Rural healthcare infrastructure needs booster dose amid Covid-19 pandemic

The second wave of the pandemic ravaging the villages of India has laid bare the severe shortcomings in the country’s rural healthcare infrastructure.

Health in rural India is a three-tiered system, with sub-centres (SC) as the most peripheral and the first points of contact. After those come the primary health centres (PHC) and then the community health centres (CHC), maintained by state governments. Each of these are covering more population than they are intended for.

While there has been an increase in the facilities compared to 2005, accord­ing to the health ministry data, the shortage in many states means that the resources are overstretched and inacc­essible. The government report on rural health infrastructure 2019-20 high­lighted that a significant percentage of posts are vacant at all levels. Around 24 per cent of the sanctioned posts for doctors were vacant in 2020. As on March 31, 2020, the overall shortfall in the posts of auxiliary nurse and midwives (ANM) is two per cent of the total requirement according to the norm of ANM per sub-centre and PHC. The picture, however, differs across regions with several states, including some Northeastern and southern states, showing surplus capacity, while states such as Bihar, Uttar Pradesh and Jharkhand fall short.

Data as on March 31, 2020; *All-India shortfall is derived by adding state-wise figures of shortfall ignoring the existing surplus in some of the states; Source: Health Ministry