Indian rural healthcare centres are so few and so burdened that people are avoiding them

• There is a massive shortage of primary healthcare centres in states like Uttar Pradesh, West Bengal, Jharkhand and Andhra Pradesh.
• A shortfall here means that the number of existing centres are quite less to fulfill the demand for healthcare services in the states.
• Bihar has the highest percentage shortfall in sub-centres.

An average rural family in India spends ₹4,280 towards childbirth at a government hospital. If they choose to go to a private facility, this expense can be as high as ₹27,000, according to a recent State of Inequality report.

Since childbirth is the most common healthcare seeking event for most villagers, a government facility in the vicinity can help. More than half of the population of Bihar – at 58% – does not have access to even a midwife let alone doctors who are usually available at sub-centers. A subcentre also has a male healthcare worker and takes care of basic needs like immunisation.
Healthcare – still a distant dream for most Indian villages
If the rural population needs a doctor, they need to go to a PHC or a primary healthcare center. More than half of the people in Jharkhand, Uttar Pradesh, Andhra Pradesh and West Bengal do not have it.

Yet, a large number of rural areas lack proper healthcare infrastructure – and in particular, the states of Bihar, Jharkhand, Andhra Pradesh, Uttar Pradesh, and West Bengal – which face an acute shortage of PHCs.

A PHC or a primary healthcare center (PHC) is manned by at least one doctor covering a population of 20,000 people, has at least four beds, and is preventive and curative while a sub-center offers very basic services like immunization.

Fewer PHCs means more ‘distance’ in healthcare access and extra burden on existing centres. In fact, Jharkhand has only 291 PHCs, while it needs at least 1,000 to cover its population, according to the report.

State	Shortage
Uttar Pradesh	51%
West Bengal	58%
Jharkhand	73%
Andhra Pradesh	60%

Source: Inequality in India report
A few states however added more medical facilities
On the other hand, some states like Rajasthan, Jammu & Kashmir, Gujarat, and Chhattisgarh have reported a rise in the number of PHCs from 2005, according to the report.

State	No. of PHCs added
Rajasthan	381
Gujarat	407
Jammu and Kashmir	589
Chhattisgarh	275

Source: Inequality in India report
Footfalls going down at rural healthcare centres
The rural population is also becoming increasingly disillusioned with government-provided healthcare services. In a few states, people have started to avoid them.

“Andhra Pradesh has recorded a downfall in all three centres pointing towards a possibility of overburdened healthcare units leading to less interaction with the community, inadequate medical attention to the patients and thinly stretched medical facilities,” the report said referring to sub-centres, PHCs and also community healthcare centers (CHCs).

CHCs house specialists, at least 30 beds and an operation theatre.

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