Holistic Approach to Healthcare : Bihar 2015

Bihar’s health services were in a dismal state when Nitish Kumar’s government took over in 2005. Knowing full well that access to basic healthcare is the right of every citizen of Bihar, Nitish Kumar’s government undertook a series of measures to fix the state’s ailing health sector.

The government took a holistic approach to reforming healthcare with an emphasis on both basic health services and preventive factors such as nutrition, water, and sanitation. It also launched special health schemes such as the Janani Evam Bal Suraksha Yojana and Indira Gandhi Matriyva Sahyog Yojna to target better health for women and children. For improving healthcare for newborns and children, the state partnered with global organizations and made rapid strides in immunization and child nutrition.

Measures taken by the government of Nitish Kumar:

  • Ensured that all public health centers to operate on a 24×7 basis.
  • Provided resources for health centers to have six or more hospital beds, requisite medical, nursing and paramedic staff, free medicine and diagnostic services, free food for patients, power backup, and landline phone facilities.
  • Focused in improving health infrastructure. In the last 6 years alone, 36 district hospitals, 71 referral hospitals, 63 sub-divisional hospitals and 11,559 health centers have come up.
  • Appointed 535 senior residents, tutors, assistants, and heads of departments to hospitals between 2005 and 2010 and 2,191 doctors, residents, and other staff between 2010 and 2015.
  • Focused on improving routine immunization, with schemes as earmarking 2006 as a routine immunization year, Muskan Ek Abhiyaan in 2007, and declaring 2012 the Year of Immunization.
  • Initiated the Nayi Peedhi Swasthya Guarantee Karyakram in 2011 for routine health and eye checkups for children.
  • Declared the year 2011 as Safe Motherhood Year to increase awareness of a mother’s health.
  • Initiated the Mukhyamantri Kishori Swasthya Karyakram to provide 150 rupees to every girl in class VIII to XII to purchase sanitary napkins.
  • Established Mobile Medical Units in 2009 to provide medical services in hard-to-reach areas.
  • Established 9 trauma centers alongside national highways to cater to road accident victims or medical emergencies.
  • Invested 7,011 crore rupees in Integrated Child Development Services and Anganwadi centers between 2005 and 2015 to cater to the health of women and children.
  • Created the State Nutrition Policy for providing better nutrition to women and children.
  • Introduced family planning measures to bring down the total fertility rate in the state.
  • Established the Chief Minister Relief Fund to provide health services to people with an annual wage of less than 2.5 lakh rupees.

The efforts of Nitish Kumar’s government have been lauded nationally and internationally. Nobel Laureate and noted economist Amartya Sen noted the state’s rapid strides in immunization and child nutrition. Bill and Melinda Gates, whose foundation focuses on public health issues worldwide, traveled to Bihar in 2012 to praise the government’s efforts in improving healthcare. The government, for its part, continues to remain committed to improving the quality of lives of ordinary Biharis. To this end, healthcare remains one of its topmost priorities.

Achievements & Impact:

  • The state saw substantial improvements in health indicators such as decline in total fertility rate, crude death rate, and maternal mortality rate.
  • Bihar’s total fertility rate declined by 0.4 points between 2007-12, faster than the national average of 0.3%.
  • Life expectancy at birth has gone up by 9.3% in 10 years.
  • Institutional deliveries increased by 42% between 2007-13.
  • Infant mortality rate declined by 29.5% over the last decade.
  • Maternal mortality rate has decreased by 43.9% in the last decade.
  • The number of patients treated per primary health center rose from an average of just 39 per month to 4,000 per month.
  • Average life expectancy of women in Bihar has increased from 61.6 years in 2006 to 66.2 years in 2011.
  • Routine immunization coverage increased to 78%—higher than the national average—as opposed to just 18.6% in 2005.
  • Under the Nayi Peedhi Swasthya Guarantee Karyakram of 2011, a total of 2,39,10,697 children have undergone routine health and eye checkups through 1,19,496 health camps.
  • Each district in Bihar now has a Mobile Medical Units for medical services in remote areas.
  • Integrated Child Development Services is now running in all 38 districts of Bihar. 91,677 Anganwadi centers cater to 1.91 crore children between the ages of 0-6 years and 60.3 lakh mothers.
  • Bihar was declared a “Maternal and Neonatal Tetanus Free” state in 2015.
  • In 2012, 86% of the citizens surveyed through the independent Public Affairs Foundation, a Bangalore-based NGO, said they were satisfied with improvements in health facilities in Bihar.

For the future, Nitish Kumar’s government has prioritized reforms within the health sector with the long-term vision of universal healthcare for all. The government has pledged to invest in healthcare study and research. It also plans to focus on providing specialized treatments, equipping health centers with modern health facilities, and encouraging private sector participation.