Owing to the high rate of Maternal Mortality Rate and Infant Mortality Rate, 392 and 50 respectively in Uttar Pradesh, the Central Government of India launched Aarogyam, a technology based initiative. First to be launched in Uttar Pradesh to curb the mortality rates in 2008, Aarogyam leverage the use of technology for efficient healthcare delivery in the state (Khurana 2014). An ICT based responsive system, Aarogyam ensures active participation of all key stakeholders such as, local administration, doctors, frontline health workers like ASHA (Accredited Social Health Activists), village heads and beneficiaries (OneWorld Foundation India 2012). Through joint participation it ensures that a pregnant woman is provided with Ante-natal Care, Post-natal care and children are given complete immunisation.
Based on the report of the World Bank which emphasised on the need to develop the healthcare sector of India, the project Uttar Pradesh Health system Development Project (UPHSDP) was launched. The time frame of the said project was July 2000 to December 2005, with a total estimated cost of US$ 109.65 million (478.07 crores). The coverage area was entire state, with infrastructure development (technological innovation) and capacity building of 117 facilities across 28 districts (Jahan 2009). The project also emphasized on policy reforms, skill development of human resources with public-private partnerships. But the project was unable to meet its goal of reaching every area of the state with appropriate healthcare facilities, making the achievement partial.
|Region||Total population||Population benefitted||% benefitted|
Percentage population served under the UPHSDP project. (Source: Jahan, 2009. visit: http://ehealth.eletsonline.com/2012/07/ict-requirements-for-strengthening-primary-healthcare/ for further insights).
Present condition of health care facility in Uttar Pradesh
The healthcare sector of India is a significant area, which needs considerable development, as “improved health status of individuals not only indicates greater human development but also is an important parameter of economic development” (Iyengar & Dholakia 2011; 1). Presently, as the given conditions suggest, the population of the country is on constant rise, with nearly 18 million people added per year (Kapilashrami 2000). Such significant rise in population poses as an important determinant in the economic well-being of the country, which can be achieved through effective policies and its implementation in every sector. Introduction of reform policies such as, the National Rural Health Mission (NRHM), Mission Indradhanush, Uttar Pradesh Health System Strengthening Project (UPHSSP), State Innovations in Family Planning Services Project Agency (SIFPSA) and Uttar Pradesh AIDS Control Society (UPAIDS) along with an extensive infrastructural network of Medical and Health services in the government as well as private sectors have intended to meet the demand for health services in the state (Jahan 2009; Department of Economic Affairs 2015). The healthcare sector, similar to the rest of the country is divided into three tiers— primary, secondary and tertiary, each having its own health centers at both rural and urban region.
The present healthcare sector report projects an increase in crude birth rate, crude death, maternal mortality rate and infant mortality rate in comparison to the entire country (National Health Mission 2015). Such determinants place the state in underdeveloped position in comparison to other states (Gangoli et al. 2005). The table below reflects the present health scenario in Uttar Pradesh and India, resulting in comparative understanding.
|Primary Health Centre||5172||3692||1480|
|Community Health Centre||1293||515||778|
|Health worker (Female)/ANM at Sub Centers & PHCs||24213||22464||1749|
|Health Worker (Male) at Sub Centers||20521||1729||18792|
|Health Assistant (Female)/LHV at PHCs||3692||2040||1652|
|Health Assistant (Male) at PHCs||3692||4518||*|
|Doctor at PHCs||3692||2861||831|
|Obstetricians & Gynecologists at CHCs||515||475||40|
|Pediatricians at CHCs||515||547||*|
|Total specialists at CHCs||2060||1740||320|
|Radiographers at CHCs||515||181||334|
|Pharmacist at PHCs & CHCs||4207||5582||*|
|Laboratory Technicians at PHCs & CHCs||4207||1836||2371|
|Nursing Staff at PHCs & CHCs||7297||2627||4670|
Infrastructure of Healthcare sector of Uttar Pradesh (Source: National Health Mission, 2015)
|YEARS||O.P.D (in lakhs)||I.P.D. (in lakhs)|
In & out Patient treated in District health centres of Uttar Pradesh (2005-07). (Source: Department of Medical Health & Family Welfare, 2008)
As per the Ministry of Home Affairs’ (2011) Census report, total population of Uttar Pradesh in 2008 was 190,891 thousand, which rose to approximately 204.2 million in 2012. But from the above table it is seen that significant shortfall exists in meeting the required target in terms of health centers and medical staff, affecting the quality of service and meeting of demands that arises.
Observing the necessity to improve the present state of healthcare scenario in Uttar Pradesh, it is deemed fit for the Health Department of the state, along with relevant authorities to implement digital healthcare in the sector. Such an initiative will enable local population to take self-care of relatively pettier health issues, instead to depending on the professionals. Consequently, there will be less crowd and waiting queues in the healthcare centers, which will not only save time of the locals (including the aged), but will also enable the professionals to devote time and resources to serious patients.
Concluding remarks and future healthcare initiatives
Uttar Pradesh, given its large population and land is full of opportunities with thriving IT industry, infrastructural facilities, such as roads and highways for efficient communication. Besides, there has been considerable growth in Public-Private Partnership (PPP) and Foreign Direct Investment (FDI) for future development of healthcare sector. In such an immense potential growth of Healthcare sector, India should adopt certain future initiatives with an ability to meet the rural healthcare— expected to expand at a pace of 44% by 2015, totaling its worth to US$ 8.8 billion (McKinsey&Co. 2012). Certain initiatives which needs to be dealt for future development includes:
- Making the present telemedicine sector user-friendly, thus making it efficient to handle the ongoing demands. An intelligent telemedicine system is required to competently identify the patients that require immediate care to be linked with right specialist/physician.
- In today’s age most of the rural community possess a basic Android based cell phones, with additional features of camera, Bluetooth with built 3G support. The applications based on health sector, hence are supported by the mobile phones, making access to facilities easier and also recording the patients’ blood pressure, temperature, ECG and blood sugar, thereby storing information about patients. Such in-built applications can be seen in Samsung and Apple phones.
- The applications on mobile phones furthermore upload the patient details and vitals collected through sensors to hospital information system from remote location. Besides, the SOS alert mechanism within the applications will inform the specialist/doctor, whenever a vital sign cross the threshold that is life threatening or indicating a serious disorder.
- Developing a cloud system, through which patients’ information will be stored with their real time vitals and physicians can access them across the globe. This will help save the patients’ life in critical situation by establishing communication with the patient/paramedic/nurse instantaneously by directly connecting to peers mobile device.
To summarize the future initiatives, India needs to adopt a state-of-the-art platform for citizens, hospitals and healthcare professionals, investing a larger share of the budget in the weaker sector, thereby making its human resource (citizens) the healthiest.
- Department of Economic Affairs, 2015. Economic Survey 2014-15: Volume II, New Delhi. Available at: http://www.indiabudget.nic.in/es2014-15/echapter-vol2.pdf [Accessed September 5, 2015].
- Department of Medical Health & Family Welfare, 2008. Progress Report of Department of Medical Health & Family Welfare, Lucknow. Available at: http://uphealth.up.nic.in/Transfer/depprogress.pdf [Accessed January 11, 2016].
- Gangoli, L. V, Duggal, R. & Shukla, A., 2005. Review of Healthcare In India, Mumbai. Available at: http://www.cehat.org/publications/PDf files/r51.pdf [Accessed September 5, 2015].
- Iyengar, S. & Dholakia, R.H., 2011. Access of the Rural Poor to Primary Healthcare in India, Ahmedabad. Available at: http://www.iimahd.ernet.in/assets/snippets/workingpaperpdf/3937368102011-05-03.pdf [Accessed September 5, 2015].
- Jahan, B.I., 2009. Public Private Partnership in Uttar Pradesh Health Care Delivery System- UPHSDP as an Initiative. In T. Barai-Jaitly, ed. Emerging health care models: Engaging the private health sector. Lucknow: CEHAT, pp. 1–18. Available at: http://www.cehat.org/go/uploads/PPP/bibisratpaper.pdf [Accessed September 5, 2015].
- Kapilashrami, M.C., 2000. REVIEW OF THE PRESENT HEALTH STATUS OF INDIA, EMERGING HEALTH PROBLEMS AND THEIR SOLUTIONS. Health and Population: Perspectives and Issues, 23(1), pp.1–10. Available at: http://medind.nic.in/hab/t00/i1/habt00i1p1.pdf [Accessed September 5, 2015].
- Khurana, M., 2014. AAROGYAM – An ICT-based community-centric approach for improving Reproductive and Child Health, New Delhi. Available at: https://negp.gov.in/pdfs/c1.pdf [Accessed September 5, 2015].
- McKinsey&Co., 2012. India healthcare: Inspiring possibilities, challenging journey,
- Ministry of Home Affairs, 2011. Census India, New Delhi. Available at: http://censusindia.gov.in/Census_Data_2001/Projected_Population/Projected_population.aspx#2008 [Accessed January 11, 2016].
- National Health Mission, 2015. Uttar Pradesh – Governnment of India, New Delhi. Available at: http://nrhm.gov.in/nrhm-in-state/state-wise-information/uttar-pradesh.html#health_profile [Accessed September 5, 2015].
- OneWorld Foundation India, 2012. Aarogyam Digital Health Mapping and Service Delivery, New Delhi. Available at: http://indiagovernance.gov.in/files/gkc_oneworld_aarogyam.pdf [Accessed September 5, 2015].