Uttar Pradesh’s Public Health Infrastructure: Reform or Repeat?
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- December 5, 2025
- Development, Uttar Pradesh
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A Critical Diagnosis of Progress
Uttar Pradesh, India’s most populous state, bears a disproportionate burden of the country’s health challenges, from maternal and infant mortality to the spread of communicable diseases. While the state has introduced ambitious reforms to improve its public health infrastructure, systemic issues persist. Are these initiatives leading to real transformation, or are they merely repeating past mistakes in a new guise?
The State of Public Health in Uttar Pradesh
Key Statistics (2023-24):
- Maternal Mortality Ratio (MMR): 167 deaths per 100,000 live births, higher than the national average of 97.
- Infant Mortality Rate (IMR): 41 deaths per 1,000 live births, compared to the national average of 28.
- Hospital Bed Density: 0.63 beds per 1,000 people, significantly lower than the WHO recommendation of 3 beds per 1,000.
- Doctor-Patient Ratio: 1:3,600, well below the WHO standard of 1:1,000.
Despite these alarming figures, Uttar Pradesh has shown some progress in recent years, with health indicators gradually improving due to targeted interventions.
Reforms Undertaken
1. Ayushman Bharat and Pradhan Mantri Jan Arogya Yojana (PM-JAY):
Under the Ayushman Bharat scheme, Uttar Pradesh has issued 2.85 crore health cards, providing cashless treatment to over 1.8 crore beneficiaries in empaneled hospitals. The initiative has significantly improved access to secondary and tertiary care for low-income families.
2. Strengthening Rural Healthcare:
The state has revamped its Health and Wellness Centers (HWCs), aiming to convert 13,000 sub-centers and primary health centers (PHCs) into HWCs by 2025. These centers focus on preventive healthcare and early diagnosis.
3. Infrastructure Development:
The government has allocated ₹10,000 crore for upgrading district hospitals and building new medical colleges in underserved areas, such as Bahraich, Shravasti, and Basti. Uttar Pradesh now boasts 35 operational medical colleges, with plans to increase this number to 45 by 2025.
4. Immunization Campaigns:
The Mission Indradhanush program has improved immunization coverage, with 90% of children under two years of age receiving essential vaccines, up from 65% in 2018.
5. Digital Health Initiatives:
Digitalization of healthcare records and the launch of telemedicine services have enhanced access to medical advice, particularly in rural areas. Over 5 lakh teleconsultations were conducted in 2023, bridging the gap between urban specialists and rural patients.
The Challenges Persist
1. Workforce Shortages:
Despite increased recruitment drives, Uttar Pradesh faces a severe shortage of doctors, nurses, and paramedics. Rural health centers are particularly under-staffed, leading to inequitable access to care.
2. Poor Quality of Care:
A significant portion of the population still relies on private healthcare due to the perceived inefficiency of public facilities. Overcrowding, long waiting times, and inadequate resources plague government hospitals.
3. Urban-Rural Divide:
Rural areas continue to lag in healthcare infrastructure, with only 20% of the state’s health workforce serving nearly 70% of its population.
4. Disease Burden:
Communicable diseases like tuberculosis and encephalitis remain rampant. In 2023, Uttar Pradesh reported over 2,50,000 new TB cases, the highest in India.
5. Financial Constraints:
Out-of-pocket expenditure on healthcare remains high, with over 60% of households incurring catastrophic health expenses annually.
Recommendations for Reform
- Increase Health Budget:
Uttar Pradesh currently spends less than 2% of its GDP on healthcare. Raising this allocation to at least 5% can fund critical infrastructure and human resource gaps. - Strengthen Primary Healthcare:
Invest in PHCs and HWCs to reduce the burden on tertiary hospitals. Focus on preventive care and community engagement to tackle diseases at the grassroots level. - Expand Telemedicine:
Scale up telemedicine services with better internet connectivity and digital literacy programs in rural areas to ensure equitable access to medical advice. - Public-Private Partnerships:
Leverage partnerships with private players to enhance hospital infrastructure, diagnostic services, and specialist availability in underserved regions. - Enhance Workforce Training:
Establish more nursing and paramedical institutes to address the shortage of healthcare professionals. Incentivize postings in rural areas through financial benefits and career growth opportunities. - Focus on Disease Prevention:
Intensify campaigns against communicable diseases with mass awareness drives, improved sanitation, and timely vaccination programs.
Progress or Repetition?
Uttar Pradesh’s public health system is undergoing a gradual transformation, but significant hurdles remain. While schemes like Ayushman Bharat and HWCs have expanded access to care, systemic issues such as workforce shortages and poor infrastructure continue to hinder progress.
The state stands at a crossroads. With a focused approach, UP can transition from reactive to proactive healthcare, ensuring its vast population receives quality medical services. However, without sustained efforts, the risk of repeating past mistakes looms large.
The ultimate test lies in the state’s ability to turn policies into impactful action. Will Uttar Pradesh deliver a health revolution, or will history repeat itself? The answer lies in the choices made today.
