Access to healthcare remains a major challenge in India
Access to healthcare remains a major challenge in India

Hospital facilities to shrink as population rises: Economic Survey

  • India already faring poorly relative against other emerging and developed economies in terms of per capita availability of hospital beds
  • The country is likely to to witness a sharp slowdown in population growth in the next two decades

New Delhi: Rising population over the next two decades will sharply reduce the per capita availability of hospital beds in India across all major states, if country’s hospital facilities remain at current levels, according to the Economic Survey 2018-19 released on Thursday.

Noting that access to healthcare was still a major challenge in India, the Survey report said the country already fared poorly relative to other emerging and developed economies in terms of per capita availability of hospital beds.

However, the Economic Survey also noted that India was likely to to witness a sharp slowdown in population growth in the next two decades. Although the country as a whole will enjoy the “demographic dividend" phase, some states will start transitioning to an ageing society by 2030, it said.

Population in the 0-19 age bracket has already peaked due to sharp decline in total fertility rates (TFR) across the country. Southern states, Himachal Pradesh, Punjab, West Bengal and Maharashtra now have fertility rates well below the replacement rate. TFR in Bihar, Uttar Pradesh, Jharkhand, Chhattisgarh, Rajasthan and Madhya Pradesh are above the replacement rate, but are also experiencing significant declines. As a result, the national TFR is expected to be below the replacement level by 2021, the Survey noted. Yet the hospital facilities continue to be scarce.

“If India’s hospital facilities remain at current levels, rising population over the next two decades even with slowing population growth rates will sharply reduce the per capita availability of hospital beds in India across all major states," the Survey report highlighted.

The Survey noted that all major states are projected to witness a decline in the share of young population and an increase in the share of elderly population over the next two decades. States ahead in the demographic transition, such as Himachal Pradesh, West Bengal, Maharashtra, Punjab and most of the southern states, would have less than one-fourth of the population under the age of 20 but about one fifth or more population over the age of 59 by 2041.

Even states in earlier stages of demographic transition, such as Bihar, Uttar Pradesh, Jharkhand, Chhattisgarh, Madhya Pradesh and Rajasthan, will see a significant decline in the share of young population, though these shares will remain relatively, the survey report said.

“States with high population growth are also the ones with the lowest per capita availability of hospital beds. Hence, there is a straightforward case for expanding medical facilities in these states. For states in the advanced stage of demographic transition, however, the rapidly changing age structure will mean that the type of health care services will have to adapt towards greater provision of geriatric care," the survey report said.

“A major problem with planning for the provision of medical facilities is the paucity of specific data, especially on private hospitals. Available data on government hospitals have been used here but it is clear even from basic research that it does not provide a true picture of the quality or quantity of health care in the country," the survey report said.

The Survey also noted that the proportion of elementary school-going children, i.e. 5-14 age group, will witness significant declines. Contrary to popular perception, many states need to pay greater attention to consolidating/merging schools to make them viable rather than building new ones.

The report has recommended to policy makers to pay attention to ageing population and school going children as younger population is to shrink.

“At the other end of the age scale, policy makers need to prepare for ageing. This will need investments in health care as well as a plan for increasing the retirement age in a phased manner," the Survey noted.

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