Developments in Health Sector of Rajasthan economy

Developments in Health Sector of Rajasthan economy

Rajasthan is the largest state of India, positioned
in the north-western region of the country. It embodies 11% of the total
geographical surface of the country equaling to 342,239 square km. The
population of Rajasthan as per the census of 2011 is 6.86 crore. Topographically Aravali Range separates Rajasthan into 2
geographical zones – desert on one side and forests on the other. Population
density differs with the desert region having 60-80 people per square km and
other areas up to 200 people per square km. 10 High Priority Districts & 6
Tribal Districts (3 under HPD) have been identified in Rajasthan based on lower
composite health index.

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Infant Mortality Rate: 41 in

Under 5 Mortality Rate: 51 in

Maternal Mortality Rate:  244 in SRS 2011-13

Sex Ratio – Sex Ratio at birth:
887 in NFHS 4

Literacy Rate: 67.06 % in
Census 2011

Age at Marriage:  20—24 years women married before 18 years: (35.4%

Full immunization: 74.2% in AHS

Total Fertility Rate: 2.4 in

Institutional Births: 84% in

10.  Children under age 6 months exclusively breastfed: 58.2% in NFHS 4

11.  Rajasthan has reported percentage of Underweight (Weight for age) of
under five children is 36.7% in 2015-16(30.7% in urban areas and 38.41% in
rural areas)

12.  Percentage of stunted (height for age) under five children are 39.1%
in 2015-16(33% in urban areas and 40.8% in rural areas)

13.  Percentage of wasted (weight for age) under five children is 23% in
in urban areas and 23.4% in rural areas)

14.  Percentage of anemia in 60.3% children aged 6-59 months (85%)
in new sputum positive patients

Ø  Increase of 50% in utilization of public health facilities by 2025

Ø  Ensuring skilled birth attendance and ANC care above 90% by 2025

Ø  Ensuring more than 90% of newborns are fully immunized by one year
of age (2025)

Ø  Addressing family planning need above 90% at national and sub
national level by 2025.

Ø  80% of known hypertensive and diabetic individuals at household
level maintain

Ø  Decrease in prevalence of tobacco use (15% by 2020 and 30% by 2025)

Ø  40% reduction in prevalence of stunting of under-five children by

Ø  Under Swachh Bharat Mission, access to safe water and sanitation to
all by 2020

Ø  Decline in the health expenditure of households by 25% by 2025

Ø  Ensure availability of paramedics and doctors as per Indian Public
Health Standard (IPHS) norm in high priority districts by 2020 and establishing
primary and secondary care facilities in High priority districts.

Ø  Ensure district-level electronic database of information on health
system components by 2020

Ø  Strengthening the health surveillance system and ensuring district-level
electronic database of information

Finance and Impact on Gross Domestic Product

The policy recommends
enhancement of public health expenditure from 1.15% to 2.5 % of the GDP in a
time-bound manner. Earlier we have had experience of experiencing decline in
public health investment as a percentage of GDP declined from 1.3% in 1990 to
.9 percent in 1999. India’s public health spending is 1.16% of gross domestic
product (GDP) while the World Health Organization (WHO) recommends spending 5%
of GDP. India has yet to go a long way to meet the 2010 target of spending of 2%
of GDP on health, it has always been on the lower side while as Global mean
health spending is around 5-6 %. But this is a very bold and pragmatic
initiative and will definitely reap dividends. The policy has also laid down
increase in state health spending upto >8% of their budget by 2020.

Hence state should give tail wind to the following
pointers to achieve the indicators laid down by Health policy 2017 and SDGs are

The need allocates strengthen primary
health care, ensure availability of two beds per 1,000 population, provide
comprehensive primary healthcare services – including maternal and child
health, nutrition services, CDs, NCDs, collaboration with National Health

Address the high Total
Fertility Rate (TFR) in HPDS by having availability family planning commodities
and ensuring counselling.

Ensuring maternal nutrition
before, during and after pregnancy. Ensuring balanced energy, protein, calcium,
and multiple micronutrient supplementation

To address malnutrition and
guaranteeing good healthy practices in children the practices followed should
be growth monitoring, exclusive breastfeeding and appropriate complementary
feeding, full immunization, prophylactic iron supplementation

In addition to counselling of
families; distribution of iron and folic acid (IFA) supplements to children as
well as mothers. This can be achieved through appropriate training to ASHAs,
ANMs and Angan wadi workers.

Urgent need of having adequate
staff both clinical and administrative staff, functional equipment’s, medicines
and diagnostic tests.

Well monitored centers (e.g.,
doctor attendance/ Paramedical attendance).

Capacity building, supportive
supervision, onsite correction of gaps and hand holding of staff nurses,
Medical officers and Pediatricians.

Uniform centers with delivery
protocols, cleanliness / hygiene protocols, designated and approved IEC
materials, appropriate signage, uniform coloring

Grievance redressal mechanism,
feedback systems gauge and enhance patient satisfaction and engage, empower the
community to drive accountability

Need to have a robust MIS
system with a common platform linking all the current information system which
work in silos Patient focused systems: 
PCTS (NIC), Arogya (NIC), Raj eOffice (DoIT), ASHASoft (NIC), eAushadhi
(CDAC), eUpkaran (CDAC).

MIS that encourage the use of
evidence-based medicine, guidelines, electronic prescribing in inpatient and
outpatient settings though the implementation of the EHR; this will, in time,
encourage healthcare data collection, transparency, quality management, patient
safety, efficiency, efficacy and appropriateness of care.

Transport availability for
which people fail to access institutional health service.

Develop standard operating
measures for examination by which doctors, nurses and pharmacists are able to
practice and get employment.

 Ensuring that Hospitals
in the state get national accreditation in order to get paid by insurance
companies. However, a performance incentive plan for those who address the
quality and specific treatment parameters.

 Looking at the provision of connecting with
private insurance agencies so as to provide medical insurance coverage to the
larger populace.

 Develop partnerships
between the line departments and private sectors players for better convergence

Conclusion: Rajasthan, given its large population base and
a diversified economy in mining, agriculture and tourism has shown significant
progress in improving governance and tackling high mortality indicators.
However, to meet SDG indicators the state should invest in the interventions
that will help in accelerated decline population growth as well as reduce child,
infant and maternal mortality. Measures should also be taken to reduce disparity
of rural urban divide by chalking out strategies to address tribal and scattered
population, interdepartmental convergence and involvement of PRIs in the
planning, implementation and monitoring process. The state should benefit from considerable
growth in Public-Private Partnership (PPP) and Foreign Direct Investment (FDI)
for the development of healthcare sector and adopt certain measures to meet the
rural and urban healthcare needs. Thus, there is a need of appropriate planning
to reduce inter and intra district variations in educational and health
development, adopt a state-of-the-art platform for people, hospitals and
healthcare professionals















[i]Atlas of Sustainable Development Goals 2017



[i]National family Health Survey-2014


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