Annual Report to the People on Health


The Ministry of Health and Family Welfare published the first Annual Report to the People on Health in September 2010. The report’s objective was to examine critical macro-level issues related to health, in particular, the constraints faced by the government in providing universal healthcare, and the challenges in the organisation, financing and governance of health services. 

The report provides information about key health indicators such as life expectancy at birth, infant mortality and maternal mortality, and explains the variation in their numbers in different states. It also provides an overview of the National Rural Health Mission (NRHM), which was launched in 2005 to revitalise and scale up basic health services in rural areas. Besides this, it discusses the non-availability of skilled healthcare providers and their uneven distribution across the country, and suggests remedies for this problem.

Lastly, the report lists key policy issues related to health that, according to the ministry, need to be debated widely and drafted into a new health policy. Some of these issues are increased public investment in healthcare, public-private partnerships in the health sector, access to safe drinking water and sanitation, good quality education for healthcare providers, use of modern technology and technological audits of the sector, rising out-of-pocket expenditure on drugs, reduced emphasis on preventive healthcare, limited participation of community organisations, and investment of the states in primary healthcare.     


  1. The Union health budget increased from Rs. 5,255 crores in 2000-01 to Rs. 8,086 crores in 2004-05 and to Rs. 21,680 crores in 2009-10. The health budget of the states for 2009-10 was Rs. 43,848 crores.

  2. India’s per capita public health spending was among the five lowest in the world. It declined from 1.3 per cent of GDP in 1990 to 0.9 per cent in 1999, increasing marginally to 1.1 per cent in 2009.

  3. The World Bank estimates that Indians spent nearly Rs. 84,600 crores of their own money on healthcare in 2004 – or 3.3 per cent of GDP that year.

  4. Life expectancy in India increased from around 30 years at the time of Independence to over 63.5 years in 2002-06. Between 1970-75 and 2002-06, it increased by 14.1 years in rural areas and 9.9 years in urban areas. 

  5. In rural areas, 41 per cent of deaths were due to communicable diseases and maternal, perinatal and nutritional disorders, while 40 per cent were due to non-communicable diseases.

  6. The level of malnutrition has been persistently high, with over 40 per cent of children and 36 per cent of adult women classified as undernourished. 

  7. Primary healthcare was provided by the government through a network of over 146,036 health sub-centres, 23,458 primary healthcare centres and 4,276 community healthcare centres.

  8. At the district level, on an average, there was a 150-bed civil or district hospital in the main district town and a few smaller hospitals and dispensaries spread over other towns and larger villages. Around 68 per cent of an estimated 15,097 hospitals in the country and 37 per cent of 623,819 beds are in the private sector. Most of these services are available in urban areas. 

  9. The private sector in India had a dominant presence in medical education and training, medical technology and diagnostics, pharmaceutical manufacture and sale, hospital construction, ancillary services and the provision of medical care.

  10. According to the 2001 Census, the ratio of health workers in India is a little over 8 per 10,000 people, with allopathic physicians at 3.8 and nurses and nurse-midwives at 2.4. In urban areas, the ratio of health workers is 42 per 10,000, nearly four times what it is in rural areas (11.8). 

  11. Almost 60 per cent of health workers reside in urban areas and a majority (70 per cent) are employed in the private sector.

  12. According to the National Sample Survey Organisation, in 2004, 28 per cent of ailments in rural areas remained untreated due to financial reasons as compared to 20 per cent in urban areas.

    Focus and Factoids by Vedika Inamdar.

    PARI Library's health archive project is part of an initiative supported by the Azim Premji University to develop a free-access repository of health-related reports relevant to rural India.


Ministry of Health and Family Welfare, Government of India


Ministry of Health and Family Welfare, Government of India


01 Sep, 2010