Manipur is a small state of 22327 Sq.Km. area with a population of 2,721,756 (2011 census) and having 9 (nine) Districts. Barring a central valley comprising about 9% of the total area, the remaining area is hilly terrain. 60% of the population reside in the valley districts and 40% in the hill districts.The hills are subdivided into 5 districts whereas the valley is organised into 4 districts. 60% of the State’s population resides in the valley districts. The State is backward economically and industrially and lacks in basic infrastructure. The state practically sustains on central assistance.The State is land-locked and not freely accessible with other neighbouring states. Intra-state transport system is equally poor.
The population and area of the districts in the State are as under:
|Sl.No.||Name of Dist.||Area (Sq Km)||No. of Vilgs.(2001 Census)||Populn. 2011 Census||Populn. density per sq.km||Sq.km/1000 populn|
|A. Valley Dist.|
|B. Hill District|
2.Health Care in the State:
The health service in the state is primarily under the government sector, although there are a few private hospitals/nursing homes to reckon with.
The health system under the State Health Department is organised at three levels, each level supported by a referral centre. The levels are:-
a) Primary care level comprising of Primary Health Sub-Centres (PHSC), Primary Health Centres (PHC) and Community Health Centres (CHC). Essential basic health care are provided at this level.
b) Secondary care level comprising of CHCs and District Hospital, which act as referral centres and where comparatively better services are provided with basic specialist facilities.
c) Tertiary care level where specialist and super specialist care are provided. The State Level Hospital (JN Hospital) is providing the service.
The health indicators in the State are as follows:
|Sl.No.||Item||Manipur State||All India average|
|1.||Infant Mortality rate||11||(SRS-11)||44||(SRS-11)|
|2.||Crude Birth Rate||14.4||(SRS-11)||21.8||(SRS-11)|
|3.||Crude Death Rate||4.1||(SRS-11)||7.1||(SRS-11)|
|4.||Maternal Mortality Rate||64||(RIMS-2010-11)||212||(SRS-07-09)|
|6.||Sex ratio||987||(Census 2011)||940||(Census 2011)|
|7.||% of mother with full ANC||46.7||(HMIS-10)||26.5||CES-09(Unicef)|
|8.||Institutional Delivery %||68.3||(HMIS-10)||47.0||DLHS-3|
|9.||% of delivery by skilled health personnel||90.3||(HMIS-10)||76.2||CES-09(Unicef)|
|10.||Early institution of Breast Feeding||75.1||CES-9(Unicef)||33.5||CES-09(Unicef)|
|11.||% of Child exclusively breast fed for 6 months||79.2||DLHS-3||57.1||DLHS-3|
|12.||Fully immunized children 12-23 months||81.4||(HMIS-10)||61.0||CES-09(Unicef)|
The demographic indicators in the State and target by the end of 12th plan.
|Sl.No.||Item||Current Status||Target by 12th plan end|
|1.||Infant Mortality rate (SRS-11)||11||9|
|4.||Maternal Mortality Rate||64-80||60|
|5.||Total Fertility Rate||1.5||1.5|
|4.||Malnutrition of Children (0-3 yrs)||22||15|
|5.||Anaemia among Women (15-49 years)||35||20|
|6.||Sex Ratio (0-6 years)||934||960|
|2.||Crude Birth Rate (SRS-10)||14.4||12|
|3.||Crude Death Rate (SRS-10)||4.1||3.5|
|6.||Sex ratio(Census 2011)||987||995|
|7.||Mothers with full ANC||46.7||80|
|9.||Delivery by skilled health personnel||90.3||95|
|10.||Early institution of Breast Feeding||75.1||90|
|11.||Child exclusively breast fed for 6 months||79.2||90|
|12.||Fully immunized children 12-23 months||81.4||90|
There has been considerable progress numerically in the establishment of health institutions in the State during the past 30 years.
The number of health institutions in the state along with bed strength is as in the table below:
|Sl.No.||Category of Institution||Number||Sanctioned bed Strength||Actual bed in position||General hospital beds|
|A.||Under the State Health Department|
|1.||State General Hospital||1||500||376||376|
|2.||State TB Hospital||1||100||100||0|
|3.||State Leprosy Hospital||1||30||6||0|
|B.||Under Ministry of Health GoI|
|C.||Under Private Sector||0|
|Regd.Hospital andNursing Home||26||807||807||807|
The bed population ratio to be achieved is 1 bed per 1000 population. If we take into account the 807 beds under private hospitals and 1074 beds under RIMS the bed population ratio desired may be said as achieved for the State. However, beds in CHCs and PHCs cannot be counted as giving the desired quality care.
Again, the beds at RIMS hospital are meant for patients in the NE region and although currently almost all the beds are used by patients from Manipur State, the trend is likely to change when other new super-speciality services are added and patients start coming from other states. Again the beds in private hospitals are subject to change at their own discretion and cannot be fully relied upon.Although the health institutions under the State Health Department look adequate in number they cannot function effectively due to poor physical infrastructure and their poor maintenance.
This is most evident in the area of Secondary Health Care Institutions particularly in the district hospitals.