[67th BPSC] Bihar: Human Development-I

Human Development

Abstract

• Human Development is one of the foremost development agendas of the Government of Bihar, along with economic growth. It emphasizes prosperity of human life, rather than affluence of the economy.
• The basic pillars of human development are —
  • health, education,
  • water supply and sanitation,
  • social welfare and
  • social security,
  • all of these have profound impact on the quality of life.
• To achieve this goal, the State Government has allocated 44.0 percent of its total budget in 2020-21 to the human development-related sectors.
• Between 2015-16 and 2020-21 , the Per Capita Development Expenditure in Bihar grew annually at 14.5 percent, while the national average was 10.3 percent.
  • Moreover, the expenditure on education and health in the state registered an annual growth rate of 14.3 percent and 16.6 percent, respectively.
• Sector-wise analysis shows indicators like institutional delivery, IMR, immunization, etc. have recorded substantial improvement in the health sector.
  • Similarly, stable enrolment and steady fall in the dropout rate at primary, upper primary and secondary levels of education also reflect the strengthening of education, another pillar of human development.
• To achieve the comprehensive goals of human development, access to safe drinking water and sanitation are also needed, which is a major concern for the State Government.
• Along with these agendas, the well-being of SCs, STs, minorities and women are also given high priority in the development policy in Bihar.
• The recent progresses in human development parameters in Bihar are the result of fruitful implementation of various programmes of the State Government

Introduction:

• Social sector is a vital sector of the economy and plays a significant role in human development. Human development is a trajectory of the overall progress of human life.
• The critical elements of human development are
  • long and healthy life,
  • access to knowledge,
  • decent standard of living,
  • gender equality,
  • old age security, and
  • community participation.
• An adequate investment in social sectors, particularly education and health, is necessary for human resource development. In the recent years, the State Government has steadily enhanced its expenditure on social services.
• The share of expenditure on social services in total expenditure of the State Government has increased from 34.4 percent in 2015-16 to 44.0 percent in 2020-21.
  • The growth rate of expenditure on health during this period was 16.6 percent, compared to 13.8 percent at all-India level.
  • Likewise, in education too, Bihar registered an annual growth rate of 14.3 percent during those years, which is again higher than India’ s growth rate of 10.9 percent.
• The expenditure on health increased from Rs. 4571 crore in 2015-16 to Rs. 10,602 crore in 2020-21. Similarly, on education, the expenditure increased from Rs. 18,980 crore in 2015-16 to Rs. 39,807 crore in 2020-21.
  • This positive trend is also reflected in the growth of the Per Capita Development Expenditure (PCDE) of Bihar during the last six years. The PCDE of Bihar has been growing at the rate of 14.5 percent, compared to 10.3 percent for national PCDE.

Demographic Layout

• Population growth is in a continuous process of change, both in terms of size and characteristics. With 104.0 million population as per 2011 census, Bihar is the third most populous state of India, after Uttar Pradesh and Maharashtra.
  • The state accounts for 8.6 percent of the India’s population, with only 2.9 percent of country’s surface area.
• Growing population is a burden on the limited natural resource base of the state. Normally, the growth of population depends upon fertility, mortality and migration.
  • Thus, to analyse all these, it is important to understand the pattern of demographic change in Bihar.
• A close look at the census figures of the last six decades reveals a perceptible change in the growth rate of population both in Bihar and India.
  • 
  • During 1951-61 and 1961-71, India recorded a higher population growth compared to Bihar. In the next two decades of 1971-81 and 1981-91, the decadal growth rate of population was almost the same for Bihar and India. Subsequently, during 1991-2001 and 2001-11, the decadal growth of population of Bihar became higher than that of India. During 2001-11, Bihar’s population growth rate was 25.4 percent, compared to 17.7 percent for India.
• At present, the demographic scenario in Bihar is not similar to that in India.
  • First, Bihar is yet to experience the demographic transition, as experienced by most other states.
  • Secondly, the density of population (1106 persons per sq.km) in Bihar is much higher than that of India (382 persons per sq.km).
  • This poses enormous pressure of population on natural resources of Bihar.
• Urbanisation, another determining factor of development, is extremely low in Bihar as compared to India — 11.3% (as per 2011 census. It was 10.5 % in 2001) in Bihar against 31.2 percent (as per 2011 census. It was 27.8% in 2001) for India.
  • Also, the decadal increase in urbanisation in Bihar during 2001-11 has been only 0.8 percent, against a much larger increase (3.4 percent) in India.
• As regards sex ratio, it is lower in Bihar (918) than in India (943); but fortunately, the child sex ratio in Bihar (935) is higher in Bihar than the national average (919).
• Wide variation in indices across the districts:
  • In terms of decadal growth of population, the best performing districts are — Arwal, Gopalganj and Darbhanga.
  • The range of sex ratio varies from 876 (Munger) to 1021 (Gopalganj), the state average being 918.
  • For child sex ratio, the figures are fairly uniform. The density of population also shows a wide variation.
  • Out of the 38 districts, 10 districts have a population density of more than 1400 persons / sq.km.
• Status of Fertility Rate:
  • Fertility rates are crucial for determining both growth rate of population and its age structure.
  • Total Fertility Rate (TFR) measures the level of childbearing in population and would decline in the coming years as per projection.
  • It is encouraging to note that the TFR for India is expected to decline from 2.1 in 2016-20 to 1.7 during 2031-35.
    • In the same period, the TFR for Bihar is expected to decline from 3.2 to 2.4, a decline of 0.8 in TFR.
• Age Structure:
  • Age- sex structure is one of the important dimensions of a country’s population.
  • Broadly, the population may be divided into three categories —
    • child (0-14 years),
    • working age group (15—59 years) and
    • elderly (60 years and above).
  • Over a period of time, the proportion of total population in these age groups may undergo a transition because of the effects of fertility and mortality.
  • A comparative analysis of the projection of Bihar and India shows that, by 2036, the share of working population (15-59 years) will higher in both Bihar and India.
    • For Bihar, the share of working age-group population is expected to be 61.4 in 2036, increasing from 53.5 in 2011.
    • In case of India, this increase is only of 4.2 percentage points, from 60.7 percent in 2011 to 64.9 percent in 2036.
  • Regarding child population (0-14 years), it will decline for both Bihar and India.
    • However, the share of child population to total population in Bihar will be 27.7 percent in 2036, which is 7.6 percentage points higher compared to India’ s share of 20.1 percent.
  • Population ageing is poised to cause another significant transformation in the demographic profile of Bihar and India.
    • For India, the share of elderly population in total population is projected to increase from 8.4 percent in 2011 to 15.0 percent in 2036, denoting an increase of 6.6 percentage points.
    • Contrary to this, the growth of elderly population is slower in Bihar. Between 2011 and 2036, the share of elderly population will increase from 6.3 percent to 10.9 percent, an increase of 4.6 percentage points.
  • Age Pyramid for Bihar(2011 and 2016):
    • 
• Health Scenario:
  • Health is essential for all-round development of society. A healthcare system is dependent on four criteria.
    • First, universal access to an adequate level of care.
    • Second, fair distribution of financial costs and a constant search for improvement in the existing system,
    • Third, training healthcare practitioners for competence and accountability.
    • Last, care for vulnerable groups such as children, women, disabled and the elderly.
  • With the emergence of the Covid- 19 pandemic across the globe, these issues assume even more importance,
  • To meet all these requirements, the State Government has strengthened both infrastructure and manpower for health services at all levels — primary, secondary and tertiary.
  • Better infrastructure, easy availability of drugs, and expansion of human resources for health services, together they have led to an improvement in public health services in Bihar.
    • This may be attributed to the increased expenditure on health, as well as constant monitoring of the health services.
  • For proper healthcare, five kinds of health services are needed — promotive, preventive, curative, rehabilitative and palliative, a perfect combination of these five services ensures proper healthcare.
    • The Common understanding about health is limited to curative care at hospitals. But preventive and promotive health services are more cost-effective than curative services.
    • Examples of preventive services are vaccination, and protection against communicable and non—communicable promotive include and education for adopting proper healthy behaviour and adopting guard against risks to health, like wearing masks, controlling diet, exercising and the like.
  • Selected Health Indicators
    • One of the fundamental indicators of the health status of population is the Life Expectancy at Birth (LEB), which reflects stability in health condition and social security.
      • The LEB for Bihar has recorded an increase by one year, from 68.1 years in 2010-14 to 69.1 years in 2014-18. For India, this increase was by 1.5 years, from 67.9 years in 2010-14 to 69.4 years in 2014-18.
      • Regarding other Empowered Action Group (EAG) states, this increase ranged between 0.4 and 3.5 years, with only Uttarakhand reporting a decline of 0.8 year.
      • When compares the LEB for male and female, it is usually found to be higher for females, because of biological reasons.
      • In case of India, this general pattern was observed, in both 2010-14 and 2014-18. For all EAG states, this pattern was obsctvcd in 2010-14, but not in 2014-18, when Bihar and Jharkhand reported higher LEB for male.
      • In 2010-14, LEB in Bihar (68.1 years) was higher than in India (67.9 years), but in 2014-18, LEB in Bihar (69.1 years) became lower than in India (69.4 years).
    • Besides LEB, two other sensitive indicators of health are Crude Birth Rate (CBR) and Infant Mortality Rate (IMR).
      • For Crude Birth Rate (CBR), the figures are consistently higher for Bihar. Secondly, between 2016 and 2019, the difference between CBR of Bihar and India has remained unchanged.
        • The rural-urban differential also remained stagnant over these years.
        • The birth rate has continued to be higher in rural areas, both for India and Bihar, compared to urban areas in the last four years.
        • In 2019, the CBR in Bihar were overall (26), rural (27) and urban (21) and, for India, the figures were — overall (20), rural (21) and urban (16).
      • Another indicator of health is Infant Mortality Rate (IMR) (deaths 1000 live births), which has continuously declined in Bihar from 38 in 2016 to 29 in 2019. For India also, there was a decline, from 34 in 2016 to 30 in 2019.
        • It is interesting to note that, in spite of being an economically and socially disadvantaged state, the IMR in Bihar is less than the all-India average in 2019.
        • The superior status Of Bihar vis-å-vis India is because of superior status of rural Bihar where IMR stands at 29, compared to 34 for mural India.
• Health Infrastructure:
  • Health care means provision of services to improve the overall health status of individuals. An adequate health infrastructure is obviously a pre-condition for such services.
  • Healthcare infrastructure means a balanced mix of physical infrastructure and human resources, as both are required to deliver the desired health services.
  • The healthcare services in Bihar consists of three levels — primary, secondary and tertiary.
    • Healthcare System in Bihar:
      • 
    • Primary healthcare denotes the first level of contact between people and the health system.
      • The primary healthcare is provided through a network of Sub-Centres (SC), Primary Health Centres (PHC), and Additional PHCs (APHC).
    • The secondary healthcare refers to a second tier of health system, where patients from primary health care are referred to specialists in bigger hospitals for treatment.
      • The health centres for secondary healthcare include District hospitals, Sub-divisional hospitals, and Community Health Centres at block level.
    • The tertiary care means a third level of health system, in which specialised consultative care is provided, usually on referral from primary and secondary medical care.
      • Tertiary care includes specialised intensive care units, advanced diagnostic services and specialised medical personnel.
      • The tertiary care service is provided by medical colleges and hospitals.
    • Due to limited income of the majority of the population in Bihar, their dependence on public health services is very high.
      • In recent years, the State Government has taken a number of steps to improve the functioning of the public health institutions in Bihar and, consequently, the number of patients visiting government hospitals has increased significantly.
      • The average number of patients visiting government hospitals per month was 8996 in 2016, which increased by 5.8 percent and became 9517 in 2019. In 2020, due to Covid-19 and lockdown, there was a 40 percent fall in the attendance in outpatient department and the patient footfall was 5684. But in 2021 (between April and August), the number of patient footfall again increased to 6219.
      • This shows people’s trust in the public health system in Bihar.
  • The health infrastructure in Bihar consists of district hospitals, referral hospitals, sub-divisional hospitals and health centres. Within the last category, there are three types — Primary Health Centres (PHCs), Sub-centres and Additional PHCs (APHCs).
    • Presently, there are 36 district hospitals, 67 referral hospitals and 45 sub-divisional hospitals.
    • In addition, there are 533 PHCs, 10,258 Sub- centres and 1399 APHCs; the last three categories adding up to 12,190 health centres.
    • Thus, per lakh of population, there are about 12 health centres in the state.
    • Towards strengthening of the health services, the approach of the State Government has been a pragmatic one, with thrust on improving the functioning of the existing facilities, rather than extension of the infrastructure.
  • Bihar has a wide institutional network providing health services in all 38 districts. There is considerable variation across in the number of health institution in the districts in terms of availability of health infrastructure.
    • The average number of health institutions per lakh of population varies from 7.8 in Sitamarhi to 18.0 in Jamui.
    • The best three districts in terms of availability of health institutions per lakh population are — Jamui (18.0), Sheikhpura (17.3) and Sheohar (16.6).
    • On the other end, the three most disadvantaged districts are Sitamarhi (7.8), Darbhanga (8.3) and Patna (8.7).
  • The quality health services in Bihar can also be assessed in terms of two indicators — (a) average number of outpatients visiting hospitals per day and (b) the in-patient bed occupancy rate.
    • According to the data for last three years, average number of patients vising hospital day has declined from 311 in 2018-19 to 182 in 2020-21, which can be clearly linked to Covid-19 and lockdown.
      • In 2020-21 , three districts with the highest average number of outpatients visiting hospitals day are — Muzaffarpur (316), Khagaria (306) and Darbhanga (282).
      • At the other end, three districts with the lowest average number of outpatients visiting hospitals per day are — Jamui (91 ), Sheikhpura (98) and Sheohar (109).
    • Similarly, the in-patient bed occupancy rate also reduced to 42 percent in 2020-21 from 55 percent in 2018-19.
      • The hospitals admit people with serious illness for their treatment. The extent of such services for the in-patient can be judged from the occupancy rate of hospital beds.
      • In 2020-21, the in-patient bed occupancy rate was the highest in Supaul (109 percent), Saran (83 percent) and Khagaria (77 percent).
      • Similarly, three worst performing districts were Sheohar (10 percent), Arwal (13 percent) and Jehanabad (21 percent).
  • The health personnel play a critical role in ensuring access to and quality of health care.
    • The health personnel in Bihar encompass — Doctors, Nurses, Auxiliary Nurse-cum-Midwife (ANM), and Accredited Social Health Activist (ASHA).
      • In 2020-21, against the sanctioned posts of 12,895 regular doctors, 6330 were working, indicating a vacancy ratio of 50.9 percent. Likewise, for the contractual post of doctors, 3030 were working against the sanctioned of 4751, showing a vacancy ratio of 36.2 percent.
      • Regarding regular nurses, there were 15,613 sanctioned posts, but the number of working nurses was 10,013, indicating a vacancy ratio of 35.9 percent. Parallelly, in case of contractual nurses, against the sanctioned strength of 4942, a total of 422 were working, implying a high vacancy ratio of 91.5 percent.
      • In 2020-21, the strength of regular ANM was 17,655, against the posts of 29,479, indicating a vacancy ratio of 40.1 percent. Similarly, the strength of ANMs on contractual posts is lower at 1584, against 1 1 ,204 sanctioned posts, indicating a vacancy ratio of 85.9 percent.
      • In contrast to the situation of doctors, nurses and ANMs, the strength of health personnel is much higher in case of ASHAs. For ASHA it is found that 87.7 thousand of them are working, against a sanctioned strength of 93.7 thousand, implying a vacancy ratio of only 6.4 percent.
    • On comparing the district-Wise positions, the variation is found to moderate for ANM and ASHA workers, but in terms of doctors and nurses, there is substantial inter-district variation.
• Institutional Delivery:
  • Proper delivery care is crucial for both maternal and perinatal health of children and, as such, increasing attendance of skilled health worker at birth is a crucial requirement for safe motherhood and child survival.
  • In addition to professional attention, it is also important that mothers deliver their babies in an appropriate setting, where lifesaving equipment and hygienic conditions are available to reduce the risk of complications for either mother or the child. Institutional delivery is an effective way to combat maternal morbidity and mortality.
  • Janani Suraksha Yojana (JSY) is a safe motherhood intervention under the National Health Mission (NHM), which is being implemented with the objective of reducing maternal and neo-natal mortality by promoting institutional delivery.
  • The scheme was launched in April 2005, and is now being implemented in all states, with special focus on low performing states (LPS).
    • The low performing states are Assam, Bihar, Chhattisgarh, Jharkhand, Jammu and Kashmir, Ladakh, Madhya Pradesh, Odisha. Rajasthan, Uttar Pradesh and Uttarakhand.
  • It is a Centrally Sponsered Scheme, which combines cash assistance with delivery and post-delivery care. It has identified ASHA as an effective link between the government and pregnant women.
  • The scheme also provides performance-based incentives to ASHAs for promoting institutional delivery. Under this, ASHAs are required to identify pregnant women, facilitate at least four antenatal check-ups for them, and motivate them to opt for institutional delivery.
    • They are also required to visit the mother and newborn for a natal check-up within seven days of delivery and counsel them on early breastfeeding.
  • In rural areas of low-performing states, an incentive amount of Rs. 1400 to mothers and Rs. 600 to ASHAs are given under the scheme. As a financial assistance for home delivery, an amount of Rs. 500 is given to women belonging to BPL households.
  • Similarly, in urban areas of the low-performing states, an incentive of Rs. 1000 to mothers and Rs. Rs. 400 to Anganwadi Workers (AWW) is provided.
  • Also, for delivery at home with trained health personnel, Rs. 500 is given to women from BPL households. The payments under JSY are made through Benefit Transfer (DBT) mode, using Aadhar-linked bank accounts.
  • The situation of institutional deliveries in Bihar, which has been steadily improving.
    • The number of institutional deliveries increased from 14.98 lakh in 2014-15 to 16.47 lakh in 2019-20, indicating an increase of 10.2 percent over six years.
    • In 2020-21, there was a drop in institutional delivery (15.77 lakh), which is probably because of the Covid-19 pandemic, which restricted movement of people.
    • According to Sample Registration System of 2019, the Infant Mortality Rate (IMR) in Bihar is 29 deaths per 1000 live births, which is even lower than the national figure of 30. This is most likely due to the rigorous efforts made by the State Government for promoting Institutional delivery.
  • The ASHA workers have worked effectively for promoting safe delivery in health institutions. and this is reflected in the extent of institutional delivery in different districts of the state.
  • In 2020-21, Samastipur (87 thousand), Purnea (80 thousand) and East Champaran (68 thousand) have been the three best performing districts. On the other hand, the three worst performing districts are — Alwar (10 thousand), Sheohar (13 thousand) and Jehanabad and Sheikhpura (14 thousand each).
• Immunisation:
  • Immunisation is a basic need of the babies, as they are susceptible to many diseases. In recent times, due to the spread of communicable diseases, it has also become important for adults who are highly vulnerable.
  • To achieve the target of full immunisation, both the State and Central Governments have launched a number of schemes.
    • Complete eradication of polio is a landmark in the history of the state.
    • Not only polio, a tremendous achievement has also been attained in terms of protecting children from preventable diseases like TB, diphtheria, whopping cough, tetanus, measles, etc.
  • The full immunisation coverage among children (aged 12-23 months) in Bihar has increased substantially from 61.7 percent in 2015-16 (NFHS—4) to 71.0 percent in 2019-20 (NFHS-5), registering an increase of 9.3 percentage points.
  • Bihar has made notable improvement in universal immunisation in recent years.
  • Looking at the most recent figures for 2020-21 , one observes that Bihar has achieved more than 80 percent immunisation coverage against Measles, PENTA (I &2), OPV (I and BCG.
  • The pentavalent vaccine provides protection against five life-threatening diseases haemophilus influenza Type B, whooping cough, tetanus, hepatitis B and diphtheria.
  • Even for other components of immunisation, the coverage is more than 70 percent, except for Oral Polio Vaccine (OPV) Zero. This immunisation gap needs the attention of the State Government.
• Prevalence of Main Diseases
  • One of the important objectives of the State Government is to reduce the state’s disease burden, which includes both non-communicable and communicable diseases.
  • The most common vector- borne diseases, which are widespread in the state, are — diarrhoea, malaria, dysentery etc.
  • For proper healthcare, it is necessary to identify the main diseases and arrange for their prevention or cure.
    • In 2020-21 , the number of cases was the highest in respect of Fever of Unknown Origin (0.8 lakh), followed by Acute Respiratory Illness (0.6 lakh).
    • Other important diseases as per their prevalence in 2020-21 are Acute Diarrhoea (0.2 lakh), Viral Hepatitis (0.1 lakh), Dysentery (0.1 lakh) and Enteric Fever (0.1 lakh).
    • Another illness which is having a huge impact on the health system of Bihar is Rabies, caused by dog bite. In 2020-21, about 0.4 lakh patients were suffering because of dog bite.
  • Overall, there is a decline in the number of patients in the state.
• National Health Mission:
  • The National Health Mission (NHM), which was first launched in 2005 as National Rural Health Mission (NRHM), now encompasses two Sub-Missions
    • The National Rural Health Mission (NRHM) and
    • The National Urban Health Mission (NUHM).
  • The main components include —
    • Health Systems Strengthening in rural and urban areas,
    • Reproductive-Maternal-Neonatal Child and Adolescent Health (RMNCH+A) and
    • Communicable and Non-Communicable Diseases.
  • The NHM envisages achievement of universal access to equitable, affordable and quality health care services. The NRHM funds have been released to districts through the health societies under seven components. They are-
    • Reproductive and Child Health (RCH) flexi-pool (NRHM-A),
    • Mission flexi-pool (NRHM-B),
    • Immunisation (including Pulse Polio) (NRHM-C),
    • National Disease Control Programmes (NRHM-D),
    • National Urban Health Mission (NUHM) (NRHM-E),
    • Integrated Disease Surveillance Programme (IDSP) (NRHM-F) and
    • Revised National Tuberculosis Control Programme (RNTCP) (NRHM-G).
• Achievements of the Health Department
  • During the last three years, the Health Department of the State Government has taken several steps to strengthen the health care system in the state. Some of these important steps are:
    • Approval has been given for purchase of 750 ambulances, of which 534 are advance life support ambulance and 216 are basic life support ambulance, to strengthen the ambulance fleet.
    • To strengthen health services, a proposal has been approved under which nutrient and quality food to in-door patients in 33 district hospitals and 13 sub-divisional hospitals will be provided by JEEViKA Didis through Didi ki Rasoi. This system will be evaluated and monitored by State Health Society and JEEViKA.
    • To convert Patna Medical College Hospital (PMCH) into an international standard hospital with a facility of 5642 beds, an amount of Rs. 55,40.07 crore has been approved and, for this, the foundation stone has been laid on August 08, 2021 by the Honourable Chief Minister.
      • The seats for MBBS at PMCH will be increased from 200 to 250 and, for PG course, from 146 to 200.
    • The proposal to Start Homi Bhabha Cancer Hospital in Shrikrishna Medical College Hospital, Muzaffarpur with the collaboration of Tata Memorial Hospital (Mumbai) has been approved.
      • In the first phase, a temporary 50-bed hospital has been started, where treatments like chemotherapy, cancer surgery and palliative therapy are being provided since February, 2021.
    • A Pediatric Intensive Care Unit (PICU) with 100 bed facility and a hospice has been set up in Muzaffarpur to prevent the children of the district from Acute Encephalitis Syndrome (AES). Also, 100-bed trauma centre has been set up in Muzaffarpur. In 15 other districts, 10-bed PICU is ready to treat AES patients.
    • To convert Indra Gandhi Institute of Medical Sciences (IGIMS) into a super-specialty hospital, the number of beds Will be increased from 1032 to 2732. Also, an eye hospital with 200 bed facility is under construction.
      • To purchase the equipment and for the establishment of an Advance Molecular Microbiology and Molecular Genomics Lab in IGIMS, an amount of Rs. 78.50 crore has been approved. The Institute has started kidney transplant, comea implant, liver transplant and heart transplant.
    • In 2019, 6316 ANMs and in 2020, 5189 Grade A Nurses have been appointed in different hospitals in Bihar. In 2021, 9594 ANMs and 4033 Grade A Nurses are to be recruited.
• Response to Covid-19:
  • The emergence of the Covid-19 pandemic in the country in 2020 threw an healthcare challenge for the state. To control the situation, the State Government had to take prompt action, starting with the lockdown, and implementing several other multi-pronged initiatives.
    • Till December 2021 , there were 7.27 lakh active cases in the state.
    • The recovery rate in Bihar is 98.3 percent, nearly the same as national average at 98.0 percent.
  • Testing for Covid-19 is one of the most critical to assess the spread of the pandemic. As such, the State Government has made tremendous efforts in strengthening the testing capacity in the state, bringing the total number of tests to no less than 609.21 lakhs by December 2021.
  • The daily testing has been consistently above the target of 5600 tests per day, as per World Health Organization (WHO) benchmarks.
  • Phase-wise Vaccine Dose :
    • Before starting the vaccination against Covid-19 in the state, all necessary preparations were made. In addition to the vaccine store at Nalanda Medical College and Hospital in Patna, 10 regional vaccine stores and 38 district vaccine stores were established.
    • For appropriate vaccine management and storage, all the 679 functional cold chain units were strengthened.
  • The Bihar State Cabinet had taken a decision in December, 2020 to provide Covid-19 vaccines free of cost in the entire state.
    • The first phase of vaccination for all the health workers (Government and Private) had started from January, 2021.
    • The second phase of vaccination for frontline workers had started from early February, 2021.
    • The third phase had started for the people who were either 60 years and above or persons in the age-group 45-59 years, with comorbidity, and the target was 2.00 crore.
    • The fourth phase of vaccination for the people in the age group 18-44 years had stalled from early May, 2021.
    • Prior to the start ff vaccination for 18-44- age group, 624 vaccination sites were created across the state and a pool of trained paramedics and other health workers were prepared to carry out the vaccination.
    • Till December, 2021, a total of 10.00 crore persons were vaccinated, 5.78 crore with the first dose and 4.22 crore with the second in the state.
    • The State Government had approved Rs. 1000 crore to provide free 19 vaccines to people aged 18-44 years.
    • The campaign song for the vaccination drive was ‘Kar Dikhaega Bihar, Corona Ka Tika Lagaega Bihar‘.
  • Tika Express:
    • The State Govemment had also taken a decision to vaccinate all above 45 near their homes. For this, 121 Tika Expresses (Vaccination Vehicles) were flagged off for different districts of Bihar.
    • Tika Express is a mobile van carrying healthcare staff to far-flung areas offering on-site free vaccination to residents. Through these Tika Expresses, 88 lakh people were estimated to be vaccinated across 1437 municipal wards. The mission was initiated in June, 2021 and each vehicle was allotted a target of vaccinating 200 persons per day.
  • 24X7 Vaccination Centres:
    • The State Government also made arrangements for 24-hour vaccination facility at four centers. Three of them were in Patna and one in Rohtas.
    • Also, there were 9-hour vaccination centres in all 38 districts of Bihar.
    • In addition, five additional vaccination centres were also set up in five districts (Madhubani, Katihar, Bhagalpur, Gaya and Darbhanga) and all these centres were operational till September, 2021.
  • Isolation Centres:
    • During the second wave of Covid-19, 537 Isolation Centres were established, at some of the government and private hospitals.
    • There were 12 Dedicated Covid Hospitals, 116 Dedicated Covid Health Centres, 166 Covid Care Centres and 243 Private Hospitals.
  • Beds with Oxygen :
    • There were 16,986 beds with oxygen, including some in Private Hospitals.
    • There were 3474 beds in Dedicated Covid Hospitals, 5322 beds in Dedicated Covid Health Centres, 3379 beds in Covid Care Centres and 4811 beds in Private Hospitals.
  • Home Isolation Tracking App :
    • The Home Isolation Tracking (HIT) App helped the authorities to keep an eye on the condition of Covid-19 patients, recuperating at their homes.
    • By using the App, health authorities also checked whether the Covid-19-infected patients were following the isolation guidelines or not.
  • Provision of Medical Oxygen:
    • The State Government had come out with its Oxygen Production Promotion policy 2021 , to cater to the need for medical oxygen in the state.
    • As a result, the proposals for nine oxygen production units, worth Rs. 67.28 crore, were given Stage-I clearance by the State Investment Promotion Board (SIPB).
    • An Oxygen Monitoring Cell was also set up in the Industries Department and it between Liquid Medical Oxygen suppliers and medical oxygen refillers in the state.
      • It also collaborated with the Central Government to obtain liquid oxygen allocation for 274 MT for the state.
      • It also coordinated with Petroleum and Explosives Safety Organization (PESO) for clearance Of all pending refillers’ licenses and thus increased the number of refillers in the state from 11 in mid-April, 2021 to 23 by May-end, 2021.
    • Presently, 122 Pressure Swing Adsorption Plants have been set up in 38 districts of Bihar, with capacity ranging from 80 LPM (litres per minute) to 5000 LPM.
  • Recruitment of Health Staff: In the second phase, a total of 1 179 health staff were recruited in different temporary posts, created during the Covid-19 period.
  • Didi Ki Rasoi: This is an initiative, in which JEEViKA workers (JEEViKA Didis) have been given charge of running the hospitals’ canteens to prepare quality meals for patients admitted there.
    • Cleanliness and hygiene are always maintained and the canteens are inspected by the District Magistrate and Civil Surgeons and other senior officials at regular intervals.