Executive Summary:
This document addresses India's healthcare infrastructure, focusing on bed availability relative to population. It outlines the current bed-population ratio, steps taken to meet WHO norms, and government initiatives to increase financial support for healthcare schemes. Data is provided as of March 31, 2023, with budget allocations extending to FY 2025-2026.
Key Points / Main Content:
* **Bed Availability and Standards:**
* Indian Public Health Standards (IPHS) 2022 recommends 1 bed per 1,000 population.
* Specific bed allocations are defined for Ayushman Arogya Mandir Primary Health Centres (AAMPHC), Community Health Centres (CHCs), Sub-District Hospitals, and District Hospitals based on population coverage.
* As of March 31, 2023, there were 8,18,661 beds in PHCs, CHCs, Sub-District Hospitals, District Hospitals, and Medical Colleges. State/UT-wise details are available in the annexure.
* **Government Initiatives:**
* The Central Government assists States/UTs in improving healthcare facilities through various schemes.
* **National Health Mission (NHM):** Provides technical and financial support to States/UTs to strengthen public healthcare systems based on Programme Implementation Plans (PIPs).
* **PM-Ayushman Bharat Health Infrastructure Mission (PMABHIM):** Supports the establishment of 100 and 50-bedded Critical Care Hospital Blocks (CCBs) at district hospitals or medical colleges, and 150-bedded Critical Care Blocks in AIIMS and Institutes of National Importance (INIs).
* **India COVID-19 Emergency Response and Health System Preparedness Package II (ECRP-II):** Sanctioned support to improve bed availability, including ICU beds and Critical Care Blocks.
* **15th Finance Commission (FCXV):** Recommended grants through local governments for health sector components, including PHC AAMs.
* **Pradhan Mantri Swasthya Suraksha Yojna (PMSSY):** Aims to correct regional imbalances in tertiary healthcare and augment medical education facilities through new AIIMS and upgrades to existing Government Medical Colleges/Institutions (GMCIs).
* **Establishment of new Medical Colleges:** 157 Medical Colleges have been approved in the country.
* **Healthcare Workforce:**
* There are 13,86,150 registered allopathic doctors.
* There are 7,51,768 registered practitioners in the AYUSH system of medicine.
* The estimated doctor-population ratio is 1:811, assuming 80% availability of registered practitioners.
* There are 39.40 lakh nursing personnel, resulting in a nurse-to-population ratio of 2.23 nurses per thousand population.
* 5310 Nursing institutions produce approximately 3.82 lakh nursing personnel annually.
* **Budget Allocation:**
* The budget allocation for the Department of Health & Family Welfare has increased from Rs. 83,000.00 crores in 2022-2023 to Rs. 95,957.87 crores in 2025-2026.
* Central releases under the National Health Mission (NHM) have also consistently increased, from Rs. 27,447.56 crores in FY 2021-22 to Rs. 36,529.14 crores in FY 2024-25.
Impact Analysis:
* **State/Union Territories (UTs):**
* *Impact:* Responsible for increasing bed strength in hospitals under their jurisdiction based on requirement and fund availability. Receive central assistance through various schemes.
* *Action Required:* Develop Programme Implementation Plans (PIPs) for NHM, utilize funds from PMABHIM and ECRP-II for infrastructure development, and implement FCXV health sector grants.
* **Central Government (Ministry of Health and Family Welfare):**
* *Impact:* Provides financial and technical support to States/UTs, manages centrally sponsored schemes, and monitors healthcare infrastructure development.
* *Action Required:* Approve proposals under NHM, allocate funds for PMABHIM and ECRP-II, and oversee the establishment of new AIIMS and medical colleges.
* **Healthcare Professionals (Doctors and Nurses):**
* *Impact:* Affected by efforts to improve the doctor-population and nurse-population ratios. Increased availability of institutions.
* *Action Required:* Continue to provide healthcare services and work towards improving healthcare access for the population. The nursing personnel are expected to meet the growing demand in this sector.
Key Entities Referenced
World Health Organization: International organization that sets norms and standards in healthcare, including bed-population ratios.
Indian Public Health Standards (IPHS) 2022: A set of standards for public health facilities in India, including norms for bed availability.
Ayushman Arogya Mandir Primary Health Centre (AAMPHC): Primary healthcare centers established under the Ayushman Bharat scheme, with a specific number of indoor observation beds.
Community Health Centres (CHCs): Secondary level healthcare facilities in India, with a specified number of beds.
National Health Mission (NHM): A centrally sponsored scheme to strengthen public healthcare systems in India.
PM-Ayushman Bharat Health Infrastructure Mission (PM-ABHIM): A scheme aimed at strengthening healthcare infrastructure, including critical care blocks.
India COVID-19 Emergency Response and Health System Preparedness Package II (ECRP-II): A package to address the COVID-19 pandemic, including improving bed availability in public sector hospitals.
Pradhan Mantri Swasthya Suraksha Yojna (PMSSY): A scheme to correct regional imbalances in tertiary healthcare and augment medical education facilities.
GOVERNMENTOFINDIA
MINISTRYOFHEALTH AND FAMILYWELFARE
DEPARTMENTOFHEALTH AND FAMILYWELFARE
LOK SABHA
UNSTARREDQUESTION NO. 1000
TO BE ANSWERED ON25.07.2025
INDIA’SHEALTHCARE INFRASTRUCTURE
1000. THIRU D M KATHIRANAND:
Will the Ministerof HEALTH AND FAMILYWELFAREbe pleasedtostate:
(a) whether it is true that India's healthcare infrastructure is extremely short of WHO norm of
3.5 bedsper1,000people andif so, the detailsthereof;
(b) the detailsof the current population- bedsratiointhe country,State-wise;
(c) the steps taken by the Government to comply with WHO norms in Patient-Doctor ratio,
Patient-Nurse ratio, Beds - population ratio in both Government and Private hospitals in
the country; and
(d) the steps taken by the Government to increase financial support for all the Central Sector
SchemesandCentre Stateschemesinthisregard?
ANSWER
THE MINISTER OFSTATE IN THE MINISTRYOFHEALTH AND
FAMILYWELFARE
(SHRIPRATAPRAO JADHAV)
(a)to(c): As per IndianPublic HealthStandards(IPHS 2022) recommend provision of of 1
bed per 1000 population. As per IPHS norms, Ayushman Arogya Mandir- Primary Health
Centre (AAM-PHC) with 6 indoor/ observation beds is to be established to cover 20,000 to
30,000 population, Community Health Centres (CHCs) with 30 beds to cover population of
80,000-1,20,000, Sub-District Hospitals with 31-100 beds to cover population of 1,00,000 -
5,00,000andDistrict Hospital with 101-500 bedstocover populationupto30,00,000.
Health Dynamics of India (HDI) 2022-23 (Infrastructure & Human Resources), formerlyknown as Rural Health Statistics, based on Health care administrative data reported by
States/UTs states that there were 8,18,661 beds at PHC, CHC, Sub District Hospital, District
Hospital andMedical Colleges inIndia ason31.03.2023.
The State/UnionTerritories (UTs) wise detailsof bedsavailableisprovidedasAnnexure.
It is primary responsibility of the State/Union Territories(UTs) to make efforts for
increasing bed strength in the hospitals under their jurisdiction in accordance with requirement
and fund availability. However, the Central Government provides assistance to the State/UT
Governments in their efforts to provide better health care facilities to people through various
schemes. The detailsof the schemesare asunder:
National Health Mission (NHM): The Ministry of Health and Family Welfare provides
technical and financial support to the States/UTs to strengthen the public healthcare system,
basedontheproposals receivedintheform ofProgrammeImplementationPlans(PIPs)under
National Health Mission. Government of India provides approvalfor the proposal inthe form
ofRecordofProceedings(RoPs)aspernorms&availableresources.
PM-Ayushman Bharat Health Infrastructure Mission (PM-ABHIM): Under the Central
Sponsored Scheme(CSS) components of the scheme,support for 100 and50-bedded Critical
Care Hospital Blocks (CCBs) at district hospitals or medical colleges for an amount of
Rs.18,799.21 Crore have been accorded to States/UTs for FY2021-22 to 2025-26 for setting
up of 621 CCBs. Under Central Sector component of PM-ABHIM, 150 bedded Critical Care
Blocks are envisaged to be established in 12 AIIMS and Institute of National Importance
(INIs).
India COVID-19 Emergency Response and Health System Preparedness Package II
(ECRP-II): The “India COVID-19 Emergency Response and Health System Preparedness
Package”: Phase II for Rs.23,123 Crore. The ECRP-II has the Central Sector (CS) and
Centrally Sponsored Schemes (CSS) components. Centrally Sponsored Schemes (CSS)
includes central Share as well as State Share. Under the Central Sponsored, components
include support to State/UT level through NHM Framework with a State Share as is
applicable in NHM.Under ECRP-II, to respond to the bed availability during Covid-19
pandemic, the following sanctions were given to the States/UTs to improve bed availabilityinPublicSector Hospitals includingMedical Colleges. The detailsare asunder:
Total 37,834 ICU beds inclusive of 9,873 Pediatric ICU Beds, 7,008 Pediatric High
Dependency Unit (HDU) Beds, 20,953 Adult ICU Beds in Medical Colleges, District
Hospitals andSub-Divisional Hospitals.
26 Critical Care Blocks (CCBs) (50 bedded) in Hilly States in the Hilly and North
EasternState/UTs.
15th Finance Commission (FC-XV): The Fifteenth Finance Commission (FC-XV) has
recommended grants through local governments for specific components of the heath sector
to the tune of Rs.70,051 crore. Under FC XV Health Sector Grants, 2673 PHC AAM
approvedfor anamountof Rs 3581.47Cr for FY2021-22 toFY2025-26.
The Pradhan Mantri Swasthya Suraksha Yojna (PMSSY): It aims at correcting regional
imbalances in the availability of affordable teritiary healthcare services and to augment
facilities for quality medical education in the country. The scheme has two components,
namely, (i) Setting up of All India Institute of Medical Sciences (AIIMS); and (ii) Up-
gradation of existing Government Medical Colleges/Institutions (GMCIs). So far setting up
of 22 New AIIMS and 75 projects of upgradation of GMCIs have been approved under the
scheme invariousphases.
Under Centrally Sponsored Scheme for ‘Establishment of new Medical Colleges attached
with existing district/referral hospitals’, a total of 157 Medical Colleges have been
approvedinthe country.
As of now, there are 13,86,150 registered allopathic doctors. The Ministry of AYUSH has
informed that there are 7,51,768 registered practitioners in the AYUSH system of medicine.
Assuming that 80% of registered practitioners in both the allopathic and AYUSH systems are
available,the doctor-population ratiointhe countryisestimated tobe 1:811.
As informed by Indian Nursing Council (INC), there are 39.40 lakh nursing personnel in
the country and assuming 80% active, resulting in a nurse to population ratio of 2.23 nurses per
thousand population. There are 5310 Nursing institutions including 806 government institutions
producing nearly 3.82 lakh nursing personnel annually, to meet the requirement of nursing
personnel inthe country.(d) The three year Budget allocation of funds in Department of Health & Family Welfare is as
under:
(Rs. incrores)
Sl. Financial Year BudgetEstimates
No. (BE)
1 2022-2023 83000.00
2 2023-2024 86175.00
3 2024-2025* 87656.90
4 2025-2026 95957.87
*Actualsupto31.03.2025
The details of Central Release under National Health Mission from FY 2021-22 to FY2024-25
isasunder:
(Rs. incrores)
Sl. Financial Year CentralRelease
No.
1 2021-2022 27,447.56
2 2022-2023 31,278.84
3 2023-2024 33,042.62
4 2024-2025 36,529.14
As evident from the aforementioned tables, the budgetary allocation for Ministry of
Health and Family Welfare and largest CSS scheme under MoHFW, National Health Mission
(NHM) hasconsistently increasedyearon year.
This reaffirms the Government’s commitment to enhancing financial support, with the
aimof improvinghealth outcomesacross the country.
****Annexure-I
NUMBER OFBEDS ATPHC, CHC, SDH,DH & MEDICALCOLLEGES IN INDIA(Rural+Urban)
(Ason31stMarch2023)
SUB
Sl.
State/UT DISTRICT/
No. DISTRICT MEDICAL
PHC CHC SUB
HOSPITAL COLLEGE
DIVISIONAL
HOSPITAL
1 AndhraPradesh 8712 6400 5400 2600 12583
2 ArunachalPradesh 397 594 NApp 1151 350
3 Assam 3166 6218 844 3677 9343
4 Bihar 5596 8039 2459 4575 7251
5 Chhattisgarh 5015 6726 629 3542 4458
6 Goa 183 210 253 600 1342
7 Gujarat 9422 11167 4492 3257 17899
8 Haryana 2183 3079 1581 3647 3660
9 HimachalPradesh 1005 969 3665 1924 2632
10 Jharkhand 1229 3647 534 3215 2900
11 Karnataka 15112 6500 14530 6174 13712
12 Kerala 5727 6371 8347 15113 7175
13 MadhyaPradesh 8640 10590 9721 16650 5850
14 Maharashtra 18276 15004 7903 4108 16998
15 Manipur 420 365 10 551 1449
16 Meghalaya 1127 867 40 1960 594
17 Mizoram 655 240 70 903 500
18 Nagaland 706 325 NApp 1017 NApp
19 Odisha 1501 6290 1946 7288 9291
20 Punjab 1688 3711 2509 3931 3160
21 Rajasthan 13866 23820 2500 9474 17131
22 Sikkim 257 28 NApp 400 NApp
23 TamilNadu 10025 12582 21978 7695 29888
24 Telangana 4662 3320 5400 2270 596025 Tripura 918 630 900 1260 727
26 Uttarakhand 2111 1699 2035 1511 1850
27 UttarPradesh 13548 26157 NApp 22812 14726
28 WestBengal 7640 11205 13110 7599 25086
Andaman &
29 230 210 NApp 220 700
NicobarIslands
30 Chandigarh 23 120 100 527 3096
Dadra & Nagar
31 Haveli and Daman 177 132 100 240 589
&Diu
32 Delhi 12 NApp 431 9789 12060
33 Jammu&Kashmir 3955 2769 NApp 1862 5420
34 Ladakh 320 190 NApp 370 NApp
35 Lakshadweep 40 90 70 50 NApp
36 Puducherry 185 120 NApp 1853 2794
All India/Total 148729 180384 111557 153815 224176
Note: NApp-NotApplicable