A recent health survey has revealed alarming shortcomings in India’s rural healthcare infrastructure, particularly at Sub-Centres (SCs)—the first point of contact for most citizens in need of medical help.
The report, published in the Indian Journal of Medical Research (IJMR), highlights that only 40% of these facilities are adequately equipped to manage common yet critical conditions such as diabetes and hypertension.
Conducted across 19 districts in seven states, the survey was led by a team of researchers from the Indian Council of Medical Research (ICMR) and the World Health Organisation (WHO). Their findings reveal a troubling lack of essential medicines and trained personnel at the grassroots level of India’s public health system.
Among the 105 SCs evaluated, nearly one-third lacked metformin, a standard medication for managing diabetes. Even more concerning, 45% reported stock-outs of amlodipine, a key drug used to control high blood pressure.
These medicine shortages lasted anywhere from one to seven months, putting patients at risk of complications. By contrast, government medical colleges had better drug availability, showing the disparity between primary and higher-level healthcare facilities.
The study adds to existing evidence from the ICMR-India Diabetes Study (ICMR-INDIAB), which indicates that lifestyle-related diseases are no longer limited to urban populations. Non-communicable diseases (NCDs) are rapidly gaining ground in rural India, demanding urgent improvements in the preparedness of primary health units.
Specialist shortages at the Community Health Centre (CHC) level further exacerbate the problem. Rural Health Statistics (2020–21) indicate that 82% of CHCs lack physicians and 83% lack surgeons—highlighting a severe human resource crisis.
India currently ranks second globally in the number of adults (ages 20–79) living with diabetes. In 2019, nearly 3% of all deaths in the country were attributed to the disease. Hypertension is also on the rise and is a leading risk factor for heart disease and stroke. Experts emphasize that early access to medicines and basic screening at sub-centres can significantly reduce the health and economic burden associated with these diseases.
The researchers noted that the Ayushman Bharat Health and Wellness Centres initiative aims to address some of these issues by strengthening Comprehensive Primary Health Care (CPHC). However, the survey makes it clear that consistent medicine supply, better staffing, and timely diagnostics remain urgent priorities for India to move closer to Universal Health Coverage.
