basis of rural population from the 2011 census. According to the data, 83 sub-centres are required in the rural areas of the national capital, whereas only 27 sub-centres are in the position as on March 3, 2014. As the number of shortfall of sub-centres is 56, the percentage of shortfall has gone up to 67—the highest in the country.
Similarly, with the requirement of 13 primary health centres, Delhi has only five in place. While the all-India average percentage of shortfall of primary health centres is 23, the Delhi has 62 per cent. The sub-centre is the first peripheral contact point between health workers and the village community. In other words, a sub-centre is supposed to be the nearest dispensary in the locality to get first aid. As per National norms, population coverage is 5,000 in the plains and 3,000 in hilly or tribal areas. It is manned by at least one female (auxiliary nurse midwife) and one male health worker. One Lady Health Visitor (LHV) is provided for six such sub-centres.
Sub-centres are assigned tasks relating to maternal and child health, family welfare, nutrition, immunization, diarrohea and pneumonia control and control of communicable diseases. As per statistics, 13 Primary Health Centres (PHCs) are required in Delhi. A PHC is the first contact point or nearest dispensary in the locality where people can consult a doctor. The activities of PHC involve curative, preventive, promotional and family welfare services. It acts as a referral unit for six sub-centres. It has four to six beds for patients. Delhi has only five PHCs with a shortfall of eight. While the all-India percentage of shortfall of PHCs is 23 per cent, the shortfall percent in Delhi is 62.
The national capital has no Community Health Centre to cater to the health needs of the rural population. Community Health Centres serve as a referral centre for four PHCs. Each has 30 in-door beds with one operation theatre, X-ray, labour room and laboratory facilities. According to the 12th plan document, there has been an increase in the number of public health facilities in the country over the 2007-2011 period: sub-centres by 2 per cent, PHCs by 6 per cent, CHCs by 16 per cent and district hospitals by 45 per cent.
Yet, the shortfall remains: 20 per cent for sub-centres, 24 per cent for PHCs and 37 per cent for CHCs, particularly in Bihar, Jharkhand, Madhya Pradesh and Uttar Pradesh. Though Mobile Medical Units (MMUs) have been deployed in 449 districts of the country, their outreach medical services are not adequate.
Bihar continues to lag behind in health infrastructure in rural areas. While the number of sub-centres required in the state is 18,637, there are 9,729 sub-centres and the shortfall is 8,908 sub-centres. Similarly, while the required number of PHCs is 3,099, there are only 1,883, a massive shortfall of 1,216.
In Jharkhand, while the number of required sub-centres is 6,060, there are only 3,958, a shortfall is 2,102. Jhakhand needs 966 PHCs and has just 330. The shortfall is 636 PHCs.
Madhya Pradesh is also competing with Bihar in lack of health infrastructure. While Madhya Pradesh requires 12,415 sub-centres to cater to the rural population, the state has 8,764. The shortfall is 3,651. Similarly, while Madhya Pradesh requires 1,989 PHCs, it has 1,157 with a shortfall of 832.
While Uttar Pradesh requires 31,200 sub-centres, 20,521 are in operational with a shortfall of 10,679.
West Bengal needs 13,083 sub-centres and has 10,356, a shortfall of 2,727. While the state requires 2,153 PHCs, it has just 909. Maharashtra requires 13,512 sub-centres but has 10,580, a shortfall of 2,932. The state needs 2,201 PHCs and has 1,811, a shortfall of 390.
According to Union Health Ministry, there are wide variations among states in terms of healthcare facilities, the availability of human resources of health and hospital beds. Under National Health Mission, financial and technical support is provided to states to strengthen their healthcare system.
Delhi
Area: 1,483 sq km
Population: 1.86 crore
Districts: 9
Blocks: 14
Villages: 165