Sheena ChhabraRajasthan has made significant improvement in healthcare sector, but the State still has to make progress in many health indicators to deliver world-class quality health services, said Sheena Chhabra, Senior Health Specialist, Global Practice on Health, Nutrition and Population, World Bank, in her special address at the 3rd Healthcare Summit Rajasthan recently.

“Rajasthan is characterised by a young population — 45 per cent of the population is under 19 years of age with 3/4th of it residing in rural areas. In terms of socio-economic status, three out of every 10 people either belong to Scheduled Caste or Scheduled Tribe, which is one of the highest proportions that we see across India,” she said while setting the context for the summit.

In terms of female literacy, Rajasthan is still comparatively lower than other states. But as Rajasthan is marching towards addressing issues relating to pregnancy, maternal and child directed causes, it also has an equal burden of non-communicable diseases, according to Chhabra.

“In terms of progress, I think that although Rajasthan started from a very low base what is exciting to see is that significant progress has been made over the last decade or so. If we see infant mortality rate, the rate of decline mirrors the rate of decline nationally. Infant mortality has declined by 36 per cent in Rajasthan. Similarly when we look at maternal mortality, it has reduced from 445 to 244 per 100,000 live births from 2001 to 2013 period. However, having achieved this Rajasthan is also the third largest contributor to mortality nationally.”

“In terms of total fertility rate, there has been much sharper decline in Rajasthan. In terms of life expectancy, it really mirrors the national average.”

Sex ratio at birth is another good story that is emerging, she added. “There has been an uplift in 2013-15. If you look at the period between 2005-14, the SRS data shows that Rajasthan has made impressive improvements in sex ratio at birth, through very innovative initiatives.”

Moving from health outcomes to looking at utilisation of services and intermediate indicators, one finds that across most of the indicators whether its institutional birth, post natal care, full immunisation of children or exclusive breast feeding one finds that utilisation of services has improved many folds. “The rate of utilisation of services has improved more substantially as compared to India,” Chhabra said.

“However, having said that, the agenda still remains unfinished and the issue of quality still remains a concern. One issue where Rajasthan has not made much progress is that of malnutrition. It is also an issue that most of the Indian States are grappling with. As much as 39 per cent of children have stunted growth and are too short for their age. Similarly, 37 per cent of children are underweight,” she pointed out.

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