The health indicators across the country have shown significant improvements. The life expectancy has increased by 5 years in the past decade. What used to be 62.3 years for male and 63.9 years for female in 2001-2005 is now 67.3 years for male and69.6 years for female in 2011-2015. There has been reduction in new HIV cases by as much as 57%. Infant Mortality Rate has come down to 42 in 2012 from 58 per 1000 live births in the year 2005. Maternal Mortality Ratio has declined from 301 per 100,000 live births in 2001-03 to 212 in 2007-09. The pace of decline has shown an increasing trend from 4.1% annual rate of decline during 2001-03 to 5.5% in 2004-06 and further to 5.8% in 2007-09. Total Fertility Rate has come down to 2.4 in 2011 from 2.9 in 2005. Adding a new feather in the cap is declaration of India as Polio Free Nation. On the 13th January, 2014, India made history by completing three years without a single case of wild polio. This feat was unimaginable till 2009, when India accounted for more than half of the global polio burden.
The appreciable developments in the healthcare sector are attributable to the strengthening of the health infrastructure in the country, and a focused approach by the Ministry of Health and Family Welfare. The Government has increased budget outlay by 335% to Rs 3 lakh crore in 12th Plan for healthcare to achieve universal and inclusive healthcare for all citizens. Moreover, under the National Health Mission (NHM) there are two subcomponents namely National Rural Health Mission (NRHM) and National Urban Health Mission (NUHM) which aim to provide accessible, affordable and quality health care to the rural as well as urban population.
The National Urban Health Mission (NUHM) as a sub-mission of National Health Mission (NHM) was approved by the Cabinet on 1st May, 2013. It envisages to meet health care needs of the urban population with the focus on urban poor, by making available to them essential primary health care services and reducing their out of pocket expenses for treatment. In the 12th Plan an allocation of Rs. 15,143 crores has been made for National Urban Health Mission.
NRHM was launched by the Government over eight years ago and substantial progress has been achieved under it. More than Rs. 1, 11, 000 crores has been released by the Health Ministry to 35 State Governments and UTs. Nearly 51,000 new health infrastructures have been created, including new construction and up-gradation works to improve health facilities. More than 70,000 beds have been added in Government health institutions for provision of essential and emergency services across the country. Addition of nearly 1.6 lakh human resources that include specialists, doctors, nurses, ANMs and para-medics and nearly 9 lakh community health workers called ASHAs have been appointed in villages to facilitate interface between the communities and health system.
Under NRHM National Ambulance Services, support free ambulance services to provide patients transport in every nook and corner of the country connected with a toll free number to a Call Centre. Over 15,000 basic and emergency patient transport vehicles have been provided under NRHM. Besides these, over 3,000 vehicles have been empanelled to transport patients, particularly pregnant women and sick infants from home to public health facilities and back. To increase visibility and awareness- 102 & 108 ambulances are being repositioned as “National Ambulance Service” with universal colour and design.
NRHM also provides for institutional delivery among the poor pregnant women under the Janani Suraksha Yojna (JSY). Substantial increase in institutional deliveries has resulted in the steep decline of the IMR and MMR. The scheme is operationalized in all the States with more than 12 million beneficiaries.
The Janani Shishu Suraksha Karyakram (JSSK), launched in June 2011, entitles all new-borns and children under one year of age besides pregnant women to absolutely free and no expense services including free diagnostics, drugs, consumables, food and blood, if required, besides free transport from home to institution, between facilities in case of a referral and drop back home. Nearly 1 crore 23 lakh pregnant women and more than 12 lakh children have benefitted in 2012-13.
Rashtriya Bal Swasthya Karyakram (RBSK) was launched in February, 2013. It entitles children in the age group of zero to eighteen years across the country to receive free health screening services and free treatment including surgeries, where required. An estimated 27 crore children are to be covered across the country eventually, with screening for 30 common health conditions for early detection of: Defects, Diseases, Deficiencies and Developmental disorders. More than 1 crore 86 lakh children screened; more than 7 lakhs 64 thousand children referred; more than 90 thousand children have availed free secondary or tertiary health care.
The Government has implemented Home Based Newborn Care up to 42 days of life through ASHAs, Newborn care corners (NBCC) at delivery points and training of health care providers in Navjaat Shishu Suraksha Karyakram(NSSK) for effective essential newborn care is a key component of the newborn continuum of care have been established. And Special New Born Care Units (SNCUs) at FRUs/DH and Newborn Stabilisation Units (NBSUs) have been established to provide care to sick, low birth weight and preterm newborns.
For management of children with Severe Acute Malnutrition, 872 Nutrition Rehabilitation Centres have been operationalized in the country till December 2013. Training Package for Facility Based Management of Children with Severe Acute Malnutrition has been shared with the States in 2013.
The Rashtriya Kishor Swasthya Karyakram (RKSK), launched recently, aims to bring in several new dimensions like- mental health, nutrition, substance misuse, gender based violence and non-communicable diseases. The programme introduces community based interventions through peer educators. The strategic approach to RMNCH+A (Reproductive, Maternal, New born, Child Health + Adolescent) in which `A` denotes adolescents
To meet the challenge of high prevalence and incidence of anaemia amongst adolescent girls and boys, the Ministry of Health and Family Welfare launched the Weekly Iron and Folic Acid Supplementation (WIFS) Programme for 10-19 years adolescent population. Also the National Iron + Initiative was launched for prevention and treatment of Iron Deficiency Anaemia among different age groups. Under National Iron + Initiative initiative it is envisaged to ensure provision of IFA supplementation and therapeutic management of mild, moderate and severe anaemia in the most vulnerable groups – children (6months- 10 years), adolescents (10-19 years), pregnant and lactating women and women of reproductive age group (15-45 years) through a continuum of care approach.
The National Programme for the Health Care of Elderly (NPHCE) addresses health related problems of elderly people. The basic aim of the NPHCE programme is to provide separate, specialized and comprehensive health care to the senior citizens at various levels of state health care delivery system including outreach services.
Government of India initiated an integrated National Programme for Prevention and Control of Cancers, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS).
The Government has launched some of new vaccines like indigenously developed JE Vaccine (JENVAC) in 2013. Also, Hepatitis B vaccine and second dose of measles vaccine are now part of the Universal Immunization Programme. Pentavalent, a combination vaccine, which includes DPT + Hep-B + Hib has been introduced in eight states: Kerala, Tamil Nadu in December 2011 and Puducherry, Goa, Haryana, Gujarat, Karnataka and J & K in 2012-13. This ensures complete immunization against five diseases and also reduces the chances of an adverse event following immunization due to less injection load. Government of India earlier provided only one JE dose and now has introduced two doses of JE vaccine under Routine Immunization with first dose at 9-12 months and 2nd dose at 16-24 months with effect from 1st April 2013.
The Government has also launched Reverse Dot Blot Hybridization (RDB) Thalassemia Diagnostic Kit and AV Magni-Visualiser the screening device for cervical cancer in December, 2013 and indigenously developed Diabetes Screening System and Test Strips in January 2014.
Efforts have been made to increase the number of doctors the Government rationalized the land use norms for setting up New Medical Colleges, bed occupancy norms, retirement age of faculty, and teacher student ratio was relaxed from 1:1 to 1:2 generally and 1:3 in some specific cases for post-graduate courses. The availability of MBBS seats has gone up from 33,567 to 51,979, i.e. an increase of 18,412 seats or almost 55%. During the same period, the number of PG seats has increased from 13,838 to 23,931 i.e. an increase of 10,093 seats or almost 73%. Within this period, 97 new medical colleges, including six new AIIMS, have been established raising the number of Medical Colleges from 290 to 387, which is all time high. Similarly, 19 Government Medical Colleges have been up-graded as super speciality hospitals. Together the 6 new AIIMS, and 19 up-graded institutions would provide speciality and super-speciality care in all disciplines with a net addition of 11,390 beds covering 27 locations spread across the country.