Maharashtra has been at the forefront of healthcare development in India. It was one of the first states to achieve the norms mandated for primary health centres, sub-centres and Rural Hospitals, under the Minimum Needs Programme. The state also has the largest private health sector in India whose reach is quite extensive.

Although Maharashtra is one of the affluent states in India with the highest per capita income, and contributes over 15% of the country's national income and 40% of the tax revenues, having one of the largest industrial economies, post-SAP Maharashtra's position has faced a reversal. In terms of the social infrastructure too (schools, health care facilities, water supply, housing etc.) it no longer dominates the country. There are two areas of concern which plague Maharashtra, one is food availability (rather access) which is the cause of unacceptable levels of malnourishment, and the other, the declining sex-ratio, especially in the 0-6 year age-group, which has clear linkages with sex-selective abortions linked to sex-determination. Further, there is a decline in public expenditure on health care from 1 per cent of NSDP in the eighties to 0.7 percent in 2001-02, and as a proportion to total government spending from over 6 per cent in eighties to a low of 4.6 per cent in 2001-02 and this declining expenditure has contributed to the adversities faced by the public health sector and consequently the health status of the citizens of the state.

The book has six chapters which focus on socio-economic and demographic profile of Maharashtra, the organisational structure and systems of public health care services at various levels in urban as well as rural areas, the physical infrastructure for delivery of health care services and the wide rural-urban disparity in access to these services, review of healthcare facilities available in public sector in the state, analysis of declining public expenditure on health care services including curative care as well as preventive and promotive programmes and some indicators of health status such as infant mortality, child mortality, life expectancy, morbidity and hospitalisation, nutritional status, water supply and sanitation in Maharashtra. The discussion in all chapters is analytic and backed by strong evidence in 46 tables with time-series data on a wide range of health and related issues.

Health and Healthcare in Maharashtra – A Status Report is a comprehensive and analytical compilation of healthcare development of Maharashtra bringing together all available information and data on health and healthcare.

Contents

1. Contextualising Health Care
   
2. Organisation of Public Health Services
   
3. Health Care Delivery: Physical Infrastructure
   
4. Health Care Facilities in Public Sector
   
5. Public Health Expenditure
   
6. Some Indicators of Health Status