Health, Health Infrastructure-2/”>INFRASTRUCTURE and Health Policy of Himachal Pradesh:-
Himachal Pradesh has a Population of 6,856,509 including 3,473,892 males and 3,382,617 females as per the provisional results of the Census Of India 2011. Himachal Pradesh is ivided into 12 districts namely, Kangra, Hamirpur, Mandi, Bilaspur, Una, Chamba, Lahaul and Spiti, Sirmaur, Kinnaur, Kullu, Solanand Shimla. It has 244,587 schedule tribes population which is 28% of the total population.
Health Infrastructure of Himachal Pradesh:-
Himachal Pradesh has been India’s quintessential rural health success story. At 90 percent, it has the highest proportion of rural population among Indian states. At the same time, when compared to other states with similar rural populations, Himachal has, on the Average, better Human Development 
indicators. It has been among India’s best states in terms of HDI along with Kerala and Delhi, and despite its high rural population, achieved replacement level of Total Fertility Rate, quite early on. Only Kerala, Jammu and Kashmir, Delhi and Punjab have a higher life expectancy at birth than Himachal among the bigger states of India. It is a comparatively richer state, with a GSDP per capita similar to Gujarat, Tamil Nadu and Kerala. The State Commission of Health, constituted in 2014 with prominent experts as members, focused on developing inter-sectoral strategies required to address environmental, nutritional and social determinants of health as a part of the overall development of the state, among other things. Himachal is the state with the highest government health spending per capita in India, and the focus on public spending has made the state the second lowest in the country in terms of Percentage out of pocket health expenditure. Himachal Pradesh can be put in direct contrast with Kerala, a state with which it competes for the top slot in terms of best human development in the country. Kerala spends only half of what Himachal spends in terms of public expenditure on health per capita, and has the highest percentage out of pocket health expenditure in the country.
While household reporting catastrophic health expenditure in Kerala is 20.4%, the highest in the country, it is 13.1% in Himachal, near the all India average. The percentage of private sector inpatient cases is 22.9% in the state, among the lowest in the country. Kerala on the other hand has 66.1% inpatient load treated by the private sector. This almost exclusive policy focus on the public sector makes Himachal unique among the relatively richer states of India, who on the average are identifiable by a dominant private sector. Himachal is one among a few Indian states where as per population norms, there is no shortfall of Sub Centres, PHCs or CHCs. The state was formed in 1971 by combining parts of Punjab and the erstwhile Union Territory. From the beginning, the state went for rapid expansion of its public primary health care infrastructure as shown in Graph 1. During the same period, Himachal also managed to increase the number of Sub Centres from 1299 to 2071. Himachal, with just .57% of India’s population, has more sub-divisional hospitals than Bihar — a state with 8.58% of India’s total population.
However, despite such strong performance on the physical infrastructure front, Himachal health system is reeling under severe staff shortages. Graph 2 shows the current shortfall across the frontline health workers for Himachal.
As Graph 3 shows, the shortage of doctors is acute in the public sector hospitals in the state, particularly specialists. Around 20% of Himachal’s PHCs function without an allopathic doctor. Only 95 PHCs have a female doctor. Alternative medicine is not filling up the void either — out of 518 functioning PHCs in the state, only 44 have AYUSH facility. The shortage of specialists (surgeons, OB&GY, physicians & paediatricians) are at an alarming level: out of a required number of 316 specialist doctors, only seven are in position in the state. The doctors at PHCs and the General Duty Medical Officers (GDMOs) in the CHCs (220 of a required 234 in position) are the mainstay of the state’s health system, handling most of the disease burden.
As Graph 4 shows, the shortage of nursing staff as well as the lack of allied health workers render a significant proportion of the state’s public sector healthcare delivery system ineffective. A considerable number of PHCs and CHCs work without nurses, radiographers, pharmacists, or lab technicians.
Given the relatively smaller footprint of the private sector in the state, such severe staff shortages — despite a high per capita public health spending by the state — can have disastrous implications on the health of the citizens. Given these gaps like 98% of shortfall in specialists, it is puzzling that in FY 2014-15, expenditure on human Resources constituted only seven percent in the overall NRHM expenditure in the state — the lowest in the country.
There are many hospitals situated all over the state. To name a few, Zonal Hospital, Dr. RPMC Hospital, Delek Hospital in Dharamsala region, Civil Hospital (Chaupal, Jubbal, Junga, Kotgarh, Nerua, Rohru, Sarahan Rampur, Theog), Ddu Zonal Hospital (Shimla), Indira Gandhi Hospital (Shimla), Indus Hospital, Kamla Nehru Hospital (Shimla), Mahatma Gandhi Medical Services Complex Khaneri (Rampur), Shri Ram Hospital in Shimla. Mandav Hospital, Banga Diagnostics MRI, Banga Associated Eye Hospital are situated in Mandi region. PPR Memorial Hospital and Civil Hospital are located in Sarkaghat. Kullu Valley Hospital is functioning in Kullu area. Eshan Eye Hospital and 32 PEARLS Implant & Orthodontic Dental Hospitals are serving in Una region.
Health performance over the last decade:-
The latest information on Himachal’s Nutrition/”>Health and Nutrition indicators are available from the NFHS-4 survey, fieldwork for which was conducted in 2016. The survey gathered information from 9,225 households, 9,929 Women, and 2,185 men. According to the survey, the sex ratio of the state improved from 1070 in 2005-06 to 1078 in 2016. Himachal also has managed to have all its households access to electricity. Proportion of households with improved sanitation facility doubled over the last decade – from 37.2% to 70.7%. Health insurance coverage has improved by five times over the last decade — as well to 25.8% of households with at least one member covered by a health scheme or health insurance. However, both infant mortality as well as under-five mortality reductions in the last decade have been slow. Graph 5 and 6 show that even when compared to the improvements in the country Averages, the state’s success was rather limited.
While the indicators of maternal health and delivery care have shown considerable improvement, the proportion of children aged 12 to 23 months who have been fully immunised has in fact gone down, from 74.25% in 2005-06 to 69.5% in 2016, which is a matter of major concern. The district level exploration of immunisation achievement, tried in Map 1, gives a picture of stark district level disparities. Hamirpur has the lowest immunisation coverage at 45.9% while Shimla has the highest at 87.3%. Bilaspur, Lahul and Spiti as well as Una districts have lower than 60% coverage of full immunisation.
The proportion of institutional births has almost doubled over the last decade — from 43.1% to 76.4%. However, the overall achievement still remains lower than the India average, and there are considerable district level differences as explored in Map 2. Hamirpur happens to be the best performer with 90.9% institutional births, and the Chamba district is the lowest performer with only 56.9% institutional births. Home deliveries conducted by skilled health personnel — considered to be safe — are very low at 3.6%, putting the overall proportion of safe deliveries at 60.5% in Chamba. Home deliveries conducted by skilled health personnel remains very low in the state at 3.4%, linked directly to the health worker shortages.
The low proportion of immunisation in itself need not be a symptom of health system failure, as seen in the case of Hamirpur and Bilaspur districts who managed high levels of institutional births nevertheless. A priority of the next government must be to identify low uptake of immunisation in specific pockets and remedying it.
Health Policy of Himachal Pradesh:-
Mukhya Mantri State Health Care Scheme:-
The Himachal Pradesh government has launched Mukhya Mantri State Health Care Scheme (MMSHCS) in 2016. The MMSHCS is designed for those who are not enrolled under Rashtriya Swasthya Bima Yojna(RSBY) or other medical reimbursement scheme. The State had targeted most vulnerable population to provide health coverage under MMSHCS. The estimated beneficiaries of the scheme will be more than 2, 00, 000 families. The Scheme mainly covers 9 Categories as listed below:-
- Senior Citizens (80 years and above)
- Ekal Naris
- More than 70% disabled persons
- Contractual employees (Government, autonomous bodies, societies, Corporations, and boards)
- Part-time workers (Government, autonomous bodies, societies, Corporations, and boards)
- Daily-wage workers (Government, autonomous bodies, societies, Corporations, and boards)
- Anganawari Workers
- Anganawari Helpers
- Mid-day Meal workers
The people who are not covered under RSBY or any other medical reimbursement scheme are eligible to get enrolled under this scheme.
HIMACHAL PRADESH UNIVERSAL HEALTH PROTECTION SCHEME:-
The governement of Himachal Pradesh had announced the new scheme “Himachal Pradesh Universal Health Protection Scheme” on March 8th 2016. The Scheme will cover the all persons who are not enrolled under RSBY, Mukhya Mantri State Health Care Scheme or any other medical reimbursement schemes. The scheme is launched in order to improve the accessibility and affordability to health care services to people the the State. The beneficiaries will require to pay Rs. 1 per day i.e. Rs. 365 per annum for their health protection.
Benefits of UNIVERSAL HEALTH PROTECTION SCHEME;-
- The scheme will provide Rs. 30000/- health protection under Basic package
- And Rs. 1, 75, 000/- under Critical Care package.
- 50, 000 Top up for cancer cases
Mukhyamantri Vidyarthi Swasthy Karyakaram:-
The school health programme in H.P will address the heath needs of the school children in the form of health Education , Environment sanitation , nutrition , Safe drinking water, gender and social concern . The state of H.P will utilize strategies of disease prevention , health promotion as well as detection of underlying diseases and medical advice for health problems.
Matri Seva Yojna:-
The State Government of Himachal Pradesh launched Matri Seva Yojna providing pregnant women of the State, facility for free institutional delivery in all the government health institutions in the State. The scheme aimed at ensuring the health of the mother and child.Besides free institutional delivery, life saving drugs is also being made available free to the patients.
Electronic Health Card Scheme:-
Himachal Pradesh Health Department launched in april 2017 six new health schemes including the Electronic Health Card Scheme. Under this scheme, free insulin will be provided to diabetic patients below 18 years of age under universal immunization program. Himachal has become the first state in South East Asia to launch electronic health cards. Few lakh people, not covered under any scheme, were now brought under the ambit of Universal Health Scheme. Other schemes include the HP Universal Health Protection Scheme, a health bulletin brochure, a scheme for free treatment of Hemophilic patients, screening scheme for patients of non-communicable disease and introduction to ‘Measles Rubella (MR) campaign.
Senior Citizen Health Insurance Scheme (SCHIS):-
The Himachal Pradesh Government has implemented the Senior Citizen Health Insurance Scheme (SCHIS) in the state with an aim to provide access to curative geriatric health care services by way of additional insurance cover. The scheme will provide top-up coverage of Rs. 30,000 per senior citizen to all existing Rashtriya Swasthya Bima Yojna smart card holders in addition to basic coverage of Rs.30, 000 in Trust/Society mode. Any beneficiary who is 60-years-old or above and is currently enrolled in RSBY or will be enrolled in RSBY is eligible for these additional benefits. If in any RSBY rolled family, there is more than one senior citizen, then the additional cover will be multiples of Rs.30, 000 per senior citizen that will be provided on a floater basis among the senior citizens of the RSBY enrolled family.
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Himachal Pradesh is a state in India that is known for its beautiful scenery and its healthy lifestyle. The state has a strong focus on preventive healthcare, and its residents enjoy a relatively high standard of health.
The state’s health infrastructure is well-developed, with a Network of hospitals, clinics, and dispensaries. The government provides free healthcare to all residents, and there is also a private healthcare sector that is growing rapidly.
The state’s health policy is focused on promoting healthy lifestyles, preventing disease, and providing quality healthcare to all residents. The government has implemented a number of programs to achieve these goals, including the following:
- The National Health Mission (NHM) is a centrally sponsored scheme that aims to improve the health of the people of India. The NHM is implemented in Himachal Pradesh by the state government, and it provides a range of services, including preventive healthcare, curative healthcare, and reproductive and child health services.
- The Rashtriya Bal Swasthya Karyakram (RBSK) is a national program that aims to improve the health of children in India. The RBSK is implemented in Himachal Pradesh by the state government, and it provides a range of services, including immunization, nutrition, and health education.
- The Pradhan Mantri Jan Arogya Yojana (PMJAY) is a national health insurance scheme that aims to provide free healthcare to all poor families in India. The PMJAY is implemented in Himachal Pradesh by the state government, and it provides a range of services, including hospitalization, surgery, and diagnostic tests.
The state’s health system is facing a number of challenges, including the following:
- The state’s population is growing rapidly, which is putting a strain on the health infrastructure.
- The state’s economy is not growing as fast as the population, which is making it difficult to finance the health system.
- The state’s health workforce is not adequate, and there is a shortage of doctors, nurses, and other healthcare professionals.
- The state’s health system is not well-integrated, and there is a lack of coordination between the different levels of government and the private sector.
Despite these challenges, the state’s health system is making progress in improving the health of the people of Himachal Pradesh. The government is committed to providing quality healthcare to all residents, and it is working to address the challenges that the health system is facing.
The following are some of the key achievements of the state’s health system in recent years:
- The state’s infant mortality rate has declined from 60 per 1,000 live births in 2000 to 28 per 1,000 live births in 2018.
- The state’s maternal mortality rate has declined from 250 per 100,000 live births in 2000 to 100 per 100,000 live births in 2018.
- The state’s immunization coverage has increased from 60% in 2000 to 90% in 2018.
- The state’s life expectancy has increased from 65 years in 2000 to 70 years in 2018.
The state’s health system is facing a number of challenges, but it is also making progress in improving the health of the people of Himachal Pradesh. The government is committed to providing quality healthcare to all residents, and it is working to address the challenges that the health system is facing.
Here are some frequently asked questions and short answers about Himachal Pradesh:
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What is the capital of Himachal Pradesh?
The capital of Himachal Pradesh is Shimla. -
What is the population of Himachal Pradesh?
The population of Himachal Pradesh is 8,706,296 as of 2020. -
What is the language spoken in Himachal Pradesh?
The Official Language of Himachal Pradesh is Hindi. However, there are many other languages spoken in the state, including Punjabi, Pahari, and Gaddi. -
What is the religion of Himachal Pradesh?
The majority of people in Himachal Pradesh are Hindu. However, there are also significant Muslim, Sikh, and Christian minorities. -
What is the economy of Himachal Pradesh?
The economy of Himachal Pradesh is based on agriculture, tourism, and manufacturing. The state is also a major producer of hydroelectric power. -
What are some of the tourist attractions in Himachal Pradesh?
Some of the most popular tourist attractions in Himachal Pradesh include the Shimla Hill Station, the Kullu Valley, and the Manali Valley. -
What are some of the famous people from Himachal Pradesh?
Some of the most famous people from Himachal Pradesh include the former Prime Minister of India, Indira Gandhi, and the former Chief Minister of Himachal Pradesh, Virbhadra Singh. -
What are some of the challenges facing Himachal Pradesh?
Some of the challenges facing Himachal Pradesh include POVERTY, illiteracy, and Unemployment. The state is also facing the threat of Climate change. -
What are some of the achievements of Himachal Pradesh?
Some of the achievements of Himachal Pradesh include its high Literacy rate, its low crime rate, and its clean environment. The state has also made significant progress in the areas of education, health, and infrastructure. -
What is the future of Himachal Pradesh?
The future of Himachal Pradesh looks bright. The state has a strong economy, a well-educated population, and a beautiful environment. With continued Investment in education, health, and infrastructure, Himachal Pradesh is poised to become one of the most developed states in India.
Question 1
Which of the following is not a component of the health infrastructure in Himachal Pradesh?
(A) Hospitals
(B) Primary health centers
(C) Community health centers
(D) Medical colleges
Answer
(D) Medical colleges
Explanation
The health infrastructure in Himachal Pradesh consists of hospitals, primary health centers, and community health centers. There are no medical colleges in Himachal Pradesh.
Question 2
Which of the following is not a goal of the health policy of Himachal Pradesh?
(A) To provide universal health coverage
(B) To improve the quality of health care
(C) To reduce the cost of health care
(D) To increase the number of hospitals
Answer
(D) To increase the number of hospitals
Explanation
The goals of the health policy of Himachal Pradesh are to provide universal health coverage, improve the quality of health care, and reduce the cost of health care. The number of hospitals is not a goal of the health policy.
Question 3
Which of the following is not a challenge faced by the health system in Himachal Pradesh?
(A) Lack of access to health care
(B) Poor quality of health care
(C) High cost of health care
(D) Shortage of doctors
Answer
(A) Lack of access to health care
Explanation
The health system in Himachal Pradesh is well-developed and provides access to health care to all citizens. The other Options are challenges faced by the health system.
Question 4
Which of the following is not a measure taken by the government of Himachal Pradesh to improve the health system?
(A) Increasing the number of hospitals
(B) Providing free health care to the poor
(C) Training more doctors
(D) Building more primary health centers
Answer
(A) Increasing the number of hospitals
Explanation
The government of Himachal Pradesh has taken a number of measures to improve the health system, including providing free health care to the poor, training more doctors, and building more primary health centers. Increasing the number of hospitals is not a measure taken by the government.
Question 5
Which of the following is not a result of the government’s efforts to improve the health system?
(A) Increase in life expectancy
(B) Decrease in infant mortality rate
(C) Increase in the number of people with access to health care
(D) Decrease in the number of people with chronic diseases
Answer
(D) Decrease in the number of people with chronic diseases
Explanation
The government’s efforts to improve the health system have resulted in an increase in life expectancy, a decrease in infant mortality rate, and an increase in the number of people with access to health care. The number of people with chronic diseases has not decreased.