Ayush Concept

PROJECT
“CONCEPT REPORT OF DEVELOPMENT OF

AYUSH HOSPITAL IN TUMAKURU CITY”
DETAILED PROJECT REPORT

“CONCEPT REPORT OF OF DEVELOPMENT OF
AYUSH HOSPITAL IN TUMAKURU CITY”
Project Management Consultant for Implementation of Smart City

Mission Project of Tumakuru City
APRIL 2019
Submitted to: Tumakuru Smart City Limited
Submitted by:
IPE Global Limited Grant Thornton India LLP Aryavartha Design

Consultants LLP
Contents
Executive Summary 6
1 BACK GROUND 7
1.1 THE SMART CITIES MISSION 7
2 INTRODUCTION 9
2.1 TUMAKURU CITY PROFILE 9
2.2 ECONOMIC LANDSCAPE OF TUMAKURU 11
2.3 TUMAKURU SMART CITY 12
3 PROJECT UNDERSTANDINGS 13
4 Objective 14
5 LOCATION AND CONNECTIVITY 15

6 EXISTING SITE CONDITION 15
7 HEALTHCARE PROFILE 16
7.1 HEALTHCARE IN INDIA – MACROECONOMIC CLIMATE 16
7.2 Healthcare Setup in India 17
7.3 HEALTHCARE IN KARNATAKA 19
YESHASVINI COOPERATIVE FAEMERS HEALTH CARE SCHEME 20
JYOTHI SANJEEVINI SCHEME 21
VAJPAYEE AAROGYASHREE 21
RAJIV AAROGYASHREE 21
JANANI SURAKSHA YOJANA 21
MISSION INDRADHANUSH 22
AROGYA KAVACHA 108 22
MOBILE HEALTH UNITS 22
AROGYA SAHAYAVANI-104 22
7.4 HEALTHCARE IN BENGALURU CITY 23
7.5 HEALTHCARE IN TUMAKURU DISTRICT 25
7.6 DISTRICT HOSPITAL, TUMAKURU 27
7.7 HOSPITAL BED MIX OF TUMAKURU 29
7.8 HEALTH SPECIALISTS IN TUMAKURU 29
8 Hospital Design Guidelines 30

8.1 ENVIRONMENTAL MANAGEMENT IN THE HOSPITAL 30
8.2 HAZARDOUS WASTE MANAGEMENT 31
8.3 PARKING 32
8.4 AREA REQUIREMENT 32
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Project Management Consultant for Implementation of Smart City Mission Project of Tumakuru City
List of Figures
Figure 1: Conceptualization of Smart City ...................................................................................................................7
Figure 2: Location maps of Tumakuru .........................................................................................................................9
Figure 3:Details of ABD Area ....................................................................................................................................... 13
Figure 4: Proposed location for AYUSH Hospital ................................................................................................. 15
Figure 5: Existing site condition ................................................................................................................................. 16
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List of Tables
Table 1: Key facts about Tumakuru (As per Census 2011) ................................................................................. 10
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Disclaimer
This report (including any enclosures and attachments) has been prepared by IPE Global Limited (IPE
Global) for the exclusive use by Tumakuru Smart City Limited and solely for the purpose for which it is
provided. IPE Global does not accept any liability if this report is used for an alternative purpose from
which it is intended, nor to any third party in respect of this report.
IPE Global has used reasonable skill and care in checking the authenticity, accuracy and completeness of
information obtained from the public domain or from external sources in the report. IPE Global assumes
no responsibility for such information.
IPE Global does not accept responsibility for any legal, commercial or other consequences that may arise
directly or indirectly as a result of the use of third-party information or information sourced from public
domain in this report or used for an alternative purpose from which it is provided.
Executive Summary
Tumakuru Smart City Limited (TSCL) envisions improved living standers and better safety & security for its
citizens in the TCC jurisdiction. Accordingly, the TSCL has appointed consultants for realization of the idea.
The consultants after various discussions with TSCL and the different stakeholders designed the project
the various components involved. These components together provide a holistic approach to the safety
and security of its citizens and a comprehensive package to keep its citizens informed while keeping them
safe.
The Ministry of AYUSH was formed on 9th November' 2014. Earlier it was known as the Department of
Indian System of Medicine and Homeopathy (ISM&H) which was created in March 1995 and renamed as
Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy (AYUSH) in November
2003, with a view to provide focused attention for the development of Education and Research in
Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy.
Objectives
 To upgrade the educational standards of Indian Systems of Medicines and Homoeopathy colleges
in the country.
 To strengthen existing research institutions and to ensure a time-bound research programme on
identified diseases for which these systems have an effective treatment.
 To draw up schemes for promotion, cultivation and regeneration of medicinal plants used in these
systems.
 To evolve Pharmacopoeia standards for Indian Systems of Medicine and Homoeopathy drugs.
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1 BACK GROUND
1.1 THE SMART CITIES MISSION
Rapid growth in small and medium scale urban centres plays an important role in economic and societal
progress. However, it also strains a city’s infrastructure. Key challenges, such as traffic congestion, energy
usage, public safety, and the building of sustainable communities are top of mind. Such challenges need to
be addressed through the development and implementation of intelligent solutions. Smart cities are
measured by the integration of their infrastructure and the intelligent ways by which they tackle challenges.
A smart city puts emphasis on creating a system of networks to allow for a systematic flow of information
and effective management of resources. Enabling integration and convergence with organizations and local
authorities to provide solutions for the development of a smart city is crucial.
Figure 1: Conceptualization of Smart City
Adequate
Water Supply
Inclusive and
Proper
Sustainable
Sanitation
Development
Social Infrastructure in Efficient

Infrastructure a Smart City Urban Motility
Assured
E-governance Electricity
Supply
Robust IT
Connectivity
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A Smart City offers decent living options to every resident. This would mean that it will have to provide a
very high quality of life i.e. good quality but affordable housing, cost efficient physical infrastructure such
as 24 x 7 water supply, sanitation, 24 x 7 electric supply, clean air, quality education, health care, security,
entertainment, sports, robust and high-speed interconnectivity, fast & efficient urban mobility etc
Nearly 31% of India's current population currently resides in cities and contribute 63% of GDP (Census
2011). Urban areas are expected to house 40% of India's population and contribute 75% of India's GDP by
2030. This requires comprehensive development of physical, institutional, social and economic
infrastructure. All are important in improving the quality of life and attracting people and investment,
setting in motion a virtuous cycle of growth and development. Development of Smart Cities is a step in that
direction.
The Smart Cities Mission is an innovative and new initiative by the Government of India to drive economic
growth and improve the quality of life of people by enabling local development and harnessing technology
to create smart outcomes for citizens.
The objective of the Smart Cities Mission is to promote cities that provide core infrastructure and give a
decent quality of life to its citizens, a clean and sustainable environment and application of 'Smart'
Solutions. The focus is on sustainable and inclusive development and the idea is to look at compact areas,
create a replicable model, which will act like a lighthouse to other aspiring cities. The Smart Cities Mission
aims to set examples that can be replicated both within and outside the Smart City, catalysing the creation
of similar Smart Cities in various regions and parts of the country.
The Smart Cities Mission is being operated as a Centrally Sponsored Scheme (CSS) and the Central
Government proposes to give financial support to the Mission to the extent of ₹ 48,000 crores over five
years i.e. on an average ₹ 100 Crores per city per year. An equal amount, on a matching basis, will be
contributed by the State/ULB; therefore, nearly INR One Lakh Crore of Government/ULB funds will be
available for Smart Cities development.
Accordingly, the purpose of the Smart Cities Mission is to drive economic growth and improve the quality
of life of people by enabling local area development and harnessing technology, especially technology that
leads to Smart outcomes.
To increase the living index of the city and to make the city safer to live is also one of the initiative under
smart city mission
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2 INTRODUCTION
2.1 TUMAKURU CITY PROFILE
Tumakuru, the district headquarters of Tumakuru district in South East Karnataka, is an industrial city
spread over about 48 Square Kilometres, popularly known as the City of Education and the City of
Coconuts. Almost 7 years ago, Tumakuru was accorded the status of a City Corporation. Tumakuru is in
close proximity to the Karnataka State Capital, Bengaluru which is located just 70 km South West of
Tumakuru.
Figure 2: Location maps of Tumakuru
The following table summarizes some key facts about Tumakuru City.
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Table 1: Key facts about Tumakuru (As per Census 2011)
Tumakuru City Population 3,05,821 (2011 Census)
Area 48.21 Sq. Km.
Population Density 6300/km2
Population of the ABD Area 43,941
ABD Area 3.62 Sq. km.
Length of Roads 575 Km
Sex Ratio 976
Literacy 88.91%
Temperature Summer: 32°C – 40°C Winter: 17°C – 30°C
Elevation 822 m
Latitude 13.34°N 77.1°E
Distance from Bangalore 70 KM
Connectivity Nearest Airport – Kempegowda International Airport,
Benguluru (86 KM)
Nearest Railway Station: Tumakuru Railway Station
Nearest Major Railway Station: Yeshwantpur Railway Station,
Bangalore (63 KM)
Tumakuru District is an administrative district in the state of Karnataka in India. It was formerly the part
of old Mysuru State. The district occupies an area of 10,598 km² and had a population of 26,78,980, of
which 18.11% were urban as of 2011. It is a one-and-a-half-hour drive from Bangalore, the capital of
Karnataka. It is the only discontinuous district in Karnataka (Pavagada Taluk has no geographical continuity
with the rest of the district).
As Tumakuru is a knowledge hub in the south interior Karnataka and boasts of its own Tumakuru
University, two medical colleges, five engineering colleges, 38 degrees and post-graduate colleges, one
dental college and many polytechnics, high schools and primary schools imparting top level education to
all classes of citizens. Tumakuru is a good study centre from primary education to higher education. It has
its own university. Within this town, there are two medical and one dental institution.
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2.2 ECONOMIC LANDSCAPE OF TUMAKURU
Tumakuru’s total GDP stands at ₹ 100.75 billion contributing 3.4% to state GSDP. It’s per capita annual
income in the district being ₹ 50,906. However, the GDP trend has been growing at 6% CAGR from 2007-
08 to 2012-13, with the Agriculture and Allied sector as the highest contributors at 6.1% for 2012-13.
Tumakuru has 46% of its land under cultivation. The region`s top three cultivated crops include Cereals
with 51% of Net Sown Area, Oilseeds with 25% and Pulses with 16% of the cultivated land. It is famous for
cultivation of Hybrids in Paddy. It grows flowers like Aster, Crossandra, Jasmine, and Chrysanthemum.
Tumakuru has a Flower market at Badavanahalli in Madhugiri. Other crops grown are Mango, Banana,
Pomegranate, Tomato, Brinjal, Cucumber, Tamarind and Ginger.
Tumakuru has a ready Industrial infrastructure spread across 7 Industrial Parks and 7 Industrial Estates
that serve 37 large and medium industries with an investment of ₹113.916 billion and 27322 SSI that have
an aggregate investment of ₹456.47 billion.
Agro & Food Processing Industry is a highly focused sector. A 103-acre Food Park at Vasanthanarsapura is
set to ignite the sector with not just infrastructure and food processing equipment, but the technology
up-gradations and better techniques of production and knowledge transfer on grading, processing,
packing and marketing being given impetus here. Rice mills, Coir industries, Oil extraction mills are the
other major agro based industries in the region. A Flower Auction Center with an investment of US$ 3.12
million and a Fish Seed Farm at Markonahalli is on the anvil too.
The district has a thrust on textiles with a proposed Textile Park, An Apparel Zone, A Readymade Garments
Zone and a Handloom Cluster in the district. The district also has plans for an Integrated Machine Tool
Industry Park and Machine tools focused technology Incubation Centre in association with GoK on PPP
mode.
Tumakuru is strategically located at the Centre of fast-growing domestic car markets in Gujarat,
Maharashtra and Tamil Nadu and has been identified as part of Electronics Manufacturing Cluster in under
M-SIP (Modified Special Incentive Package) scheme which provide financial incentive. Establishment of
Flower Auction Centers in Tumakuru with an investment of US$ 3.12 million (₹15 crores) is also proposed.
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2.3 TUMAKURU SMART CITY
The Government of Karnataka has accorded approval for implementation of Smart Cities Scheme in the
State. The High-Power Steering Committee (HPSC) for Smart Cities Scheme has also been constituted
under the Chairmanship of Chief Secretary with representatives of various State Government
departments to guide the mission in the State.
The Karnataka Urban Infrastructure Development & Finance Corporation (KUIDFC) has been nominated
as the State Level Nodal Agency (SLNA) and Mission Directorate by the Government of Karnataka.
The High-Powered Steering Committee (HPSC) had recommended selection of six cities, viz., Belagavi,
Shivamogga, Mangaluru, Hubbali Dharwad, Tumakuru & Tumakuru for development under the Smart
Cities Scheme based on the guidelines issued by the Ministry of Urban Development (MoUD), GoI.
These 6 Smart Cities prepared their “Smart City Proposal” for participation in the “City Challenge” and
submitted the same to MOUD.
Tumakuru has been selected as one among the 100 Smart Cities to be developed in India under the
Smart Cities Mission of the Government of India.
Tumakuru was selected in the second round of the challenge through its proposal that aimed at
“Transforming Tumakuru from a mere edge city of Bengaluru to the within the region with a strong focus
on economic development and provision of enhanced CONNECTIVITY, high QUALITY OF LIFE, ECOLOGICAL
integration, and INCLUSIVE development”.
Tumakuru’s Area-based development (ABD) proposal revolved around a retro-fitting of about 1400 Acres
in the CBD area along with the Amanikere Lake to be an inclusive and thriving space catering to all user
groups with the aim of decongesting the city centre, upgrading the available infrastructure & services, and
integrating the built space and the environment.
To implement the above projects, a Special Purpose Vehicle (SPV) named Tumakuru Smart City Limited
(TSCL) has been incorporated.
A consortium of IPE Global Pvt. Limited, Grant Thornton India LLP and Aryavartha Design Consultants LLP
has been appointed as the Project Management Consultants (PMC) for implementation of the Smart City
Mission Project of Tumakuru City. The consortium has entered into agreement with TSCL for the
aforementioned consultancy.
One of the projects identified as part of the Tumakuru Smart City Plan is the ‘Concept Report on integrated
city management command and control centre’ on EPC Mode. Accordingly, the PMC is presenting this
Concept Project Report for the development of the project.
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3 PROJECT UNDERSTANDINGS
Tumakuru’s Area-based development (ABD) proposal revolved around a retro-fitting of about 1400 Acres
in the CBD area along with the Amanikere Lake to be an inclusive and thriving space catering to all user
groups with the aim of decongesting the city centre, upgrading the available infrastructure & services, and
integrating the built space and the environment. The proposed projects in SCP are Mobility and
Accessibility, Quality of Life and Environmental and Ecological. And the break-up of the proposed projects
are Improvement of Footpaths/walkways, Cycle Track, Junction Design, IBT, Vehicle Parking, Auto Stands,
PBS, Smart Roads and Multi-Level Parking, Public Toilets, River Front development, Vending Zones, Smart
Lounge, STP, EWS Housing, Solar Grid Connections etc.
Figure 3:Details of ABD Area
Number of projects are divided into Area Based Development (ABD) projects and Pan City components.
Area based development: The identified area of the Tumakuru city shall be developed into a “Smart
Area” which shall incorporate the features/ elements proposed in its Smart City Proposal including revival
& rejuvenation of Amanikere Lake, Development of Integrated Bus Terminal as a central transit hub,
improved solid waste management, LED street lights, pedestrian footpaths & cycle track, underground
utility corridor, Housing for urban poor etc.
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4 Objective
Tumakuru is a rapidly growing city in close proximity to the state capital. It is expected that the city’s
development as a Smart City coupled with industrial development in the city will catalyse its growth even
further. The objective for development of the AYUSH hospital in Tumakuru is provided below:
 To upgrade the healthcare industry in Tumakuru
 To provide specialized Tertiary care to the population of Tumakuru City as well as Tumakuru District,
of the quality and level of which is not at present available in the city.
 To reduce costs, time and effort for the citizens of Tumakuru to access quality healthcare services,
and so they do not have to travel to larger cities to access these services.
 To reduce the population to bed ratio of Tumakuru city. As per WHO norms there are to be 3 beds
for every thousand population, while currently as per these norms and the target catchment area
there is a shortage of about 6119 beds.
 To promote the economy in the area by providing healthcare services in the city which can indirectly
bolster and strengthen the city’s industrial growth.
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5 LOCATION AND CONNECTIVITY
The proposed AYUSH Hospital is located 13°31'59" and 77° 10' 80" at an altitude of 812 mts above MSL to
the north of Tumakuru city.
AYUSH Hospital is proposed to be setup in Shettihalli Road towards Ring Road in Tumakuru city.
Figure 4: Proposed location for AYUSH Hospital
6 EXISTING SITE CONDITION
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Figure 5: Existing site condition
7 HEALTHCARE PROFILE
7.1 HEALTHCARE IN INDIA – MACROECONOMIC CLIMATE
The Indian economy has witnessed approx. 7.6% & 7.1% Gross Domestic Product (GDP) in the financial
year 2015-16 & 2016-17 respectively, with 7.3% as its average growth in GDP in the last decade. The
liberalization of the economy triggered tangible and sustainable gains. The role of the private sector has
proved to be effective in bringing these gains to fruition.
India’s healthcare metrics, enumerated in the tables below and compared with other developed &
developing economies are set to witness a sea-change over the next few years, with an emphasis on Class
B & Class C cities.
Sri
Health Indicators India Pakistan Australia China US
Lanka
Life expectancy at birth 68 66 75 82 76 79
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Infant Mortality Rate (per
38 66 8 3 9 6
1000 live births)
Maternal Mortality Rate (per
174 178 30 6 27 14
100, 000 live births)
Table 3: Health Indicators of various developing economies
The Indian healthcare sector is at crossroads. A decade ago, health was not in the radar screen. However,
in last decade, a paradigm shift in outlook improved the healthcare sector at large, leading to substantial
decrease in the above numbers in comparison to the decade of 90’s. India’s economic growth is bringing
with it an expected “health transition”, in terms of shifting demographics, socioeconomic transformations
and changes in disease patterns -with increasing degenerative and lifestyle diseases and altered
healthcare behaviour.
The growing demand for the quality healthcare and the absence of matching delivery mechanisms pose a
challenge and certainly a great opportunity. An unprecedented demand is witnessed within the
catchment areas across cities, which in case is not catered-to because of lack of infrastructure or the lack
of specialists, leads to spillage of the revenue to class A cities, as well as leading to spending of majority
of the family savings into the treatment of the family member.
7.2 Healthcare Setup in India
India is expected to rank amongst the top three healthcare markets in terms of incremental growth by
2020, and in 2015 the healthcare sector was the fifth largest employer in the country. Rising income levels,
ageing population, growing health awareness and changing attitude towards preventive healthcare is
expected to boost healthcare services demand in future. Further, the low cost of medical services in the
country has resulted in a growth in the country’s medical tourism. Similarly, India is emerging as a hub for
R&D activities for international players due to the low cost of clinical research. The healthcare market size
in India was valued at US$ 110 Billion as on 2016 (IBEF report on Indian healthcare industry, 2017). The
following table presents some statistics on the Indian healthcare industry.
Table 5: Statistics about the Indian Healthcare Industry (Source: IBEF Report on Indian healthcare industry, 2017)
Number of Hospitals in India 196312
Number of AYUSH Hospitals 3601
Number of Sub-Centres 156926
Hospital bed availability 1 bed for every 1050 patients
Government Medical Colleges 189
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Medical Colleges for MBBS 404
Private Medical Colleges 215
The healthcare system in India is a mixture of services offered by a combination of public as well as private
players, with the latter being the dominant healthcare provider. The main reasons cited for this
dominance of the private sector is the lack of a universalized health care system, and the poor quality
coupled with long waiting time & low penetration.
Public Health Expenditure in India has remained very low in India. The Public health system in India
consists of state-owned health care facilities which are funded and controlled by the Ministry of Health &
Family Welfare, the Central & State governments. Each state has also developed systems of health care
delivery independent of the Central Government, whose main role consists of policy making, planning,
guiding, monitoring, evaluating and coordinating the work of the State Health Ministries. Hence, the
Public Health System in India follows a multi-stage system with links in the Central, State and Local levels.
The diagram below exhibits the five major sectors within the health care system in India.
Health Care in
India
Public Health Private Sector Voluntary Health National Health

Sector Medicine Agencies Programmes
Primary Health AYUSH
Hospitals
Health Insurance
Scehemes
Other Agencies
Figure 6: Healthcare set up in India
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Further, at the lowest levels, Primary Healthcare is provided in the following way:
• Referral Unit/Hospital for atleast 4 PHCs

Community
Health Centre with specialized Health Services
Primary
• Referral Unit for 4-6 sub-centres
Health Centre
• Lowest level contact point of community

Sub-Centre with primary health care system
Figure 7: Organization of the Primary Healthcare setup
The shortage of qualified medical professionals is one of the key challenges facing the Indian health care
industry. India’s ratio of 0.7 doctors and 1.5 nurses per 1,000 people in 2015 is dramatically lower than
the WHO average of 2.5 doctors and nurses per 1,000 people.
Furthermore, there is an acute shortage of paramedical and administrative professionals. The situation is
aggravated by the concentration of medical professionals in urban areas, which have only 30 percent of
India’s population.
7.3 HEALTHCARE IN KARNATAKA
Karnataka also follows a three-tier public health infrastructure. At the primary level of health system the
state has Sub-Centres, Primary Health Centres and Community Health Centres. At the secondary level
there are the District Hospitals. At the tertiary level the health system in Karnataka has medical colleges
and speciality hospitals. The figure below illustrates the infrastructure of Public Health Services of the
State Government in Karnataka.
Table 6: Public Healthcare Setup in Karnataka (Source: Economic Survey of Karnataka, 2015-16)
Particulars Number
District Hospitals 20
Other Hospitals 11
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Autonomous & Teaching Hospitals 32
Taluk/General Hospitals 146
Community Health Centres 206
Primary Health Centres 2353
Urban PHCs 27
Health Centres 108
Mobile Health Clinic 19
Sub-Centres 8871
The next table presents some health care indicators for Karnataka. The details have been collected from
the Economic Survey of Karnataka 2015-16.
Table 7: Healthcare Indicators for Karnataka (Source: Economic Survey of Karnataka, 2015-16)
Indicator 2011 2015
Birth Rate (Per 1000 Population) 18.8 18.3
Death Rate (Per 1000 Population) 7.1 7.0
Total Fertility Rate 1.9 1.9
Maternal Mortality Rate (for every 1,00,000 178 133

Live Births)
Infant Mortality Rate (for every 1,00,000 Live Births) 35 31
Under-Five Mortality Rate (Per 1000 Children) 40 35
Average Life Expectancy – M/F 63.6/67.1 63.6/67.1
Recently Karnataka has been taking several innovative steps in promoting healthcare in the State.
Below is a list of some of the prominent health schemes and programmes in Karnataka State.
YESHASVINI COOPERATIVE FAEMERS HEALTH CARE SCHEME
 One of the largest self funded healthcare schemes in the country.
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 Offering a low priced product for a wide range of surgical cover, nearly 823 defined surgical
procedures to the farmer cooperators and his family members
 It is a contributory scheme wherein the beneficiaries contribute small amount of money every year
 The beneficiaries are offered cashless treatment subject to conditions of the scheme at 650+ Network
Hospitals spread across the State of Karnataka.
 The Scheme covers entire state of Karnataka
JYOTHI SANJEEVINI SCHEME
 Comprehensive health care to Government employees
 Scheme provides cashless treatment to all Government Employees and dependants through an
empanelled Network of Hospitals for Tertiary Care
 The scheme covers treatment of 7 broad specialities viz Cardiology, Oncology, Genito Urinary
Surgery, Neurology ,Burns, Poly-Trauma cases (excluding medico legal cases) and Neo-Natal &
Paediatric Surgery.
VAJPAYEE AAROGYASHREE
 The scheme is intended to benefit BPL families both in urban & rural area
 The Health Insurance Scheme will cover 5 members
 Government of Karnataka/ Trust will pay the premium on behalf of the BPL beneficiaries for the
insurance
 The Benefit Package will cover tertiary care for catastrophic diseases.
 All the Public Hospitals (District Hospitals, Government/ Private Medical Colleges) and identified
Private Hospitals/ Nursing Homes shall individually be empanelled
RAJIV AAROGYASHREE
 Similar to Vajpayee Aarogyashree, however for APL families
JANANI SURAKSHA YOJANA
 Centrally sponsored Scheme which is being implemented with the objective of reducing maternal
and infant
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 mortality by promoting institutional delivery among pregnant women.
 Eligible pregnant women are entitled for cash assistance irrespective of the age of mother and
number of children for giving birth in a government or accredited private health facility
MISSION INDRADHANUSH
 Centrally Sponsored Scheme
 Aims to cover unvaccinated and partially vaccinated children
 Designed to prevent seven vaccine preventable diseases like diphtheria, whooping cough, tetanus,
polio, tuberculosis, measles and hepatitis B.
AROGYA KAVACHA 108
 Scheme provides comprehensive emergency sources
 Objectives are to collect facts about the emergency and assign vehicle to provide relief & provide
pre-hospital care while transporting patient/victim to hospital
 GVK-EMRI, private agency runs the emergency 108 Arogya Kavacha
MOBILE HEALTH UNITS
 Through this initiative, the Health and Family Welfare department hopes to reach and provide
referral health
 care to the people in remote villages and deep interiors of the state
AROGYA SAHAYAVANI-104
 104” is a toll free number through which people can avail consultation for minor ailments, counseling
services,
 information on services available in public Health facilities, directory services (Eye bank, Blood Bank)
and grievance redressal (Services, Epidemics, Corruption, Hygiene, Drugs and Diagnostics, ASHA
grievances, etc.)
The current bed strength of Karnataka is 0.9 beds per 1000 population while the WHO standard is 3 beds
per 1000 population. This implies that there is a need for more number of medical colleges/ private/ public
institutions along with qualified personnel.
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In the field of specialty health care, Karnataka's private sector competes with the best in the world.
Karnataka has also established a modicum of public health services having a better record of health care
and child care than most other states of India. In spite of these advances, some parts of the state still leave
much to be desired when it comes to primary health care.
7.4 HEALTHCARE IN BENGALURU CITY
Bengaluru, the state capital of Karnataka, which is located 70km south west of Tumakuru is the nearest
Tier-I city to Tumakuru. This is the preferred destination for patients from Tumakuru who are looking to
access tertiary healthcare facilities. The total population of the Bengaluru Metropolitan Region is 8.5
Million.
In Bengaluru, healthcare is a strong mix of both government as well as private healthcare service
providers. A number of government bodies and schemes provide health services in the city. The city is
also host to several large institutions of excellence in healthcare with high quality infrastructure and
medical professionals such as National Institute of Mental Health and Neuroscience (NIMHANS) and the
Jayadeva Institute of Cardiology.
Bengaluru acts as a medical tourism hub as well, with several large super-specialty hospitals boasting
state-of-the-art treatment facilities. However, there is an issue that these are generally inaccessible to the
general public, from the working classes and the urban poor, and the problem is exacerbated by the fact
that the facilities that can be accessed by these communities are plagued by issues such as hortage of
medical staff, lack of medicines and diagnostic services, high levels of corruption and the low sensitivity
towards their needs. Tertiary care in government hospitals too are an expensive affair due to bed charges,
medicines and other expenses.
This has led many to believe that the healthcare scenario in the city is divisive with a bridge between
have’s and have nots. The results of the above problems are high levels of indebtedness and health
indicators among the urban poor that are almost as bad as the rural poor.
There is also a shortage of nearly 2000 beds as per WHO norms despite the large number of public and
private hospitals and it being a preferred destination for medical tourism.
Some of the prominent hospitals in Bengaluru are tabulated below:
Table 8: Prominent Hospitals in Bengaluru (Source: Healthcare scenario in Bengaluru, Hospaccx, 2017)
Name No. of Beds/Seats
Major Government Hospitals
Bengaluru Baptist Hospital 340
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Victoria Hospital 1000
Minto Opthalmic Hospital 300
Kidwai Memorial Institute of Oncology 429
Sri Jayadeva Institute of Cardiovascular 600

Sciences and Research
Major Private Hospitals
Narayana Hrudalaya Hospital, Bommasandra 1400
M.S. Ramaiah Memorial Hospital 500
Fortis Hospital, Bannerghatta Road 276
Columbia Asia Referral Hospital 200
Apollo Hospital Bengaluru 250
BGS Gleneagles Global Hospitals 500
Manipal Hospital 600
Panacea Hospital 105
Sakra Hospital 300
Medical Colleges in Bengaluru
A.J. Institute of Medical Sciences 150 Seats
Bengaluru Medical College 250 Seats
Dr. B. R. Ambedkar Medical College 100 Seats
Kempegowda Institute of Medical Sciences 150 Seats
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M.S. Ramaiah Medical College 150 Seats
7.5 HEALTHCARE IN TUMAKURU DISTRICT
This section will focus on the statistics for Tumakuru district as well as the city. This is important because
the city is the headquarters and largest urban centre in the district, which would entail that demand in
the city would substantially be driven by residents who live around the city.
Tumakuru district follows the same three-tier health system. It is composed of private & government,
formal & informal service providers, and secondary & tertiary hospitals with single doctor clinics. The
government healthcare facilities provide both preventive and curative services. The following table
provides details of the public health infrastructure in Tumakuru District.
Table 9: Public Health Infrastructure in Tumakuru District (Tumakuru Human Development Report, 2014)
Particulars Numbers Numbers of Beds
District Hospital 1 400
Other Hospitals 0 0
Autonomous & Teaching Hospitals 0 0
Community Health Centres 14 1050
Primary Health Centres 146 900
PHC with Maternity 2 20
Urban PHCs 1 6
Health Centres 2 -
Sub-Centres 487 -
Total 653 2376
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Table 10: Major Diseases Prevalent in Tumakuru
2014 2015 2016 2017 (till May)
Name of the
disease Cases Deaths Cases Deaths Cases Deaths Cases Deaths
Malaria 44 0 68 0 57 0 6 0
Dengue 108 0 160 0 96 0 27 0
Chikungunya 102 0 229 0 209 0 19 0
JE 0 0 1 0 1 0 0 0
GE 4549 0 5658 0 5493 1 2469 4
Cholera 0 0 0 0 1 0 0 0
Typhoid 2169 0 3904 0 4793 0 2049 0
Jaundice 77 0 70 0 26 0 5 0
TB 2947 NA 3016 NA 2850 NA 1246 NA
Leprosy 118 0 101 0 77 0 22 0
Measles 91 0 53 0 53 0 24 0
H1N1 7 2 121 14 9 3 35 4
Rubella --- --- --- --- 3 0 0 0
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Figure 8:Health Statistics of Tumakuru District (Source: Tumakuru Human Development Report, 2014)
Maternal
Mortality Rate:
70.1 per lakh
Live Births
Access to
Beds Per Life
Capita: Expectancy:
0.85 per 1000 67 Years
persons
Tumakuru
Infant Avg. Death

Mortality Rate: Rate:
13.7 per 1000
Live Births 7 per 1000
Avg. Birth
Rate:
13.3 per 1000
7.6 DISTRICT HOSPITAL, TUMAKURU
Tumakuru has a fully functional 400 Bedded District Hospital. The hospital is located in the heart of the
city straddled between J.C. Road & B.H. Road. The site of the District Hospital spreads across a sprawling
27 Acre Campus. The Campus has several buildings including the hospital itself, a diagnostics lab, Nursing
Institute, quarters for staff & doctors and a graveyard among others. Of this, the District Hospital is spread
over a built up area of 1,07,639 Square Feet. The Hospital reported a bed occupancy of about 75%-85%
consistently, and sees over 3 Lakh OPD patients and 80000 IPD patients annually. The District Hospital has
a sanctioned strength of 42 Specialist Doctors, of which 36 are currently employed, while there is a total
sanctioned staff strength of 331 of which 224 are employed.
Following are the facilities available at the District Hospital in Tumakuru.
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General Medicine General Surgery Ob-Gyn Orthopaedics Paediatrics Psychiatry
Dentistry Pathology Dermatology Opthalmology Anaesthesia
Dialysis
PICU SNCU ICU ICCU Geriatrics
Cryptopathology
Blood Bank Bio-chemistry Forensic Sciences Microbiology
Nephrology
Table 11: Major Diseases at District Hospital, Tumakuru
Year Hypertension Diabetic Cardio- Cardio Cancer Stroke

Vascular Obstructive
Disease Pulmonary
Disease
2014 2963 3357 87 54 73 31
2015 3471 4332 300 186 53 40
2016 3916 3172 424 77 62 95
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7.7 HOSPITAL BED MIX OF TUMAKURU
Tumakuru is replete with Mid-sized nursing homes which are ranging from 15 to 50 beds. Two major
private medical colleges that contribute 50% of the bed strength in the city but contribute only 20% with
respect to Medical treatment. There is acute requirement for a large Multi- Specialty Hospital or mid-size
super-specialty hospital. The Major Health-care players in Tumakuru are:
Table 14: Major players in Tumakuru Healthcare sector

Sr.
Name of the Hospital No. of Beds
No
1. District Hospital 400
2. Sri Devi Hospital 650
3. Shree Siddhartha Hospital 710
4. Aruna Hospital 50
5. Bharathi Hospital 20
6. Hemavathi Orthopaedic and Trauma Care Centre (HOTC) 30
7. Vasan Eye Care 10
8. New Goutham Hospital 40
9. Jayashree Hospital 30
10. Charaka Hospital 50
11. Tumkur Kidney Care Centre 15
12. Kasturba Hospital 40
13. B Siddaramana Hospital 56
14. Fortis Adarsha Hospital 50
15. Other Mid-sized Hospitals 150
TOTAL 2300
7.8 HEALTH SPECIALISTS IN TUMAKURU
Table 15: Availability of adequate personnel/training facilities in the city

S. Particulars Remarks
No.
1 Specialist Consultants Good
2 Surgeons Good
3 Anesthetists Good
4 Sr. Laboratory/Pathology/ Radiology Personnel Poor
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5 Lab/Radiology Technicians Fair
6 Bio-Medical Engineers Good
7 Nurses Good
The larger number of doctors in majority of the hospitals in Tumakuru are visiting consultants, barring
those stationed at the District Hospital. There was repeated emphasis placed on the lack of specialists in
fields such as Neuro-surgery, oncology, cardiology, etc.
8 Hospital Design Guidelines

The planning of site and detailed design are a function of the following factors:
 Area requirement (Space Program)
 Work flow for functional efficiency, Patient safety and comfort
 Flexibility for futuristic technology absorption and expansion
 Engineering & Research services support
 Separation of sub components
 Personnel and Material movement
 Integration of functions of utilities maintenance and support services
 Internal environment comfort, high degree of hospital hygiene and sterility levels
 Site parameter (Master plan for the best utilization of site in terms of land coverage, Floor Space
Index and permissible height.)
 Medical equipment requirement
 Operational policies
 Staff distribution
 Future integration of other components of the hospital.
The planning of the facility will ensure adherence to acceptable National Standards and norms, and will
bring in features of functional efficiency at optimum space & cost.
8.1 ENVIRONMENTAL MANAGEMENT IN THE HOSPITAL
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A Hospital generates a wide range of waste, a lot of which is toxic and requires careful management &
disposal. Without these, the pollutants may be released into the environment via the sewage system or
directly into the air from fossil fuel emission. Environment impacts may be
associated with infrastructure and work practices:
Infrastructure
Building Design, Operation & Maintenance

Air Conditioning, Heating & Ventilation System
Work Practices
Recycling
Waste Disposal
Figure 21: Infrastructure & Work Practices for sound environmental management of the Hospital
All planning shall be done taking into consideration guidelines set by the
Karnataka Pollution Control Board (KPCB)
8.2 HAZARDOUS WASTE MANAGEMENT
The different categories of Bio-medical waste include the following:
 Human Anatomical waste (Human tissue, organs)
 Blood and body fluids
 Microbial wastes
 Highly infectious wastes
 Discarded medicines
 Disposables
 Liquid wastes
 Incineration wastes
 Biotechnology wastes (genetically engineered organisms and their culture)
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The design shall provide solutions to handle and dispose of all hazardous & Bio-medical waste to the
satisfaction (and approval) of the KPCB & local authorities.
8.3 PARKING
Demand for parking shall arise from the following categories/activities:
 Hospital and support staff
 Patients brought for OP consultations, ambulatory care and day care services
 Patients taking IP care
 Visitors of patients
 Visitors to the Hospital
 Vehicles carrying supplies to the Hospital
 Consultants and staff residing in the complex
 Emergency needs- Ambulances and vehicles accompanying cases
 Vehicles dropping people and leaving after a few minutes
Segregation according to the flow, peak load flow considerations, categories of vehicles, paid parking
scope etc. shall be considered while detailing. Basement parking for staff and inmates, paid parking in the
open, exclusive movement and parking for emergency cases/ air ambulance cases, etc. have been
provided for. The possibility of Multi level parking in the future and basement connectivity of future
developments are envisaged as part of planning.
8.4 AREA REQUIREMENT
Further mentioned are the norms-and-experience based estimates required during detailing, which may
undergo changes. It will be possible to keep the total built up within 1,20,000 sq ft., including parking.
While the permissible ground coverage, FSI and building height are not expected to be a limitation, overall
space and cost optimization are considered important, without compromising on the functional efficiency
and patient comfort. Hospital space plan is based on the categorization and zoning of the functional areas.
The space requirement for different zones is a function of the following:
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Policy for allocation
Type and Size Classification of Patient Flow of consultation
Beds, OTs, ICUs segregation suites and clubbing
of Consultant Suites
Flow and internal Degree of

Patient safety, Staff conveniences automation and
movement, comfort and privacy
transportation personnel
deployment
Policy of Maximum
utilization of Vehicles parking
outsourcing
permissible height
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PROJECT

“CONCEPT REPORT OF DEVELOPMENT OF

DETAILED PROJECT REPORT

Project Management Consultant for Implementation of Smart City

IPE Global Limited Grant Thornton India LLP Aryavartha Design

5 LOCATION AND CONNECTIVITY 15

8 Hospital Design Guidelines 30

1.1 THE SMART CITIES MISSION

Figure 1: Conceptualization of Smart City

Social Infrastructure in Efficient

2.1 TUMAKURU CITY PROFILE

Figure 2: Location maps of Tumakuru

Figure 3:Details of ABD Area

 To upgrade the healthcare industry in Tumakuru

Figure 4: Proposed location for AYUSH Hospital

6 EXISTING SITE CONDITION

7.1 HEALTHCARE IN INDIA – MACROECONOMIC CLIMATE

Life expectancy at birth 68 66 75 82 76 79

Table 3: Health Indicators of various developing economies

7.2 Healthcare Setup in India

Number of AYUSH Hospitals 3601

Number of Sub-Centres 156926

Hospital bed availability 1 bed for every 1050 patients

Government Medical Colleges 189

Private Medical Colleges 215

Public Health Private Sector Voluntary Health National Health

Primary Health AYUSH

Figure 6: Healthcare set up in India

• Referral Unit/Hospital for atleast 4 PHCs

• Lowest level contact point of community

Figure 7: Organization of the Primary Healthcare setup

7.3 HEALTHCARE IN KARNATAKA

Taluk/General Hospitals 146

Community Health Centres 206

Primary Health Centres 2353

Health Centres 108

Mobile Health Clinic 19

Birth Rate (Per 1000 Population) 18.8 18.3

Death Rate (Per 1000 Population) 7.1 7.0

Total Fertility Rate 1.9 1.9

Maternal Mortality Rate (for every 1,00,000 178 133

Infant Mortality Rate (for every 1,00,000 Live Births) 35 31

Under-Five Mortality Rate (Per 1000 Children) 40 35

Average Life Expectancy – M/F 63.6/67.1 63.6/67.1

YESHASVINI COOPERATIVE FAEMERS HEALTH CARE SCHEME

 One of the largest self funded healthcare schemes in the country.

 The Scheme covers entire state of Karnataka

JYOTHI SANJEEVINI SCHEME

 Comprehensive health care to Government employees

 The Health Insurance Scheme will cover 5 members

 Similar to Vajpayee Aarogyashree, however for APL families

JANANI SURAKSHA YOJANA

 Centrally Sponsored Scheme

 Aims to cover unvaccinated and partially vaccinated children

AROGYA KAVACHA 108

 Scheme provides comprehensive emergency sources

 GVK-EMRI, private agency runs the emergency 108 Arogya Kavacha

MOBILE HEALTH UNITS

7.4 HEALTHCARE IN BENGALURU CITY

Some of the prominent hospitals in Bengaluru are tabulated below:

Major Government Hospitals

Bengaluru Baptist Hospital 340

Minto Opthalmic Hospital 300

Kidwai Memorial Institute of Oncology 429