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How Prepared is Indian Health Care?

Kritika Maheshwari
May 14, 2020, 12:22 a.m.

When China reported the first 41 Covid-19 cases to WHO on 31st December 2019, little did anyone know that this number will reach 1 million in next 94 days, next 1 million in further 12 days and next 1 million in yet further 12 days.

While the virus spreads to nearly 188 countries around the globe, the true number of people infected is far from estimation because of lack of testing of patients with mild or no symptoms.

At this time of crisis, it becomes very essential to understand the importance of health infrastructure of India. Ranked 112 among the world by WHO for its medical infrastructure and facilities, India is still far from coming at par with the developed economies of the world.



If the current pandemic has created such a havoc in developed countries like China, Italy and US with the best health infrastructure, it is difficult to imagine what the situation of India would have been with such poor medical facilities if the country had not gone into lockdown.


The official national death figure of India by Covid-19 stands at 32.82 per 1000 people. While this figure does not seem to be very extreme, we should keep in mind the low number of tests that have been conducted till date in the country which amount to nearly 9.75 lakhs as per data provided by ICMR.

Source: Covid-19 India as on 1st May, 2020


The recovery rate of India is 26.89%.

While recovery has been the most in North-Eastern states, the same is very low in those states which had the greatest number of people infected by the virus including Maharashtra, Gujarat, Delhi, Madhya Pradesh, Tamil Nadu, Rajasthan, Uttar Pradesh, Andhra Pradesh etc.

Source: Covid-19 India as on 1st May, 2020


With a population of 1.3 billion, India ranks second among the most populous countries of the world. As per World Bank, India’s health expenditure per capita amounted to only $69.29 as of 2017 while the global average figure stood at $1026.24.

Source: The World Bank – Current Health Expenditure Per Capita in USD as of 2017


As a result of this low expenditure on public health per capita by the government, the population of India spends a massive 62.4% on out-of-pocket expenditure as a percentage of current health expenditure.

This is clearly not a good sign as it indicates that the government is not equipped enough to incur health expenses for its people. It also shows the distrust of the country’s population on public health care infrastructure and facilities.

Source: The World Bank – Out-of-pocket expenditure as percentage of current health expenditure as of 2017


The country has only 0.7 hospital beds per 1000 people while the global average stands at 2.7 hospital beds per 1000 people. This affects people in need of medical emergencies.

Source: The World Bank –No. of Hospital Beds per 1000 people as of 2017



The pandemic Covid-19 has also brought to light the scarcity of doctors in India which are not adequate as per the population size. As per data from The World Bank, India has only 0.8 licensed physicians per 1000 people while the WHO recommended figure is at least 1 physician per 1000 people.

At the same time, the world average figure stands at 1.5 physicians per 1000 people. While Covid-19 affected Italy very badly, the country still had high number of physicians (4.1 per 1000) to help fight the situation.

 Its apparent that if such a massive outbreak happens in India in the near future, there will not be enough physicians and medical staff to save the country and its people.

Source: The World Bank –No. of Physicians per 1000 people as of 2017



While India has a very high population growth rate which is visible by the high birth rate and low death rate, the medical infrastructure and facilities available in India are comparatively not enough. This is visible through various other factors like infant mortality rate and life expectancy at birth.

Source: The World Bank –Birth Rate & Death Rate (per 1000 people) as of 2018


Source: The World Bank –Infant Mortality Rate (per 1000 live births) as of 2018


Source: The World Bank –Life Expectancy at Birth (in years) as of 2018


India possesses a wide range of diversity which is visible across states and union territories.

As per Niti Aayog’s report on Health Index (2019), amongst the larger states, Kerala, Andhra Pradesh and Maharashtra are the best performing whereas Odisha, Bihar and Uttar Pradesh are the worst performing. Amongst the smaller states, Mizoram and Manipur perform well but Arunachal Pradesh and Nagaland perform the worst in terms of healthcare. Chandigarh has the best healthcare facilities in the union territories category whereas Daman & Diu has the worst.


The National Health Profile of India (2019) has discussed about various demographic indicators, socio-economic indicators, health status indicators, health finance indicators, human resources for health and health infrastructure that affect the country.

The birth rate and death rate vary across different states and union territories. Uttar Pradesh and Bihar have the highest birth rate as of 2017 whereas the death rate is mostly uniform with little variation throughout the country.

The infant mortality rate is another demographic factor which helps to analyse the health condition within various states and union territories. As of 2017, this rate was highest in Madhya Pradesh and lowest in Goa.

The medical infrastructure of the country contains many public facilities like Primary Health Centres (PHCs), Community Health Centres (PHCs), Sub-District/Divisional Hospitals (SDHs) and District Hospitals (DHs).

Source: Data as uploaded by States & UTs on HMIS portal as on 20th July 2018

Blood banks form another major part of the medical facilities available in a country. India has 3108 blood banks including government as well as private. This number is quite small. In times like today when India is fighting a Covid-19 outbreak, attention needs to be brought to the insufficient amount of blood banks in the country.

Source: National Health Profile 2019


The presence of government hospitals in the country is also in a very critical situation. While Uttar Pradesh and Karnataka boast of having the highest number, the north-eastern states and the union territories appear to be in a worse situation.

Even the national capital of the country, Delhi does not have adequate number of government hospitals for its entire population while the country total stands at only 23,532 hospitals for 1.3 billion people.

Source: National Health Profile 2019


The presence of government hospital beds in the country by states and union territories is also diverse and varied as can be seen below.

Source: Data as uploaded by States & UTs on HMIS portal as on 20th July 2018


The Indian government incurs health expenditure for the country. This expenditure is varied across different states and union territories.

The health expenditure per capita changes statewise. This number is high for Union Territories as compared to the Indian states.

Source: National Health Profile 2019

It is strange to see that while public expenditure on health per capita is the highest in the Union Territories of the country rather than the states, the result is not visible in the form of improved medical infrastructure. The presence of number of public facilities, government hospitals as well as blood banks do not match the expenditure incurred in these areas.

The main issue at hand is the small amount of expenditure incurred by the Indian government on healthcare including infrastructure and facilities. India spends a very small portion of its GDP on public health as compared to other developed nations of the world. With developed countries like US spending a massive 17.06% of its GDP on public health facilities, India spends only a meagre 3.53%. At the same time, the global average figure stands at 9.9%.

Source: The World Bank – Current Health Expenditure (% of GDP) as of 2017

The recent Covid-19 outbreak has changed the outlook towards health and healthcare industry. It has made us realise that the health of one member of the society affects the other. So, the healthcare facilities need to be further widened to include the poor and deprived classes of the society. The health of a country determines its wealth, which can be seen by the current erosion of wealth because of the lockdown.

In the current situation of pandemic, India appears to be sitting on a ticking time bomb. The combination of high population and low healthcare facilities have proved to be a major hurdle for the Indian government.

This can only be eliminated if more importance is given to health by the government in the coming years. Large expenditure to boost the country’s medical infrastructure along with large number of reforms will ensure India’s readiness to fight any future pandemics




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