PUBLIC HEALTH INFRASTRUCTURE IS ‘NERVE CENTRE OF THE PUBLIC HEALTH SYSTEM’: ECONOMIC SURVEY 2023

1.5 LAKH AYUSHMAN BHARAT- HEALTH & WELLNESS CENTRES SET UP BEFORE 31ST DECEMBER 2022, LEADING TO STRENGTHENING OF PRIMARY HEALTHCARE

NOTABLE ENHANCEMENT IN HUMAN RESOURCES, CORE BUILDING BLOCKS OF THE HEALTH SYSTEM

The Economic Survey 2022-23 tabled by Smt Nirmala Sitharaman, Union Minister for Finance and Corporate Affairs has centre staged primary health care and termed public health infrastructure as ‘the nerve centre of the public health system’, forming the basic support system for the last-mile delivery of public health services.  Healthcare infrastructure has been acknowledged as an important indicator for understanding the healthcare delivery provisions and welfare mechanisms in a country.

The Economic Survey highlights the recent health sector reforms that have led to a strengthened health infrastructure in the public sector. This is amply reflected in rise in the number of Sub-centres (SCs), Primary Health Centres (PHCs), and Community Health Centres (CHCs) in rural areas. Under the Ayushman Bharat programme, 1.5 lakh Health & Wellness Centres (HWCs) have been made operational before 31^st December, 2022.  These deliver comprehensive Primary Healthcare services closer to the communities.

Rural healthcare system in India

           

Progress in Health Infrastructure

The Economic Survey 2023 also underlines the notable enhancement in human resources which are the core building blocks of the health system. These include physicians, nursing professionals, pharmacists, midwives, dentists, allied health professionals, community health workers, social health workers and other health care providers, as well as health management and support personnel.

Indicators	2014	2019	2020	2021	2022
Sub-centres (SCs)	152.3	157.4	155.4	156.1	157.9
Primary Health Centres (PHCs)	25.0	24.9	24.9	25.1	24.9
Community Health Centres (CHCs)	5.4	5.3	5.2	5.5	5.5
Doctors at PHCs	27.4	29.8	28.5	31.7	30.6
Total Specialists at CHCs	4.1	3.9	5.0	4.4	4.5
Auxiliary Nurse Midwife at SCs & PHCs	213.4	234.2	212.6	214.8	207.6
Nursing Staff at PHCs & CHCs	63.9	81.0	71.8	79.0	79.9
Pharmacists at PHCs & CHCs	22.7	26.2	25.8	28.5	27.1
Lab Technicians at PHCs & CHCs	16.7	18.7	19.9	22.7	22.8

(Numbers in thousands, as of March each year)

Source: Rural Health Statistics 2021-22, MoHWF

Public health infrastructure central to primary care; expanded Health & Wellness Centres strengthen last mile services and workforce capacity. The Economic Survey 2023 treats public health infrastructure as the nerve centre of the public health system and stresses its role in last mile service delivery. It notes operationalisation of a large network of Health & Wellness Centres under Ayushman Bharat to deliver comprehensive primary healthcare closer to communities and records notable enhancement in human resources across physicians, nurses, midwives, pharmacists, allied and community health workers, supported by trend indicators for rural facilities and staffing levels.