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The health of Rajasthan's citizens hinge on the State's commitment to a robust and equitable healthcare system. This necessitates a significant and strategic investment in the upcoming health budget.
The current reality paints a mixed picture. While strides have been made in improving healthcare access through initiatives like Mukhya Mantri Ayushman Arogya Yojana, critical challenges persist. Geographical and social disparities remain stark; rural and tribal communities lack access to quality healthcare professionals. Stories abound of families facing insurmountable financial burdens due to medical emergencies, pregnant women struggling to reach hospitals for safe delivery, and children succumbing to preventable diseases due to a lack of access to basic healthcare services.
To address these pressing concerns, the upcoming budget must prioritise several key areas:
In Rajasthan, geographical and social disparities remain stark; rural and tribal communities lack access to quality healthcare professionals. Stories abound of families facing insurmountable financial burdens due to medical emergencies ...
Right to Health
The Rajasthan Right to Health Act (RTH) of 2023 marked a significant milestone, establishing Rajasthan as a pioneer in legally enshrining patients' rights to equitable healthcare access. Clause 7(a) requires the government to provide an appropriate budget for the same. However, no budgetary allocation has been done after the bill was passed. Along with a robust budgetary allocation, there’s also a need to frame the rules to ensure effective implementation of the Act’s provisions. A set of draft rules were released but they have not been pressed into action.
Human Resources for Health
According to the Health Dynamics of India report (2022-2023) , 386 doctor/medical officer and 2021 nursing staff positions in the State remained vacant. In rural areas, only 510 of the required 2600 specialist positions in Community Health Centers (CHCs) are filled. It also reported shortage of radiographers and lab technicians in rural settings.
Chapter 3 of the Rajasthan RTH Act emphasises the need for a comprehensive Human Resource Policy for Health. This policy must prioritise the equitable distribution of doctors, nurses, and other healthcare professionals, with a focus on addressing the shortage in rural areas. The government must expedite the drafting and finalisation of this crucial policy.
Strengthening Primary Healthcare: Investing in Physician Training: Many young graduate doctors posted in Primary Health Centers (PHCs) and Community Health Centers (CHCs) often do not have adequate confidence and technical skills to perform their roles effectively.
Training in family medicine equips doctors with the required technical competence. In the past, the State government had sponsored some PHC Medical Officers to enroll for the Post-Graduate Diploma in Family Medicine (PGDFM) through CMC, Vellore, offered as a long-distance course. We urge the State government to provide and budget sponsorship for young PHC and CHC doctors for this course. This will equip them with the necessary skills and mindset to deliver quality primary care.
Many young graduate doctors posted in Primary Health Centers (PHCs) and Community Health Centers (CHCs) often do not have adequate confidence and technical skills to perform their roles effectively.
Besides technical skills, newly recruited doctors in public health systems often feel underprepared to perform their administrative, management and leadership roles. In the past, all the newly recruited doctors underwent an induction management training programme at the State Institute of Health and Family Welfare (SIHFW). The upcoming State budget should provide and budget for all the newly recruited doctors. This training should focus on essential aspects of managing PHCs, including basic administrative skills, public health principles, and community engagement strategies.
Optimising Ambulance Services
Rajasthan has a significant number of ambulances. As per Health Dossier 2021 , there are 2644 ambulances in Rajasthan including both 108 and 104 services. However, as per the State economic review 2023-24 , 600 104 Janani Express and 989 108 ambulance services were working in the State. A significant portion of this valuable resource remains underutilised as many ambulances lack dedicated drivers or face maintenance and fuel constraints. The budget must allocate funds to ensure these vehicles are operational and readily available for emergencies, including maternal and neonatal cases. Around Rs. 268.59 crores were allocated under the Ambulance Service Yojana in the year 2024-25. However, the focus has been more on providing Advanced Life Support Ambulances for trauma/accident cases. A balanced approach is needed to ensure the availability of basic ambulances for timely transport in all emergencies.
The Community Management of Acute Malnutrition) progamme under the Poshan-I rollout was implemented from 2015-16 covering 10 "high priority" districts and three tribal districts of Rajasthan. Around 2.3 lakh children aged 6-59 months were screened and 9,640 children were enrolled under the programme for treatment at the community level. After 12 weeks of intervention, 88% children had recovered from severe acute malnutrition.
Addressing Tuberculosis
Tuberculosis remains a significant public health challenge in Rajasthan. As of October 2024, the number of TB cases in the State were around 1.45 lakhs. Tragically, many TB cases go undiagnosed due to limited access to quality diagnostic services and insufficient awareness. Many individuals fail to seek timely medical care due to financial constraints, social stigma, and lack of awareness about symptoms. Furthermore, even after diagnosis, a significant proportion of patients drop out of treatment. Last year the State, allocated 86.3 lakhs for the National TB Elimination Programme. This year, the State budget must prioritise the following critical interventions to effectively combat this disease:
a. Ensure availability of digital X-Ray machines at all CHCs, along with a radiographer
b. Ensure availability of CBNAAT machines at all CHCs, along with a Lab technician (Cartridge-Based Nucleic Acid Amplification Test or CBNAAT Test is a rapid molecular diagnostic test used to detect TB and drug-resistant strains of tuberculosis).
c. Ensure buffer stock for Anti-tubercular drugs so that any national shortage of drugs does not affect availability of drugs for patients
d. It is well known that nutrition supplementation to patients and their immediate family members significantly improves recovery and reduce chances of family members contracting the disease. Provide for such nutrition supplementation at-least in high prevalence districts (all districts of South Rajasthan)
e. Provide for active transport of sputum to the facilities where CBNAAT is available.
The Rajasthan budget must allocate funds to ensure these vehicles are operational and readily available for emergencies, including maternal and neonatal cases. Around Rs. 268.59 crores were allocated under the Ambulance Service Yojana in the year 2024-25. However, the focus has been more on providing Advanced Life Support Ambulances for trauma/accident cases. A balanced approach is needed to ensure the availability of basic ambulances for timely transport in all emergencies.
Silicosis
Silicosis, a debilitating occupational lung disease, poses a significant threat to the health and livelihoods of mine workers in Rajasthan. This disease often goes undetected for prolonged periods, leading to irreversible lung damage and severe respiratory complications. As per the Silicosis Grant Disbursement portal, there were a total of 31,619 certified silicosis cases in the State. To effectively combat this challenge, we propose:
a. The establishment of fully equipped Pneumoconiosis Boards at all district headquarters, with a dedicated team of medical and radiological experts to ensure accurate and timely diagnosis of silicosis cases
b. Invest in comprehensive training programmes for all doctors in high-prevalence areas to enhance their capacity to recognise, diagnose, and manage silicosis effectively.
Patient Helpdesks
The Government of India's Surakshit Matritva Aashvasan (SUMAN) guidelines advocate the establishment of Patient Support Helpdesks within all public health facilities with high delivery loads. Recognising the significance of these helpdesks, the Rajasthan State budget must allocate funds for their establishment in all district hospitals. These helpdesks, managed by credible civil society organisations, provide essential information, guidance, and support to pregnant women and their families as they navigate the health systems.
Reviving Poshan Divas
Rajasthan, despite its progress, continues to grapple with the challenge of severe acute malnutrition (SAM) in children, particularly in the Southern districts. The CMAM (Community Management of Acute Malnutrition) Poshan-I (The acronym 'Poshan' comes from the original PM's Overarching Scheme for Holistic Nutrition) was implemented from 2015-16 covering 10 High Priority Districts (HPD) and three tribal districts of Rajasthan. Around 2.3 lakh children aged 6-59 months were screened and 9,640 children were enrolled under the programme for treatment at the community level. After 12 weeks of intervention, 88% children had recovered from severe acute malnutrition.
The project was scaled to 20 districts in its second phase and the results were impressive. Around 3.7 lakh children were screened, and 10,344 SAM children were enrolled for intervention. The intervention reported high survival rates (the death among SAM children was only 0.1%), and a cure rate of 70.4%.
Union government guidelines advocate the establishment of patient support helpdesks within all public health facilities with high delivery loads. The Rajasthan State budget must allocate funds for their establishment in all district hospitals. These helpdesks, managed by credible civil society organisations, provide essential information, guidance, and support to pregnant women and their families as they navigate the health systems.
A follow-up assessment four months post-treatment revealed a remarkably low recurrence rate of malnutrition among recovered children, at just 3%. Originally implemented with great impact, "Poshan Divas" mandated that all Health and Wellness Centers (formerly sub-centers) conduct monthly village-level assessments of all children. This proactive approach enabled early identification of children suffering from SAM, ensuring timely access to life-saving therapeutic foods and other essential support. The State budget must revive the successful "Poshan Divas" programme.
