Jharkhand, one of India’s youngest states, continues to grapple with deep-rooted public health gaps even as new institutions try to transform its healthcare landscape.
While it could be seen as getting better in many areas, urgent improvement is necessary too. According to National Health Mission’s Health Dossier 2021, Jharkhand had been flagged for limited primary care, high anaemia rates, large tribal populations and rising burden on tertiary centres.
MedBound Times connected with Dr. Nitin M Gangane, who has recently been appointed as the Executive Director & CEO, AIIMS Deoghar.
Dr. Nitin Gangane has a deep and personal connection to his alma mater. He was born in the hospital attached to the Mahatma Gandhi Institute of Medical Sciences (MGIMS), Sevagram, where he later studied medicine and completed his postgraduate training. After finishing his post-graduation, he joined MGIMS as a faculty member in the Department of Pathology, eventually becoming Head of the Department and then Dean.
Before his current role, he served as Vice Chancellor at KLE Academy of Higher Education & Research, located in Belagavi, Karnataka, giving him valuable experience in both government-regulated and private healthcare systems. Now, near the close of his glorious career, he has embraced the opportunity to lead AIIMS Deoghar, drawn by the challenge of serving in a deeply underserved region.
Jharkhand has 3,848 sub centres, 291 primary health centres, and 17 community health centres.
The actual rural requirement is 6,848 sub centres, 1,091 PHCs, and 272 CHCs.
This reflects a shortfall of 44 percent in sub centres, 73 percent in PHCs, and 37 percent in CHCs.
Urban areas have only 60 PHCs, though 196 are required.
The state has 23 district hospitals, 13 sub district hospitals, and 7 government medical colleges.
Jharkhand’s doctor to nurse ratio is 1 to 1.5.
There are 3 public healthcare providers per 10,000 people.
Public facility usage is limited: only 436 outpatient visits per 1,000 people and 20.4 inpatient admissions per 1,000 people.
Out of pocket spending is high at 68 percent of total health expenditure.
A major share of household spending goes toward medicines (59 percent of rural inpatient costs) and diagnostics. 1
What are the changes or improvements that AIIMS Deoghar would need, and what will the staff notice?
Dr. Nitin Gangane said he has begun by visiting different departments and facilities and understanding the ground reality. “I joined on the first of the month. I started visiting different departments. So initially I finished with the pre and paraclinical departments. I am also visiting the clinical departments now.”
He said the pattern of patients coming to Deoghar will be very different from other AIIMS campuses. “Patients who usually come to other AIIMS have many different options available to them. Usually they have already received treatment at a primary or secondary and also tertiary level and then they come to AIIMS. Here it is going to be an entirely different scenario because even the primary and secondary care is also not that well established.”
According to him, this means AIIMS Deoghar will carry a wider load. “AIIMS Deoghar will be unique in a sense that we will not be providing only tertiary and quaternary health services but also many of the conditions, which can be easily managed at peripheral hospitals.” He added that this will be a challenge because “the numbers I expect to be huge.”
The daily footfall has already surprised him. “Already we have crossed our OPD which is more than 1000 and at present it is not easily accessible for patients. So once the roads and connectivity will be there, I expect it to cross more than 3000 to 4000 patients per day.”
For him, the biggest constraint is not infrastructure but people. “The infrastructure is there. But there are manpower issues. It is really difficult to get qualified manpower in such a place. We have young faculty, very enthusiastic, but ultimately we require senior faculty to guide them.”
How would you want to encourage young doctors and students to work for the community?
Dr. Nitin Gagane was candid about the realities of rural service. He said the challenge does not lie in motivation alone, but in the environment young doctors are asked to work in. “That is going to be a problem because you know that if we ask them to work in a community, we have to also provide the basic infrastructure and amenities.
He pointed out that rural postings often lack the most essential support systems. “The problem with the present system is that the infrastructure is not that good in rural areas.” Even for experienced doctors, this becomes a barrier. “Even if I want to go and work for some time, I will require some basic amenities. Good residence, good education for my children. Unfortunately, unless and until those facilities are there, it is going to be very difficult to retain doctors in rural areas.”
Dr. Gangane also acknowledged that pushing postgraduate doctors into rural service is unrealistic. “We do not expect that postgraduates in modern medicine will go and serve in rural areas. So it is not going to happen until we try our best to provide infrastructure and facilities.”
Instead, he believes the solution lies in building a stronger, multi-layered workforce. “If we take into account our AYUSH doctor and take the help of other systems of medicine, maybe we will be able to provide even better services at the peripheral level.” For him, strengthening community care means broadening the team and reshaping how healthcare is delivered outside cities.
For communities spread across rural belts of Jharkhand, Bihar and West Bengal, Deoghar offers something they have not had before: a place where advanced diagnostics, specialist consultations and high-risk interventions are available under one roof. The institute is expected to stabilise the referral chain, ease the pressure on district hospitals and reduce the burden of travel that families often make when they seek care in bigger cities.
AIIMS Deoghar also brings the possibility of training a new generation of doctors who understand the realities of underserved regions. With young faculty already in place, the institute can grow into a centre that not only treats patients but shapes how healthcare is delivered in similar geographies.
AIIMS Deoghar’s success will depend on sustainable staffing, strengthened primary healthcare, and community engagement. For many families across Jharkhand, Bihar, and West Bengal, it represents a critical step toward accessible and high-quality medical care close to home.
Reference:
1. National Health Systems Resource Centre. Health Dossier 2021: Jharkhand. New Delhi: Ministry of Health and Family Welfare, Government of India, 2021. Accessed November 26, 2025. https://nhsrcindia.org/sites/default/files/practice_image/HealthDossier2021/Jharkhand.pdf.
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