BMI View: Many states in India - the second biggest country in the world by population - are lagging behind their more industrialised counterparts in terms of healthcare provision, with low per capita expenditure on healthcare, poor infant mortality, reduced literacy and geographical barriers such as flooding. Even whe re there are signs of increasing overall investment, these often d o not trickle down to healthcare. A lthough the industrialised regions contain better healthcare facilities as well as a greater number of healthcare professionals, hospitals and better training opportunities for doctors, inequalities remain even in these states . People living outside main cities can find it difficult to access healthcare. Variability across the country is also found in terms of disease burdens, with poorer areas more likely to have a high burden of communicable diseases, and areas with a higher GDP encountering more lifestyle - and pollution-related diseases.
Key Forecasts B y Region
Centre: Uttar Pradesh is the largest of the three states in the vast area that comprises Central India, and as such it has the most hospitals. Nevertheless, Madhya Pradesh is starting to catch up and will see the largest gains in hospital and doctor numbers over our five-year forecast period. Strike action in Uttar Pradesh in early 2014 led to limited healthcare provision in an area where healthcare spending per capita is already lower than any other state or union territory with available data.
East: Plentiful natural resources characterise eastern India, which attracts investment, although this has not been focused on healthcare, leading to a low per capita expenditure. Overall, there are large health inequalities across east India, although in Bihar state health workers are attempting to improve the quality of healthcare services in rural areas using mobile technology.
North: There is considerable variety of GDP across the large area that makes up the northern region of India. As the second-most populated city in the country, Delhi has invested in hospitals and healthcare in general, but the large population puts the healthcare system under pressure. Air pollution is also a problem here, while threats in some of the less wealthy states such as Punjab include communicable diseases such as polio, malaria and cholera.
North East: The healthcare markets in the seven-most isolated states that make up north-east India are characterised by their geography. Aranachal Pradesh, for example, shares a border with China, and has a high proportion of immigrants, while the small state of Tripura has only one major highway and a handful of mountain ranges. These topographical barriers inhibit the provision of healthcare services.
South: Two archipelagos and four states make up the southern region of India with healthcare provision varying widely across the state. On the Andaman and Nicobar Islands there is limited data due to the fact that tribal groups live here. However, on the islands where data is available, healthcare expenditure is high. This is because smaller islands need their own healthcare facilities. Puducherry also has a high healthcare spend per capita, which is a result of expenditure being spread across a wide area.
West: The West of India is home to both the richest state, Goa, and the financial capital, Mumbai, a hub for investors. In Goa there is a high quality of healthcare training, contributing to a high quality of life here. However, there are disparities in healthcare provision in Mumbai, particularly in rural areas, where malnutrition is a concern and having a negative effect on infant mortality rates.