Uttar Pradesh, with a population of ~24 crore, faces serious public health challenges. Recognising these gaps, the Government of Uttar Pradesh, with technical support from Deloitte, is undertaking large-scale health infrastructure expansion, PPP-based healthcare delivery, digital health initiatives and medical education reforms.
Medical and Health Issues in UP
Uttar Pradesh, India’s most populous state, faces significant medical and health challenges due to high population pressure, shortage of doctors, regional disparities, and rising disease burden. Despite a wide public health network, gaps in specialised care, diagnostics, and preventive healthcare persist, particularly in rural and backward regions, making health sector strengthening a key governance priority in the state.
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Challenges in Medical and Health sector in Uttar Pradesh
- Inadequate Doctor- Population Ratio: Uttar Pradesh has a doctor–population ratio of only 0.37 per 1,000 people, which is significantly lower than the WHO-recommended norm of 1 doctor per 1,000 population.
- Cancer Care Crisis: The state reports approximately 2.45 lakh new cancer cases every year, however there is only one cancer treatment facility for nearly 61 lakh people, leading to excessive patient load.
- Diagnostic Infrastructure Deficit: Historically, high-end diagnostic facilities such as CT scans and advanced imaging were absent in most district hospitals. This forced patients to depend heavily on private diagnostic centres, increasing healthcare costs.
- As a result, out-of-pocket expenditure remains high, especially for economically weaker sections.
- Regional Health Disparities: Regions such as Bundelkhand and Purvanchal continue to record poorer health indicators compared to western and central Uttar Pradesh.
Existing Healthcare Infrastructure: Strengths and Gaps
| Strengths | Gaps |
|---|---|
| Uttar Pradesh has an extensive three-tier public healthcare system comprising primary, secondary, and tertiary levels. | Despite infrastructure expansion, there is a shortage of specialised services such as oncology, cardiology, and advanced diagnostics. |
| The state has over 30,000 Sub-Centres, PHCs, CHCs, and sub-district hospitals, providing a wide service delivery base. | Access to advanced medical procedures in government hospitals remains limited. |
| There are 208 medical, biotechnology, and pharmacy colleges, contributing significantly to healthcare manpower generation. | Specialist availability is uneven, particularly in rural and backward regions. |
| Rapid expansion of Jan Aushadhi Kendras has improved access to affordable generic medicines. | Quality and capacity constraints affect tertiary care services in public hospitals. |
Government Response and Key Health Initiatives
- Medical Education Expansion: At present, 59 out of 75 districts in Uttar Pradesh have at least one medical college.
- Ten underserved districts are being covered through PPP and Viability Gap Funding (VGF) models.
- The primary objective is to bridge the doctor shortage and correct regional imbalances in healthcare access.
- PPP-Based Health Infrastructure: The state has identified 18 districts for the establishment of private hospitals under the Public–Private Partnership (PPP) model.
- The government provides incentives such as capital grants, operational grants, interest subsidies, and nominal land leasing to attract private investment.
- Cancer Care Strengthening: The government is focusing on expanding radiotherapy units, LINAC machines, and PET-CT facilities in public hospitals.
- Emphasis is placed on early screening, timely diagnosis, and strengthening tertiary cancer care capacity.
- Diagnostics under PPP Mode: CT scan facilities have been made available in all district hospitals through PPP arrangements.
- Private partners are responsible for installation and maintenance, while the government reimburses costs on a per-case basis, improving affordability.
- Digital Health and Telemedicine: Uttar Pradesh has implemented the eSanjeevani Hub-and-Spoke Telemedicine Model across the state.
- The system includes 17,528 spokes at Health and Wellness Centres, 4,921 hub-cum-spokes at PHCs, CHCs, and district hospitals, and 30 medical college hubs.
- Pharmaceutical and Medical Devices Ecosystem: Uttar Pradesh has developed 9 pharmaceutical clusters and 1 biotech park to support healthcare manufacturing.
- The state hosts 22 medical device manufacturing units and records healthcare exports worth over USD 100 million.
- Development of Bulk Drug Pharma Park at Lalitpur.
- This growth is supported by the Uttar Pradesh Pharmaceutical and Medical Devices Policy, 2023.
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Way Forward
- Strengthening tertiary and specialised healthcare services is essential to reduce referral burdens.
- Expansion of preventive healthcare and early disease screening, particularly for cancer, must be prioritised.
- Digital health platforms should be further scaled to bridge rural–urban gaps.
- PPP-driven infrastructure development should continue to supplement public healthcare capacity.
- Sustained focus on medical education and human resource development is necessary to improve healthcare outcomes.
Conclusion
Uttar Pradesh’s health sector faces persistent challenges of population pressure, workforce shortage, and regional imbalance. Ongoing reforms in PPP healthcare, medical education, diagnostics, and digital health are strengthening service delivery. These efforts align with SDG-3 targets related to universal health coverage, reduction in premature mortality from communicable and non-communicable diseases, improved maternal and child health, and access to safe, effective, quality, and affordable healthcare services.
