Privatisation of Health Care in India - Indian Institute of Public ...

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Privatisation of Health Care in IndiaTable 6: Distribution of Outpatient Treatment Over Sources of Treatment forStates/U.T. (Rural)States/UTs Public Primary Public Private Nursing Charit- ESI Private Other AllHospital Health Dispen- Hospital Home able Doctor DoctorCentre sary HospitalAndhra Pradesh 14.38 3.15 1.39 32.12 2.52 0.22 1.09 40.05 5.08 100Assam 20.01 16.24 16.76 7.21 0.01 - - 28.17 11.6 100Bihar 13.04 2.05 1.75 9.86 0.58 0.26 0.03 59.04 13.39 100Gujarat 25.28 4.64 2.5 20.89 0.1 2.8 0.08 40.77 2.94 100Haryana 11.94 3.28 1.68 8.52 0.8 0.35 - 68.79 4.64 100Himachal Pradesh 48.7 6.23 5.74 1.84 0.7 - - 35.79 1 100Jammu & Kashmir 37.78 5.33 15.68 0.24 - 0.07 0.99 2.37 7.54 100Karnataka 25.72 8.47 1.27 18.48 1016 0.17 0.94 41.51 21.28 100Kerala 27.5 4.32 2.32 41.64 1.04 0.11 0.38 20.57 2.12 100Madhya Pradesh 20 8.49 2.4 12.39 0.62 0.23 1.87 49.62 4.38 100Maharashtra 14.03 10.42 1.44 19.54 0.16 0.78 0.43 51.04 2.16 100Manipur 20.61 31.08 8.53 1.91 - - - 8.5 19.37 100Meghalaya 10.22 24.63 8.15 0.22 - 1.19 - 34.54 21.07 100Orissa 34.01 11.93 6 ** - 0.51 0.71 31.39 19.35 100Punjab 9.72 1.3 1.52 9.53 0.06 0.22 0.23 76.58 0.84 100Rajasthan 38.23 6017 11.04 7.84 0.72 0.07 0.68 27.39 7.86 100Sikkim 72.68 7.57 2.95 2.23 - - - 14.57 - 100Tamil Nadu 30.41 4.93 0.85 20.32 3.04 1.63 0.85 33.13 4.84 100Tripura 19.48 10.41 7.35 1.62 - 0.73 - 31.72 28.69 100West Bengal 12.48 6 0.89 0.93 0.17 0.18 0.04 74.74 4.49 100Chandigarh 10.95 - - - - - 10.95 78.09 - 100Dadar & Nagar Haveli 65.34 7.96 - 5.65 - - - 19.06 1.99 100New Delhi 30.73 3.23 - 14.69 - - - 51.35 - 100Goa, Daman & Diu 30.8 24.72 - 15.79 - - 28.69 - 100Mizoram 24.68 42.6 18.18 - 1.19 - - 0.48 12.87 100Pondicherry 46.51 8.63 1.84 9.62 - - 1.18 32.22 - 100Andaman & Nicobar 77.74 8.17 8.08 - - - - 1.57 4.44 100Lakshadweep 41.23 43.39 - 15.38 - - - - - 100INDIA 17.67 4.94 2.59 1.03 0.75 0.35 0.38 53.01 5.18 100Note: Percentages may not add up to 100 due to rounding off figures.Source: Morbidity and Utilisation of Medical Services, Report 364, 42 nd Round, National Sample Survey, Central Statistical Organisation, Government of India (1989),cited in Baru (1998).castes (SC), scheduled tribes (ST) and other groups separately.The data has also been analysed across major states.For antenatal care, which comes under outpatient consultations,at the all India level for the SC and ST categories,42 percent and 28 percent respectively, received antenatalcare from trained personnel, while only 14 percent and18.5 percent received care from trained personnel at theirhomes. It is important to note that 42.2 percent of SC and52.3 percent of ST households did not receive antenatalcare at all. The states of Maharashtra, Karnataka and Orissapresented wide variations. In Maharashtra, 10.3 percent ofSC households, 29.6 percent of ST households and 11.118
Utilisation of Private Health Servicespercent belonging to ‘others’ received antenatal care fromhealth personnel at their homes; 65.5 percent of SCs, 44.4percent of STs and 44.5 percent of ‘others’ received antenatalcare from trained personnel. In Karnataka, 24.7 percentof SCs, 20.5 percent of STs and 17.5 percent of othersreceived antenatal care at home, while 56.8 percent ofSCs, 58.1 percent STs and 66.4 percent of ‘others’ receivedantenatal care from trained personnel. In Orissa, 30.6 percentof SCs, 30 percent of STs and 18.9 percent of ‘others’received antenatal care from a health worker at home,while 35.3 percent of SCs, 22 percent of STs and 44.5percent of ‘others’ used the services of trained personnelfor antenatal care. There is clearly a variation in the utilisationof services across these three states. In all three states, thepercentage of households receiving care at home fromtrained personnel is low and in general the access to theseservices by STs is lower than for SCs. Across the threestates the levels of utilisation for antenatal care are extremelypoor (Ram et al, 1997. See Table 7).In the case of children suffering from fever, a fairly highproportion of households go to a nearby provider orhealth facility. At the all India level 66.7 percent of SCs,55 percent of STs and 68.2 percent of ‘others’ used thefacility nearby. Across states, the percentage of utilisationis high. It is found that in Karnataka, 72.3 percent ofSCs, 84 percent of STs and 76.7 percent of ‘others’ usedthe nearby health facility. In Maharashtra, 60 percent ofSCs, 68 percent of STs and 77.5 percent of ‘others’ usedthe providers. In Orissa, 51.7 percent of SCs, 41.6 percentof STs and 57.4 percent of ‘others’ used the providerfor treating their children. This data suggests thatpeople from all the three categories use the services; butthere is variation across states. While the percentage utilisingthe services is fairly high for all the three categories inMaharashtra and Karnataka, it is quite low in the case ofOrissa (Table 8).Table 7: State-wise Distribution of Access to Antenatal CareIndia /States ANC only at home Trained Personnel No ANCfrom health workerSC ST Others SC ST Others SC ST OthersINDIA 14 18.5 11.9 42.4 28.3 53 42.2 52.3 34A.P. 24.1 29.8 18.3 61.9 32.4 65.9 11.5 35.5 12.2Assam NA 0.8 3 63.6 30.3 49.3 36.4 68.9 47.2Bihar 13.4 6.4 9.7 21.2 14.8 28.3 63.6 78.8 60.8Goa NA 7.1 1.3 87.5 88.1 94 12.5 4.8 3.8Gujarat 19 39.4 22.6 62 28.3 54.2 15 31.5 22.6Haryana 5.6 NA 5.2 61.5 NA 69.4 32.8 NA 25H.P. 2.1 3.8 1.5 70.3 54.5 76.6 27.6 41.6 21Jammu 1.3 NA 0.6 74.7 NA 79.7 24 NA 18.5Karnataka 24.7 20.5 17.5 56.8 58.1 66.4 18.6 20.5 15.1Kerala NA 2.9 0.6 96.9 82.9 97 3.1 8.6 1.7M.P. 13.5 20.2 14 41.2 19.3 44 43.4 59.2 41.1Maharashtra 10.3 29.6 11.1 65.5 44.4 73 22.8 26.1 15.5Orissa 30.6 30 18.9 35.3 22.2 44.5 32.2 46.1 35.5Punjab 2 NA 1.7 85.3 NA 86.1 12.8 NA 11.8Rajasthan 4.2 14.3 7.1 17.2 16.9 27.7 76.7 68.5 63.1T.N. 25.9 13.6 65.5 81.3 8.3 NA 4.7U.P. 14.9 3.9 14.4 21.9 11.4 32.4 62.9 84.6 52W.B. 6.1 6.7 6.7 60.6 61 69.6 33.3 32.3 23.1Source: Utilization of Health Care Services by the Underprivileged Section of the Population in India: Results from NFHS, cited in Ram, Pathak and Annamma (1997).19
Page 3 and 4: Table of Contents123456Introduction
Page 5 and 6: Chhattisgarh Infrastructure ReportL
Page 7 and 8: Table of Contents123456Introduction
Page 9 and 10: Privatisation of Health Care in Ind
Page 11 and 12: Globalisation and Health Services:
Page 13 and 14: 3Private Health Services in India:A
Page 15 and 16: Private Health Services in India: A
Page 17 and 18: Private Health Services in India: A
Page 19 and 20: 4Structure and Characteristics of P
Page 21 and 22: Structure and Characteristics of Pr
Page 23 and 24: Structure and Characteristics of Pr
Page 25: Utilisation of Private Health Servi
Page 29 and 30: Utilisation of Private Health Servi
Page 35 and 36: 6ConclusionThis study has explored
Page 37 and 38: ReferencesAcharya, A.; Baru, R. and
Page 39 and 40: ReferencesShah, G. 1997. Public Hea

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