and environment have been interlinked in more than one area of study.
While human development index, as adopted by UNDP, consider non-economic
indicators to assess development, health indicators can clearly indicate
the quality of air, water, sanitation, noise vis-a-vis state of human
13.1 Health Care Facility
State of Tripura, till date, seems to suffer significantly in terms of
health care delivery system. The available data of 1999-2000, published
by Directorate of Economics and Statistics in Tripura shows that total
number of Public Health Clinic is only 59, total number of Hospitals 28
and dispensaries 621. While these figures have improved between 1985-2000
and may not sound alarming, the figures for available number of doctors
(905), nurses (920) and midwives (95) shows the extreme inadequacy of
health care delivery. While Indian figure for doctors stands at 48 per
100,000 persons, for nurses 58 per 100,000 persons and midwives 30 per
100,000 persons, the respective figures for Tripura stands at 32, 32.9
and 3.6 per 100,000 persons (Table-89).
Health Care System 1999-2000
*State of Environment in Tripura Report 1989. **Directorate of Economics
& Statistics and ***
Figures in parenthesis for the year 1999 supplied by Directorate of Health,
Govt. of Tripura]
13.2 Birth Rate &
data with regard to the estimated birth and death rate however shows a
better trend in Tripura in spite of inadequacy of heath care delivery
system. In rural areas, the estimated number of birth rate stands at 18.2
and death rate at 6.1 per 1000 persons, but in urban area the corresponding
figure stands at 14.8 and 5.4 respectively. The combined figure of rural
and urban sector stands at 17.6 and 6.1 as against All India figure of
28.7 and 9.2 (Table-90).
Estimated Live Birth rate and Death rate (per 1000 persons)
infant mortality rate for rural and urban sector stands at 50 and 39 respectively
(per 1000 persons) and combined figure stand at 49; the corresponding
figure for Indian average is much higher at 77,45 and 72 respectively
Infant Mortality rate in Tripura and India (per 1000)
CSO from Dept. of Family Welfare, Ministry of Health and Family Welfare,
1998, * Figure within parenthesis denote 1999 data supplied by supplied
by Directorate of Health, Govt. of Tripura]
Occupational Health Hazard
data on occupational health hazard could be of vital importance in assessing
impact on health of different developmental sectors. Unfortunately no
such data are available. Recent efforts of at least one large enterprise,
Indian Oil Corporation (IOC) to assess the risk and disaster management
in three of the IOC operational site in North Tripura (as a part of assessment
of 11 sites in North East India) by the Calcutta based Centre for Study
of Man and Environment may provide a possible projection of any accidental
disaster related health hazard.
total registered factories in Tripura, as per Directorate of Economics
and Statistics handbook, (1999-2000) stand at 2582
of which 1349 factories are recorded
as Notified factories; total workers employed in 2582
registered factories number 30,012.
Obviously categorization of operation
of these factories in Red, Orange and Green categories and regular check
up by Health Inspectors from State Labour Department could provide indicative
data on possible occupational health hazards.
the industries and allied activities in the State posing substantial health
hazard including death are Ferrous Metallurgical, Power generating, Acids
& alkalis Drugs & Pharmaceutical, Distilleries & Breweries,
Paints & Pigment, Leather Tanning,
Synthetic Resin and Plastic, Highly Flammable Liquid & Gases and
Lead. Number of hazardous units is 28 including 11
General Health Profile
general disease profile of the State over last 15 years up to (1999-2000)
clearly indicates highest incidence of diarrohea followed by malaria.
The comparable data for 1985-86 and 1999-2000 for bronchial diseases and
cancer are not available but the bronchial disease figure of 1,18,787
in 1997 and cancer related figure of 17,874 in 1999-2000 calls for serious
separate data are available for cholera (16,186) and tuberculosis (1435)
for the year 1985; nil data for cholera for subsequent years appear questionable;
for tuberculosis the data for 1999-2000 stands at 463 including indoor
and outdoor patients.
data on typhoid and measles may call for better immunization programme.
Of the other disease incidences of leprosy, viral hepatitis and polio
appear to be infrequent. Table-92 Provide a decadal change profile between
1985 to 1993-94 and also provide the latest health data including for
some additional diseases.
Disease Profile of Tripura
: (1) State of Environment in Tripura, 1989 p. 99
prevalence of dysentery appear on the rise when compared with the past
figure of 1985 and that of 1993-94 and 1999-2000; during 1985, 2.4% of
the population was suffering from this disease, while in 1993-94, more
than 3.3% of the population are reported to have been affected by this
water borne disease; the figure stands at 3% in 1999-2000. Data for 1998
on the total morbidity supplied by Directorate of Health indicate 3,72,436
indoor patients and 95,760 outdoor patients.
of the drinking water quality becomes an urgent necessity; to offer remedial
measure; treatment of water and improvement of distribution system become
as per National Family Health Survey (1993) has experienced considerable
decline in the fertility in recent decade. During 1990-92, the total fertility
rate (TFR) in the State was 2.7 children per woman, 21 percent lower than
the national average. The stabilization of population can have a positive
effect of more women processing family planning; in Tripura 56 percent
of currently married women are reported to resort to such practice but
only 29 percent adopt modern methods (National Family Health Survey Summary
Report, Tripura, 1993).
the other hand infant mortality rate remains high in Tripura, 1 in 13
children dying before they reach the age of one and 1 in 10 children dies
before reaching age of five. This figure goes against Human Development
programme and demands a better health care service to reduce infant and
child mortality. The picture becomes more clear from the fact that for
35 percent births mother do not get antenatal care. Most babies (69 percent)
are delivers at home and only 33 percent of deliveries are attended by
nurses and midwives. This can be corroborated with extremely inadequate
figure for such categories of health care personnel as mentioned earlier.
back to UNDPís guideline to assess Human Development, nearly half of the
children being underweight and 46 percent remaining stunted, show an alarming
child Survival and Safe Motherhood programme (CSSM) adopted in the 8th
Five Year Plan (1992-97) targeted to lower an infant mortality rate of
50 per 1000 live births, the figure for Tripura during 1988-92 was 76
per 1000 live births. Similarly the target for under five mortality was
fixed at 70 per 1000, the figure for Tripura during 1988-92 stood at 105
per 1000. The crude death rate target of 9 per 1000 population was never
achieved- the figure stood at 12 per 1000 in 1991-92. The biggest lapses
can be noted in the services for antenatal case and deliveries during
pregnancies; against a set target of 100 percent coverage for both, the
services, women in Tripura received 65 percent antenatal care and 33 percent
delivery related services during 1988-92. The population stabilization
can be better achieved with 75 percent couple protection rate as against
56 percent recorded in Tripura.
the reader may refer back to the Table-91 showing the figure of 1999 regarding
infant mortality rate per 1000; it shows a definite improvement from 1992
period (76 per 1000 to 49 per 1000). The recent figure for crude birth
and death rate per 1000 (as given earlier) also indicates a significant
change in the trend.
different methods of family programmes are being carried out by Govt.
of Tripura. The data available for the year 1995-96 to 2000-2001, show
that in each of the four programme namely (i) sterilisation, (ii) IUD,
(iii) C.C. Users and (iv) Oral pill users, percentage of achievements
against target are declining. While in 1995-96 97% was achieved in sterilisation
programme, 151% was achieved in IUD programme and 543% was achieved in
oral pill programme, the respective figure for the year 2000-2001 stands
at 61%, 81%, and 57%. Even for C.C. users the achievement of 97% of 1998-99
decline to 36% in 2000-2001. As such the implementation of family welfare
programme needs a serious review before the initiation of 10th
Five Year Plan.
these, the State Government has so far been able to implement number of
family welfare programme under National Programme Schemes till 1999-2000.
These are : National Family Welfare Programme, National Malaria Eradication
Programme, National Programmes for Control of Blindness, National Tuberculosis
Control Programmes, National Iodine Deficiency Programmes, National AIDS
Control Programmes, National cancer Control Programmes, Universal Immunisation
Programmes, Oral Rehydration Therapy Schemes, National Leprosy Eradication
Programmes, Special School Health Check-up Schemes for Primary Children,
Pulse Polio Immunisation Programmes, Village Health Guide Schemes, Prevention
of Food Adulteration Act and Sexually Transmitted Disease Control Programmes.
No data is available on the targeted programme, actual achievements and slippages with regard to the above named projects.