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Despite having good overall investment, Gujarat is still unhealthy

December 15, 2017


As per 2011 Census, Gujarat has a population of over 6.03 crore, representing 4.99% share of the national total. As one of the better-developed states in India, Gujarat is expected to have a healthy population and a modern medical infrastructure to serve the state. However, Gujarat still does invest heavily in developing its health services infrastructure that is needed to support a growing population.

Gujarat has witnessed massive investments in manufacturing that have transformed the state’s economy. However, investments in health infrastructure and medical education have not got the attention it deserved. Interestingly, Gujarat has emerged as a major destination for pharmaceutical production and exports, and yet, lags behind in hospital beds per 1000 population and doctors per 1000 patients ratio.

A population well above 6.03 crores living across the 33 districts has access to only 24 District Hospitals, 30 Sub-District Hospitals, 300 Community Health Centres, and 1208 Primary Health Centres. Nine districts still do not have a district hospital. The bed to patient ratio and doctor to patient ratio is also not in keeping with the developed status of Gujarat.

The state Budget announced for 2017-18 is Rs 1,72,179.24 crore, an increase of Rs 20,327.31 crore over 2016-17. That is impressive. But the total allocation for Health and Family Welfare Department is just Rs 7,36,817.24 lakhs. Of this, the allocation for capital outlay on medical and health services is Rs 1,35,526.63 lakhs. The investment does not match the population needs.

Infant mortality is an important indicator of the state of health in Gujarat as that forms the foundation of the health of the new generation. India has suffered from high infant mortality rates, and since independence, the goal of the central government has been to reduce it.

As per a joint report released by UNICEF, National Institute of Medical Sciences, and Indian Council of Medical Research, the Millennium Development Goal (MDG) 4 for the period 1990 and 2015 was to reduce the Infant Mortality Rate by two-thirds of children under five.

The target was to bring down the deaths from 80 per 1000 live births in 1991 to 26 per 1000 live births by 2015. Gujarat remained well behind the target, with Kerala achieving the best results by bringing down deaths to around 11 per 1000 live births.

In nutrition and women’s health, Gujarat has not performed as well as it could have and the main reason has been lack of adequate focus and investment in building medical health infrastructure. From 2005 onwards, private investment in the medical sector in Gujarat has picked up but has not been able to bridge the gap between demand and supply.

Child nutrition and women’s health care has been another area of concern. Rural Gujarat still suffers from low nutrition in children up to five years of age and consequently resulted in various diseases manifesting between 5 and 15 years. The state has adopted initiatives like setting up Bal Shaktim Kendra, Bal Sewa Kendra, and Bal Sanjeevani Kendra to fight malnutrition. Again, the overall investment does not match the developed status the state prides itself.

Children born to Scheduled Castes and Scheduled Tribes have higher levels of exposure to malnutrition and subsequent diseases. For instance, the prevalence of Sickle Cell Disease (SCD) is higher among scheduled castes and tribes resulting in deaths and SCD Anemia among infants and children.

Gujarat has a tribal population (Census 2011) of 89,12,623, representing around 14.76% of the total population. Of these, 8,91,262 show SCD traits, while 66,845 suffer from it. One of the reasons for this high level is lack of proper and timely diagnosis and availability of correct treatment.

Although Gujarat has taken the lead in fighting SCD with the goal of achieving zero child birth with SCD by 2020, the state needs to step up investment in health care facilities in rural areas, especially those with a higher concentration of SC/STs.

The maternal nutrition levels are another area of concern, especially in rural Gujarat where instances of women suffering anemia and malnutrition are still high.
In areas of various communicable and non-communicable diseases, the general population lacks access to specialized care in both rural and urban areas of Gujarat.
With the state all set to elect its government for the next five years, it is incumbent of the new cabinet to increase its focus and investment into developing a modern and adequate health ecosystem in the state.

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