The National Health Profile (NHP) 2023 was published by the Central Bureau of Health Intelligence (CBHI) in June 2024. This official document, representing the health status of our country, has been released every year since 2005. This 18th issue has been composed after a thorough analysis of massive data obtained from various sources, including the directorates of public health & family welfare of all states and union territories, National Health Programmes, organisations of the central government and several other related national agencies. It serves as a comprehensive resource for policymakers, planners, and researchers, enabling evidence-based decision-making to improve health outcomes.
Significance of National Health Profile
The NHP provides a detailed analysis of the current health status and healthcare systems in India. It includes significant systemic information regarding health across six different themes that serve as indicators of performance and achievement. These are the basis for the efficient administration and targeted interventions of any healthcare programmes.
Themes of NHP 2023
The six major themes of NHP 2023 are as follows:
1. Demographic Indicators Demography refers to the scientific study of people in a particular region. The purpose of this study is to observe and record changes in the number of males, females, marriages, births, deaths, etc. It also aims to record the number of people who possess particular characteristics.
Public health programmes and policies can be planned and implemented only after interpreting the structure of a population. This is because the health of individuals and communities is influenced by different factors such as the number of people, the area they live in, the skills they possess, and by the strong relationships among them.
Using demographic indicators, the size, composition, geographic distribution and growth of the population in a particular region can be determined besides the social, economic, and behavioural factors that affect the population.
Some Highlights
- As per NHP 2023, the population of our country is expected to increase by 25 per cent in 25 years, with a 1 per cent increase per annum. It is estimated that during 2011–36, our population will increase to 152.2 crores from 121.1 crores.
- There will be an increment in the sex ratio (number of females per 1000 males) of the total population from 943 in 2011 to 952 in 2036.
- Further, an increment of 4.2 per cent is expected in the proportion of population in the working age group (15–59 years). In 2011, it was 60.7 per cent; while by 2036, it would be 64.9 per cent.
- In 2011, the median age of Indians was 24.9 years which is expected to increase to 34.5 years in 2036.
- There has been a decline in the infant mortality rate for the country. In 2009, it was 50; while in 2020, it declined to 28.
- The life expectancy at birth increased to 70 years in 2016–20, compared to 62.3 years in 1997–2001.
- The proportion of the elderly (60+ years) is expected to rise from 8.4 per cent in 2011 to 14.9 per cent in 2036.
- The total fertility rate (TFR) has declined to 2.0 in 2020, reflecting progress towards population stabilisation.
Median age is the age that divides a population into two numerically equal groups, that is, there are as many persons with ages above the median as there are with ages below the median.
Infant mortality rate is the number of deaths of infants under one year of age per 1,000 live births.
Life expectancy at birth is the average number of years a newborn is expected to live, based on current death rates.
Total fertility rate is the average number of children a woman is expected to have in her lifetime, given current birth rates. It is a crucial indicator of population growth or decline.
2. Socio-Economic Indicators Socio-economic development is the process of making economic and social conditions of a community or nation better. It includes recognising social and economic needs within a country, and thus, forming policies and programmes that will meet those needs. While developing the policies and programmes related to society and economic initiatives, public issues are taken into account.
Under the theme ‘Socio-economic Indicators’, environment, material, and other such multi-factorial conditions are described. Besides, personal characteristics that interact deeply are also described. Considering these points, the latest information regarding socio-economic status, both state-wise and UT-wise, is included in this section.
Some important socio-economic factors mentioned under this theme include literacy and school enrolment, age at effective marriage, rate of employment, household amenities, per capita availability of cereals and pulses, and economic factors.
Some Highlights
- In 2021–22, the gross enrolment ratio for girls in primary classes was 104.8; while that for boys, it was 102.1. However, it declined to 58 per cent for girls and 57 per cent for boys when they reached higher secondary level.
- During 2018–20, the average age at effective marriage of girls remained constant at 22 years across the country.
- The highest per capita net domestic product in 2022–23 was recorded in Karnataka and Telangana. Other populous states with per capita net state domestic product above rupees 1,50,000 included Andhra Pradesh, Odisha, Tamil Nadu, Rajasthan, Punjab, Haryana, and Uttarakhand.
- The per capita availability of cereals was 460.8 grams per day, and of pulses 53.7 grams per day in 2022.
- As of April 2023, 431 habitations in 46 districts reported excessive fluoride contamination in drinking water, and 612 habitations in 22 districts were affected by arsenic contamination, all covered by mitigation measures.
3. Health Status Indicators and Disease Burden Under the theme ‘Health Status Indicators’, the problem of HIV/AIDS, communicable and non-communicable diseases (i.e., morbidity), and deaths related to these morbidities are described state-wise, UT-wise, and for the country as a whole. In order to implement any morbidity control programme in a particular region, a powerful longitudinal surveillance system is a must.
This section also includes the trends and status of maternal and child health scenario, based on surveillance data obtained from large populations using public health facilities in India.
Some Highlights
- In 2021, around 2,143, 867 patients were diagnosed with tuberculosis (TB). Out of this, the total number of microbiologically confirmed cases of TB in the same year was 1,137,328 with a treatment success rate of 82.10 per cent.
- Despite the fluctuations across states of India, we have achieved considerable success in dealing with HIV epidemic 93 its prevalence decreased from 0.40 per cent in 2010–11 to 0.22 per cent in 2020–21; over 3.13 crore individuals were tested in 2022.
- In 2022, under the National Programme for Prevention & Control of Cancer, Diabetes, Cardiovascular Diseases & Stroke (NPCDCS), 9.91 crore people were screened; approximately 75 lakhs were suffering from hypertension; 61 lakhs, from diabetes; 29 lakhs, from hypertension and diabetes both; 2 lakhs, from cardiovascular diseases; 1 lakh, from strokes; and 3 lakhs, from common cancers.
Acute Diarrhoeal diseases accounted for 5.6 million cases, enteric fever for 1.23 million, and chicken pox for 27,279 cases in 2022.
Total malaria cases declined to 1.74 lakh with 64 deaths in 2022; dengue cases were 2.8 lakh with 485 deaths, as per the National Centre for Vector-borne Diseases Control.
Maternal and child health indicators improved: Kerala achieved the highest institutional birth rate at 99.8 per cent, and Dadra & Nagar Haveli recorded a 94.9 per cent full immunisation rate for children aged 12–23 months.
4. Health Finance Indicators and Expenditure
One of the most important functions of health systems is healthcare financing. It facilitates universal health coverage (UHC), which enhances financial protection and effective service coverage. With the help of health finance indicators, comprehensive information regarding medical expenditure and public expenditure on health can be obtained. Effective financing helps ensure sufficient funds, remove obstacles, and provide equitable services.
Some Highlights
- It was estimated that Rs 95,719 crore would constitute the total public expenditure on health for 2023–24. This would be inclusive of NHM (Rs 47,347 crore), Health (Rs 38,828 crore, and NACO Rs 2,917 crore), Department of Health Research (R 2,980 crore) and AYUSH (Rs 3,648 crore).
- There has been an increment in the per capita expenditure on Central Government Health Scheme (CGHS). In 2010–11, it was Rs 4,050; while in 2022–23, it became Rs 15,260.
- In 2009, the per capita expenditure on Employees’ State Insurance Scheme (ESIS) was Rs 254. While in 2022, it was increased to Rs 908, covering 12.04 crore beneficiaries.
- Total health expenditure as a percentage of GDP stood at 3.27 per cent in 2019–20, with government health expenditure as a share of total health expenditure increasing to 41.4 per cent.
5. Human Resources for Health Human resource for health (NRH) includes various aspects such as planning, information, management, performance, retention, and research and development on HR. The HRH should be capable, disciplined, and sufficient in number to be able to carry out their duties at primary, secondary, and tertiary level in both public and private sectors, as this is essential to obtain universal health coverage. In India, there has been a considerable change in the size and composition of HRH during the past years. The implementation of National Rural Health Mission and other such reforms in the health sector focuses on reinforcing HRH in the public sector system.
Some Highlights
- As of 2022, Maharashtra had the highest number of registered doctors (2,11,046), followed by Tamil Nadu (1,49,397), Karnataka (1,34,448), and Andhra Pradesh (1,05, 804).
- There were 25,56,416 registered nurses and midwives, 1,3,49,679 total registered doctors, 2,94,102 dental surgeons, 7,55,780 AYUSH practitioners, and 17,13,730 pharmacists.
- There were 1,51,064 total seats for medical courses, including 1,04,163 MBBS seats as of June 2033.
6. Health Infrastructure and Service Delivery Another critical indicator is health infrastructure. With the help of this indicator, healthcare delivery provisions and welfare mechanisms in a country can be analysed. Adequate and well-maintained infrastructure is a pre-requisite for the efficient delivery of public health services and is regarded as ‘the nerve centre of the public health system’.
Some Highlights
- In the recent past, there has been rapid growth in medical education infrastructures. As on June 30, 2023, there were 679 medical colleges in India, with 380 being government and 299 being private.
- There are 10,137 institutions for ANM training (50,388 seats) and 43,735 nursing institutions (3,20,928 seats).
- As of March 31, 2021, there were 1,61,829 subcentres, 31,053 primary health centres, and 6,064 community health centres, alongside 1,275 sub-divisional hospitals, and 767 district hospitals.
- India has 41 government mental hospitals and 378 eye bank/eye donation centres (122 government and 256 private).
Conclusion
NHP 2023 will serve as a guiding light in the path of making our society healthier and more resilient. It consists of significant health data, analyses, and insights into the present healthcare landscape of our country. The report supports evidence-based policy-making and aids in planning comprehensive strategies to ensure equitable and accessible health care for all.
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