Chapter 3

Medical Tourism in Maharashtra

3.1 Maharashtra an Introduction

3.1.1 Maharashtra Infrastructure

3.1.2 Industries in Maharashtra

3.2 Maharashtra Tourism Market

3.2.1 Foreign Tourist Arrivals in Maharashtra

3.3 Maharashtra Healthcare Infrastructure

3.3.1 Healthcare delivery system in Maharashtra

3.3.2 Healthcare Initiatives of Maharashtra

3.3.3 Medical Tourism in Maharashtra

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 Chapter 3 Medical Tourism in Maharashtra

3.1 Maharashtra an Introduction

Maharashtra is the third largest State of India, both in area and population. Maharashtra
abounds in numerous tourist attractions ranging from ancient cave temples, unspoiled
beaches, ancient forts and monuments, forests and wildlife, unique hill stations, pilgrimage
centres, and a rich tradition of festivals, art and culture. Now in the period of globalization
Maharashtra is also ahead in health care. Maharashtra is definitely a scenic state, its beauty
enriched by its long coastline. As such, western Maharashtra, and in particular the Konkan
region, have turned into the most popular destinations1.

3.1.1 Maharashtra Infrastructure

Maharashtra state has a well-developed social, physical and industrial infrastructure. It has
good road, rail, and port and air connectivity. Apart from three international and five
domestic airports, the state has two major and 53 minor ports. It also has a well-
developed power supply grid. Maharashtra witnessed significant growth in the
infrastructure sector in the last decade. There has been a considerable increase in the
number of industrial clusters, and public private partnership projects in the infrastructure
domain. Maharashtra ranks first amongst all the Indian states in terms of GSDP

The state is well connected to its six neighboring states and other parts of India through
18 National Highways. The 93 km long Mumbai-Pune expressway is India's first six-lane,
concrete, high-speed, tolled expressway which connects the state capital and financial
hub, Mumbai with neighboring industrial hub, Pune. As of March 2011, 97.8 per cent of
the villages in the state were connected by all-weather roads. Maharashtra State Road
Transport Corporation (MSRTC) has been providing passenger road transport service in
the public sector, since 1948. The state had a total road length of 410,521 km, as of
March 2011. The state had a road density of 133.41 km per 100 sq km of area, as of
March 2011.

1 MTDC, “Maharashtra’s Medical Tourism Radiating Perfect Health”, 2012.

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Mumbai Metropolitan Region Development Authority (MMRDA) has undertaken mono
rail, metro rail projects in Mumbai, which are at various stages of development. The rail
transport system of Maharashtra is very well-developed. The state is well-connected to
other parts of the country with a railway network spanning 5,984 km (including 382 km
of Konkan Railway).

The Central Railways and the Western Railways, two of the zones of the Indian Railways,
have their headquarters in Mumbai, at the Chhatrapati Shivaji Terminus and Churchgate
respectively. Maharashtra also has an intra-city/sub-urban network of railways. The sub-
urban railways carry around 6.94 million passengers every day2.

There are three international and five domestic airports in Maharashtra. International flights
operate from the Chhatrapati Shivaji International Airport in Mumbai, Mohegan Airport
in Pune and Dr Ambedkar International Airport in Nagpur. Maharashtra Airport
Development Company Limited is developing airports in Maharashtra including Solapur,
Shirdi, Gadchiroli, Chandrapur, Amravati, Jalgaon and new international airport at
Rajgurunagar (Navin Chakan, District Pune). Mumbai Airport is one of the busiest airports in
India. In order to reduce congestion in Mumbai International Airport, an additional
airport has been proposed at Navi Mumbai.

3.1.2 Industries in Maharashtra

The Maharashtra Small Scale Industries Development Corporation Ltd. (MSSIDC), was
established in 1962 to give a new orientation and strength to the development of small
scale industries in the state. The main objective of MSSIDC is to aid, counsel, assist,
finance, protect and promote the interests of small industries. Maharashtra Industrial
Development Corporation (MIDC) is primarily responsible for the development of
industrial infrastructure in the state. Maharashtra Agro Industries Development
Corporation (MAIDC), founded in 1965, is responsible for development of agro-based units
in the state. The Government of Maharashtra is promoting the development of several
Special Economic Zones (SEZs) across Maharashtra for sectors such as IT/ITeS,
pharmaceuticals, biotechnology, textile, automotive & auto-components, gems &

2 India Brand Equity Foundation

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jewellery and food processing. Maharashtra has attracted highest number of industrial
investment proposals among Indian states (17,207 proposals between August 1991 and
October 2011). The state’s share in proposed investment and employment in the country
is 9.4 and 19.6 per cent, respectively.

Government of India is establishing the Dedicated Freight Corridor between Delhi and
Mumbai, covering an overall length of 1483km and passing through the States of U.P, NCR of
Delhi, Haryana, Rajasthan, Gujarat and Maharashtra, with end terminals at Dadri in the
National Capital Region of Delhi and Jawaharlal Nehru Port near Mumbai. This Dedicated
Freight Corridor offers high-speed connectivity for High Axle Load Wagons (25 Tonnes) of
Double Stacked Container Trains supported by high power locomotives. The Delhi- Mumbai
leg of the Golden Quadrilateral National Highway also runs almost parallel to the Freight
Corridor. DMIC aims to promote integrated development of industry and infrastructure in a
band of 150 km to 200km (Influence region). The DMIC region will be developed as a ‘Global
Trading and Manufacturing Hub’. Government of India has incorporated a special purpose
vehicle, Delhi Mumbai Industrial Corridor Development Corporation (DMICDC), specially
envisaged to coordinate DMIC Project Development, Finance and Implementation

DMIC Footprints in Maharashtra

 29% geographical area of Maharashtra catering to 26% population. 17% of DMIC

Project Influence Area (PIA) is in Maharashtra

 Major Districts covered :Thane, Nasik, Pune, Aurangabad, Ahmednagar, Dhule,

Nandurbar & Raigad

 Maharashtra is envisioned as a new sustainable global industrial region, a network of

interconnected, modern cities providing place for people to live, work, play, and
celebrate life in a safe, healthy environment

 DMIC Is likely to increase Industrial output of Maharashtra, by an additional Rs.

20,00,000 Crore over next three decades

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3.2 Maharashtra Tourism Market

Maharashtra has a wealth of tourist attractions ranging from forts, tribal arts, caves, hill
stations, beaches, water sports, entertainment and film industry, cultural activities,
pilgrimage centers, wildlife sanctuaries, intense trade and commercial activities, shopping
malls, plazas and much more making it a complete tourist destination. Mumbai is one of the
most important place in Maharashtra to visit. The state ranked first in foreign tourists arrivals
and among top 5 states in domestic tourist arrivals. The services sector is the largest sector in
the state and it has been growing at the rate of 8.5 per cent from 2001 to 2007. Within the
services sector, the trade, hotels and restaurants have the highest contribution to the total
state income (Bhandari L. and Kale S, 2009).

Table: 3.1 Foreign and Domestic Tourist Arrivals in Maharashtra

Year Domestic Visitors

2005 14329667
2006 16880348
2007 19226716
2008 20553360
2009 30628394
2010 48465492
2011 55333467
2012 66330229

3.2.1 Foreign Tourist Arrivals in Maharashtra

Maharashtra topped the list in number of foreign tourist visits, followed by Tamil Nadu and
New Delhi. While Maharashtra received nearly 4.8 million tourists, Tamil Nadu welcomed 3.4
million people and New Delhi played host to 2.2 million foreigners, according to the latest
report from the Union Ministry of Tourism. The statistics released by the Ministry for 2011,
says the number of Foreign Tourist Visits (FTVs) to Indian states/union territories was 19.5
million as compared to 17.9 million in 2010 and 14.4 million in 2009. This year, the number of
FTVs registered a growth of 8.85 percent over 2010 as compared to a growth of 24.6 percent

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in 2010 over 2009. It is the third consecutive year where the number of foreign tourist visitors
has increased.

The number of domestic and foreign tourist visits to different States/UTs during the years
2011 and 2012. It may be seen from this Table that most of the States/UTs have generally
observed increase in the number of domestic and foreign tourist visits, during 2012
Maharashtra have been estimated using all India growth rate.

Table 3.2 Domestic and Foreign Tourist Growth in Maharashtra

2011 2012 % Growth (2012

/2011
State Domestic Foreign Domestic Foreign Domestic Foreign
Maharashtra 55333467 4815421 66330229 5120287 6.33 19.87
Source: India Tourism Statistics 2012

The top 5 States in domestic tourist visits in 2012 were Andhra Pradesh (206.8 million), Tamil
Nadu (184.1 million), Uttar Pradesh (168.4), Karnataka (94.1 million) and Maharashtra (66.3
million) with their respective shares being 20%, 17.8%, 16.2%, 9.1% and 6.4 %. These 5 States
accounted for about 69.5% of the total domestic tourist visits in the country. In respect of
foreign tourist visits in 2012, the top 5 States/UTs were Maharashtra (5.1 million), Tamil Nadu
(3.6 million), Delhi (2.3 million), Uttar Pradesh (2.0 million) and Rajasthan (1.5 million) with
their respective shares being 24.7%, 17.2%, 11.3%, 9.6% and 7.0% These 5 States/UTs
accounted for about 69.8% of the total foreign tourist visits to the States/UTs in the country.

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Fig. 3.1 Top ten Domestic Tourist Visits

Source: India Tourism Statistics 2012

The top 10 States/UTs in terms of foreign tourist visits during 2012 were mostly the same as
in 2011, with marginal changes in relative ranks of States. The following graph shows the
percentage share of top 10 States/UTs in terms of foreign Tourist visits in 2012.

Fig 3.2 Top ten States Visits

Source: India Tourism Statistics 2012

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3.3 Maharashtra Healthcare Infrastructure

Maharashtra state has a three-tier public health infrastructure, comprising Hospitals,

Primary Health Centers and Health Units, Community Health Centres and Subcentres. As
of 2010, the number of beds in various public and government-aided health institutions
in the state were 115,704; the state had 102 beds per 100,000 of population As of
October 2011, the state had 498 State level Hospitals, 23 District Hospitals, 83 Sub
District Hospitals, 458 Community Health Centres, 1,809 Primary Health Centres and 10,580
Sub Centres.

Table 3.3 Healthcare Infrastructure in Maharashtra

Healthcare Infrastructure
Type of Institutions No. Type of Institutions No.
State Level Hospital 498 Sub Centres 10,580
District Hospital 23 Primary Health Units 172
Sub District Hospital with capacity of 56 Mobile Health Units 61

-50 beds
Sub District Hospital with capacity of 23 Women Hospitals 8

-100 beds
Sub District Hospital with capacity of 3 Mental Hospitals 4

-200 beds
Rural Hospital / Cottage Hospital 386 Dental Hospitals 3

Primary Health Units 1816 TB Hospitals 5

Community Health Centres 458
Source: Planning Commission of India

Maharashtra has been in the forefront of healthcare development in the country. It was
among the first states to decentralize primary healthcare administration through Zilla
Parishads as early as 1961. Further, under the Minimum Needs Program Maharashtra was
again one of the first states to achieve the norms mandated for primary health centers,
subcentres, and Rural Hospitals. The state also has the largest private health sector in India
whose reach is quite extensive. The Tertiary healthcare service in Maharashtra has witnessed
an enormous growth in infrastructure in the private and voluntary sector. The private sector

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which was very modest in the early stages has now become a flourishing industry equipped
with most modern state-of-art technology at its disposal. It is estimated that 75-80% of
healthcare services and investment in Maharashtra are now provided by the private sector
such as the Tatas, Fortis, Max, Wockhardt, Parimal, Apollo and the Escorts group.

Table 3.4 Health Indicators of Maharashtra

Health Indicators of Maharashtra

Population Served per Government Hospital 82,264*
Birth Rate (per thousand persons) 16.7
Death Rate (per thousand persons) 6.3
Infant Mortality Rate (per thousand live births) 25
Life Expectancy at Birth (years )
Male (2002-2006) 66.0
Female (2002-2006) 68.4
Source : India Brand Equity Foundation

3.3.1 Healthcare delivery system in Maharashtra

India has a universal health care system run by the local state or territorial governments.
Maharashtra state and its hospitals is part of it. Most essential drugs are offered free of
charge in these hospitals. However, the fact that the government sector is understaffed
underfinanced and that these hospitals maintain very poor standards of hygiene this forces
many people to visit private medical practitioners. The charges for basic in-hospital treatment
and investigations are much less compared to the private sector. The cost for these subsidies
comes from annual allocations from the central and state governments. Primary health care
is provided by city and district hospitals and rural primary health centers (PHCs). These
hospitals provide treatment free of cost. Primary care is focused on immunization, prevention
of malnutrition, pregnancy, child birth, postnatal care, and treatment of common illnesses.
Patients who receive specialized care or have complicated illnesses are referred to secondary
(often located in district and taluka headquarters) and tertiary care hospitals (located in
district and state headquarters or those that are teaching hospitals).

The Public Health Department Government of Maharashtra is making constant and

concerted effort to formulate and execute schemes to ensure adequate health care services
to the people in line with the National Health Policy. While implementing these schemes,

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steps are being taken to make improvements in the health care system in the State to cater
to the health needs of the people in the rural areas, particularly in the tribal and backward
regions of the State. Maharashtra is one of the largest states in the country and is also among
the best economically developed states.

It has one of the largest industrial economies in the country and is a primary financial center.
Its economic dominance is in large part due to the contributions of Mumbai, the country’s
financial and industrial capital that accounts for 35 per cent of the state’s domestic product
with only about 12 per cent of the state’s population. Maharashtra is the second most
populous state in India with a population of 96.8million (2001 Census), investment in
Maharashtra, and especially in Mumbai, has come from all over the country and the world.
Mumbai and a few other industrial cities in Maharashtra have attracted the best human
resources. All this has contributed to the present level of development of the state and the
city.

Organizational Structure of Public Health

The overall organisational structure and systems of public health care provision are not very
different across the country. Even though health is a state subject most states follow a similar
pattern of health care administration and management.

Fig 3.3 Orgnsational structure of Public health

Minister of Public Health & Family Welfare

State Minister Public Health &

Family Welfare

Secretary Secretary
(Health) (FW)

Director State AIDS Director Health System Director Genral

Director ESIS
Society Development Project Health Services

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3.3.2 Healthcare Initiatives of Maharashtra

Maharashtra has been in the forefront of healthcare development in the country. It was
among the first states to decentralize primary healthcare administration through Zilla
Parishadas as early as 1961. Further, under the Minimum Needs Program Maharashtra was
again one of the first states to achieve the norms mandated for primary health centres,
subcentres and Rural Hospitals. The state also has the largest private health sector in India
whose reach is quite extensive. While Maharashtra is today also the most affluent state in the
country with the highest per capita income here are some Healthcare Initiatives taken and
some of taking by Maharashtra last five years.

 Kumar Urban development (KUL) has signed an agreement with super specialty Nova
Hospital for a build-to-suit (BTS) project in Pune, Maharashtra. With this project, Nova
brings super specialties such as high end surgeries to the city of Pune.

 Fortis Hospital Mulund, has launched ‘Fortis Child Heart Mission’ to provide heart
surgeries and treatment at an affordable cost. Since the start of initiative in January
2013, reportedly more than 150 children with heart defects have already been treated
successfully at the Fortis.

 Health city Project in Nagpur, The Health City is spread over 40 Hectares of land within
the SEZ. It will consist of a chain of Super Specialty Hospitals accommodating about
2000 beds catering to various multi-specialty treatments. The Health city will consist
of various support facilities like Common Diagnostic Centre, Common Waste Disposal
Facilities, Economy and Luxury Class accommodation for relatives or companions of
patients admitted, Training Institute for Nurses and Technicians.

 Maharashtra and the national capital region (NCR) accounted for over 50% of foreign
direct investment inflows into the country during the first half of 2010-11, says the
latest industry ministry data. Maharashtra attracted the maximum foreign direct
investment (FDI) of about $2.67 billion (Rs 12,275 crore) during April-September,
2010, accounting for 34% of the total FDI in the country during the period. National

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 capital region (NCR), including parts of Uttar Pradesh and Haryana, received $1.96
billion (`8,961 crore) of FDI during the period.

 The Government of Maharashtra has entered into a partnership with GE Healthcare

for setting up advanced diagnostic and imaging facilities in 22 hospitals. A consortium
of Wipro GE Healthcare will run these 24/7 diagnostic facilities. The partnership in
which GE will act as the technology partner and Ensocare as the operating partner
aims at bringing technology at an affordable price point for the people of the state.
GE has invested around Rs 150 crore in this project.

 Government of Maharashtra and Government of Quebec are trying to explore

opportunities for collaboration and one of them is the signing of the Joint Declaration
on Cooperation in Health and Social Services in telemedicine. Tele-trauma and Primary
care.

 The Maharashtra Government has set up an International Biotech Park, at

Hinjewadi, 10 km from Pune city. This is the first public-private biotechnology park
initiative in the state.

 Chief minister of Maharashtra has announce the state government has prepared a
master plan of setting up 1,500 new primary health centres, sub-centres and small
hospitals so that affordable medical service is available in every corner of the state.3

3.3.3 Medical Tourism in Maharashtra

In the period of globalization Maharashtra is also ahead in health care, Maharashtra has the
best qualified professionals in each & every field and this fact has now been realized the world
over regarding medical facilities. Maharashtra has the most competent Doctors and world
class medical facilities with most competitive charges for treatment of certain Medical
problems. After carving a niche for itself on the global tourism map, Maharashtra is now
looking for creating a new identity by offering best health services to tourist.

3
http://www.dnaindia.com/pune/report-state-plans-1500-new-primary-health-centres-small-hospitals-chavan-1894427

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Undoubtedly a lot in the recent days and experts are comparing it as one of the best emerging
medical tourism destination. After Delhi, Bangalore, Chennai and Kerala, Maharashtra has
better scope in medical tourism in the coming decade, be it a Unani, Ayurveda, Homeopathy,
Allopathic medicines, local doctors are second to none, medical experts claim. On the cost
front too, Maharashtra offers affordable treatment compared to other parts of India and
foreign countries.

In Maharashtra Metropolitan cities like Mumbai & Pune, Medical Tourism is going on big way,
with this there are other destinations of Maharashtra also have potential for Medical Tourism,
and these are the sunshine city of Medical Tourism Destination in Maharashtra. i.e.,
Aurangabad, Nasik and Nagpur. Additionally, medical tourism overlaps with conventional
tourism in the sense that patients and those who accompany him or her also take time off to
visit various other tourist destinations within easy reach. For example, there have been cases
when a person and his family members, post treatment in Mumbai, have taken time off to
visit Pune, Aurangabad, Mahabaleshwar, etc. The spinoffs from medical tourism are therefore
immensely profitable.

Like any other service industry, medical tourism too depends on maintaining very high
standards and absolute professionalism. What works in favor of Medical Tourism destination
at Maharashtra is that there is the availability of English-speaking paramedics and other staff
in medicare institutions which puts visitors at ease. Additionally, visitors coming from abroad
do not face too many visa complications. Meanwhile, over the years some of the bigger
hospitals in Maharashtra have created a niche for themselves and now their brand identity is
enough to attract people from across the world.

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