Rajasthan Health Vision 2025 :

1. Vision : 

While the context is complex, the vision of healthy State calls for re-prioritization of our goals. We also need to re-deliberate the usefulness of our long-term strategies. Over the course of next three years the health care system in country must prioritize the public health and shift from being curative to preventive. Public health is the science of protecting and improving health of families, communities through promoting healthy life-style, and research for disease and injury prevention and detection and control of infectious diseases. Overall the public health is concerned with protecting the health of entire population.

2. Scope :

State faces a challenge of a double burden of diseases, where communicable disease burden still accounts for significant proportion of disease burden. In 2012 out of total number lost 33% were attributed to this disease. There is rising morbidity and mortality cost attributable to non-communicable diseases. They are collectively responsible for an estimated 60% of premature deaths. The most of treatment part is being dealt at medical college attached and private hospitals while prevention is basically related to State Health System ( Medical and Health Department in Rajasthan)

3. Goal :

•  Specific Health Goals
•  Reduce MMR to less than 120/per lack live Births
• Reduce IMR to less than 30 per thousand live births
• Reduce Under Five Mortality to less than 38 per thousand live births
• Reduce Total Fertility Rate to 2.1
• Reduce Incidence of TB to 130 per lac
• Reduce API(Application programming interfaces) for Malaria to less than One
• Reduce premature mortality from cardio-vascular diseases, cancer, diabetes or chronic respiratory disease by ¼ of NFHS-4 level.
• Reduce out of Pocket Spending from 62.4% to 50% of total expenditure.
• Medical College in all districts and 250 UG seats in all Government Medical Colleges.
• PG seats 75% of UG seats and Nursing and paramedical courses in all medical colleges.
• To ensure adequate number of highly skilled doctors equitably distributed in rural and urban areas across the State of Rajasthan.
• To develop Medical College Hospitals as centers of excellence for training, research and referral centers for State Health System.
•  Public health and minimum essential clinical interventions require about 1 physician per 1000 population (1993 World Development Report, the World Bank) (GOI target) It may be achieved by 2028. Planning Commission High Level Expert Group (HLEG). To achieve all district hospitals to be developed in to medical colleges with nursing and paramedical training.

4.  Need for more doctors and medical colleges :

The current estimated doctor population ratio in India is 1:1722 as compared to a world average of 1.5:1000. It was communicated that the targeted doctor population ratio would be 1:1000 and achievable by the year 2031. For achieving this target & considering the number of existing Medical Colleges in the country, it was felt that the current intake by Medical Colleges and the critical mass of doctors would be rationally enhanced. However, the medium and long-term goals, the need for more medical colleges need to be met, primarily through the Govt. support.

      The State of Rajasthan needs minimum of 16-18 Medical Colleges as per norms (one college for 50 lacs, Mudaliar committee 1962) but to achieve the standard doctor population ratio we need to have medical colleges in each district by developing district hospitals in to medical colleges. Apart from this the UG seats in all Government Medical colleges need to be increased to 250.

      State of Rajasthan is not only facing challenges in terms of high maternal and child mortality indicators but is also staggering with poor manpower resources like poor doctor population ratio. State has 16 Medical Colleges including 8 Medical Colleges from Private Sector.

5. Increase in UG( Under Graduate) seats:

With a view to have more doctors with existing medical colleges and promote meritorious students of low socio-economic group all existing State Medical college can be up graded in terms of increasing UG seats to have maximum intake capacity. All existing Government Medical Colleges can be developed to 250 seated Medical Colleges which can enhance UG capacity of Government Medical Colleges substantially.  CSS for strengthening of State Medical Colleges shall not only be restricted to increase in PG seats it should also include strengthening and capacity building for UG seats. The state requires central assistance for strengthening of infrastructure like hostel facilities and Lecture theatres. Government has also requested separate funds for strengthening of Hostel facilities under CSS (Centrally Sponsored Schemes).

6.  Integrated Hospital Management & Information System :

The Medical College hospitals in Rajasthan are catering to major chunk of indoors in state IPD( Hospital Inpatient care) in health system.  The influx of patient is not only from within the state but patients from neighboring states are also coming to these hospitals in a significant number. Today the annual OPD( Outpatient Department) of SMS Hospital has crossed 30 lacs and is largest in country. Looking to the increasing patient load and disease burden on tertiary care centers i.e. medical college attached hospitals it is very important to manage for the security, cleanliness, sanitation, waste management   and infection control practices. Local arrangements with routine tender process and involving manpower   are causing multiple problems in managing the medical college hospitals.The problems of resident strike due to disturbed security arrangements also add to the problem. In view of this it is essential to outsource the services to a professional agency that has good experience in managing big hospitals in terms of security and cleanliness; they also use mechanized systems for cleanliness which is cost saving in big establishments.

7. Fighting Non-Communicable Diseases-Super-speciality facility in all hospitals :

 With a view to take care of complications resulting in high mortality due to increasing burden of non-communicable disease. Super-speciality facilities are underdeveloped in all medical colleges except SMS Medical College Jaipur. 90% of the DM/MCh seats are at Jaipur. (Out of about 93 seats more than 80 are at Jaipur) Other medical colleges need attention for development of major super-speciality including Cardiology, Cardiovascular and Thoracic Surgery, Neurology, Neurosurgery, Urology, Nephrology, Paediatric Surgery, Plastic Surgery, endocrinology etc. Apart from this up-gradation of all existing hospitals by getting NABH and NABL accreditation is also required looking to the future needs and improving quality of services.