Rural healthcare in India — a boon or bane?

Rural healthcare in India — a boon or bane?

Rural healthcare infrastructure in India is a three-tiered network comprising of a sub-center, primary health center (PHC) and community health center (CHC). Unfortunately, this setup is in shambles!

Qualitative and quantitative provisions for health in rural areas are far lesser than what the World Health Organization (WHO) defines as the minimum norm. As per Rural Health Statistics 2018, there is a shortfall of 18% for Sub-centers, 22% for Primary Health Centers and 30% for Community Health Centers. What makes this worse is the inaccessibility of these PHCs and CHCs. In some cases, these centres are quite far from the villages because of which people often turn to unregistered private healthcare practitioners to save time and energy. They are located in run-down dilapidated government buildings and are rarely open or equipped to address even basic illnesses. To add to this, the shortage of vaccines and essential medicines in rural areas makes the situation even more shameful. The gap between the demand and supply of these has not only risen in the last few years but has also led to increased levels of poor immunisation and higher child mortality rates. Moreover, even when these drugs are available, patients are often unable to afford them.

Out-of-pocket (OOP) health expenses drove 55 million Indians--more than the population of South Korea, Spain or Kenya--into poverty in 2011-12, and of these, 38 million (69%) were impoverished by expenditure on medicines alone, according to a 2018 report.  

Despite being repeatedly flagged, these loopholes are seldom looked into.

Where are the doctors?

In India, there is one government doctor for every 10,189 people (the World Health Organization (WHO) recommends a ratio of 1:1,000), or a deficit of 6, 00,000 doctors overall.

Persistent refusal of registered medical practitioners to serve in rural areas is not foreign to anyone in the country. While many governments have tried to push them to relocate in the past, thousands of vacancies for doctors continue to remain unfilled; even monetary incentives have failed to attract medical graduates (MBBS students) to serve in rural centers. The reason for this is that educated, city-bred professionals are not willing to serve in locations with poor sanitation facilities and shortage of electricity and water. This is a major reason why people in rural areas do not have access to timely healthcare due to unavailability of qualified doctors. Moreover, availability of even those who are already posted in these areas remains in question due to high rates of absenteeism.

Diagnostic barriers

As hard as it is to attract medical professionals to work in rural areas, retaining them is another big challenge, especially in laboratories, since they are ill-equipped to support diagnosis and accurate investigations of diseases. As a result, rural people often migrate to urban areas in search of better diagnostic facilities. The availability of diagnostic services is dismal keeping in mind the ever-increasing demand in rural areas.

Further, in order to ensure quality diagnostics, budgetary allocations are much needed. Taxes levied on laboratory equipment and machines often increase the cost of the test; this makes these services inaccessible to most people in rural areas. Costs of life-saving diagnostic tests should be brought down to benefit the poor.

#YesDemocracy- Health for all

The state of public healthcare in India is abysmal. It is showing no signs of improvement due to government’s apathy and lack of public pressure for the same. While the privileged in our society have the means to access private quality healthcare facilities, the poor and marginalised often lose their lives to negligence and poor health facilities in the country. This can be avoided if the government and other political parties pay enough attention to the need for strengthening public healthcare system and making it more effective.

Oxfam India, through its #YesDemocracy Campaign, is demanding free and quality public healthcare for everyone in the country. Sign our petition to support us today.

Click here to sign the petition: https://donate.oxfamindia.org/stopencephalitisdeaths

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