Ayushman Bharat inaccessible to impoverished Indians
Reports indicate PM Modi’s much ambitious national health project ‘Ayushman Bharat’ has suffered a set back. Maharashtra and Rajasthan state governments, which are under BJP rule, have said the scheme is difficult to implement. The report India’s health services in global health service index is quite worrisome.
As per the survey projections for 2019, India is in 145th position in Global health services index. Our neighbour Bhutan is in 134th place. Srilanka is in 74th position and China is in 48th place. India is lagging behind all its neighbours in execution of health services. India had occupied 153 place in 1990 and in 2016 it surely has improved its positioning. Yet, a lot needs to be done in this space compared to our neighbours. State-wise, Karnataka with all its colleges imparting education in medical and allied topics, has done terribly too. Kerala and Goa have done better.
India has a mix of cultures and weather, different food habits and ecology. Hence, to implement a uniform health policy would be a challenge. Special focus will have to be given to backward states such as Jharkhand, Chhattisgarh, and Bihar this laying special emphasis on areas that need better care. The ever increasing population also plays havoc on the policies that are drafted and ready to be implemented.
In our overall GDP, we are spending only 1.15% while countries like China and Cuba spend a lot more than India on this front. Experts say India needs to increase its spending on health. Private hospitals that get land, water and other infrastructure at a highly subsidized cost from the governments, would never treat the poor for free at their hospitals. Super specialty care is a mirage for poor patients, despite the presence of such high profile hospitals in cities. Even a rap by Supreme Court on states being responsible to provide better health facilities for the poor, nothing constructive has emerged form that.
High Court has instructed that BPL card holders have to constitute at least 20% of the inpatients at hospitals. But this is hardly implemented. The health policy is evidently helping the corporate hospitals. The scheme needs to live up to its slogan of health for all, and focus on ensuring health for the rural poor too. The rural poor depend on government hospitals for their health needs. But the situation of government hospitals is not satisfactory. There is a severe shortage of doctors there. This aspect has come to light in the survey report released by National Health Mission, conducted by the central health ministry.
As per this report, though there are over a lakh registered doctors in the state, their services are not available in rural areas. Doctors who pass out of government medical colleges across districts, prefer to work in private hospitals upon completion of their course. As per 2017 statistics, per 13,257 persons, only one doctor is available in government hospitals. And this gap between people and medical professionals is ever increasing. The main reason for this is medical professionals hesitate from serving in rural areas.
Only 2136 doctors are serving in primary health centres in the state. Only 498 are serving in community health centres. As per the WHO guidelines, one doctor has to be present per thousand people at the minimum. But then, doctors are not willing to provide their services. While India is vying to become world leader, infant mortality and maternal deaths are ever increasing. State and central governments need to pay attention to these issues.
As per the 2017 national health policy, India has decided to spend about 2.5% of the overall GDP. But since public spending on health has come down, the facilities are costing quite dear for the poor in private set ups. Indians have to spend a major part of their earnings towards their health. With that, a lot of families face the threat of dropping below BPL level owing their spending towards health and related expenses. If quality health care is not available, achieving health milestone becomes a challenge and people would be forced to go to quacks and others for their health needs.
Governments need to ensure quality healthcare is available in government hospitals. More than meeting the needs of infrastructure, lack of staff needs to be tackled. If this is not fulfilled, the public health mission will fail miserably. Hence, it is not enough if the state and centre not only allocate a decent amount for health, but also ensure medical professionals are available to serve people in government hospitals. Only if those in high offices decide to work on this aspect, government hospitals will always get better.
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Sunrisers Hyderabad beat RR by 1 run in IPL
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