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DATA STORY : The Performance Of District Hospitals Report

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Published: 3rd Jan, 2022

It is released by NITI Aayog. It is first ever performance assessment of district hospitals undertaken across the country. The framework classifies hospitals in three categories: Small Hospitals (less than or equal to 200 beds), Mid-sized Hospitals (between 201–300 beds) and Large Hospitals (more than 300 beds).

Assessment Indicators:

  • Number of functional hospital beds per 1,00,000 population
  • Ratio of doctors, nursing staffs and paramedical staff in position to Indian Public Health Standards (IPHS) norm;
  • Proportion of support services available
  • Proportion of core health care services available
  • Proportion of diagnostic services available
  • Bed occupancy rate
  • C-section rate
  • Surgical productivity index
  • OPD per doctor
  • Blood bank replacement rate

Key Findings:

  • Beds per Population: On an average, a district hospital had 24 beds for 1, 00,000 people.

For the assessment, it was set that a hospital should have 22 beds for that many people (IPHS 2012 guidelines).

The World Health Organization (WHO) recommends five hospital beds for every 1,000 people.

    1. Doctor-to-Bed Ratio: Only 27% of the total 707 districts assessed met the doctor-to-bed ratio of 29 doctors per 100 beds in a hospital.
    2. 88 hospitals out of 707 had the required ratio of staff nurses.
  • Ratio of Paramedical Staff: Only 399 hospitals were found to have a ratio of paramedical staff in position as IPHS norms laid down (100 paramedical staff for 500-bed hospital).
  • Support Services: On an average, every district hospital in India had 11 support services, compared to the required 14.
  • Diagnostic Testing Services: Only 21 hospitals fulfilled the criteria of having all diagnostic testing services available.
  • Bed Occupancy: 182 hospitals out of the 707 had bed occupancy of 90% or more.

Suggestive Measures:

  • Affordability: Provide effective, affordable health care services (curative including specialist services, preventive, and promotive) for a defined population.
  • Accessibility: At least one district hospital for every district providing advanced secondary care. Extensive coverage; Service coverage encompassing both urban (district headquarter town) and the rural population in the district.
  • Broad scope: Provide wide-ranging technical and administrative support and education and training for primary health care.
  • Substantial infrastructure: The district hospital, having beds ranging from 100 to 1200, provides out and inpatient critical services including surgical interventions such as cesarean sections; care for sick new-borns, infants, and children; management of NCDs and infectious diseases; and blood storage facility on a 24-hour basis.
  • Contribution to society: District hospitals have a lot to contribute towards meeting the country’s global and national goals and targets, including the SDGs, and thus improving health outcomes.

Q. “Primary healthcare is the weakest link in providing efficient and affordable healthcare system in India”. Identify the associated problems in primary health service delivery and suggest solutions. (250 words) 15 Marks.


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