Rabindra Kumar Jena
The fundamental problem in the government’s approach to healthcare is that there is no synchronization of the reality and the data at the most official level. This is obviously a problem, because if the government does not acknowledge that it is short of meeting its targets, the policies and measures taken by the government will also reflect the same.
India’s terrible healthcare apparatus also has other problems. Only about 68.7 % of women have received the mandatory three antenatal check-ups. Again whereas most women had received iron and folic acid tablets, only 31% of pregnant women had consumed more than 100 IFA ( Iron & Folic Acid) tablets. While we have managed to successfully get rid of polio, the National Health Policy 2015 admits that only 61% of children (12 -23 months) have been fully immunized.
The Ministry of Health and Family welfare has also done some significant work in AIDS control, where progress has been good with a decline from a 0.41 % prevalence rate in 2001 to 0.27% in 2011- but this still leaves about 21 lakh persons living with HIV, with about 1.16 lakh new cases and 1.48 deaths in 2011. In tuberculosis the challenge is a prevalence of close to 211 cases and 19 deaths per 100,000 population and rising problems of multi-drug resistant tuberculosis. Though these are significant declines from the MDG baseline, India still contributes to 24% of all global new case detection. Vaccination coverage in India continues to be low, and falls short of the target of 90%. Recommended vaccinations under EPI include DPT, polio, BCG, measles.
Measles continues to cause 30% of all vaccine preventable deaths, mostly in developing countries.Challenge is to increase the immunization coverage to the desired level.Also to develop newer vaccines and new modes of delivery.
There is also a huge shortfall of specialists in Rural Health Care. There is huge shortfall of surgeons (82.5%), obstetricians &gynecologists (76.6%), physicians (82.6%) and pediatricians (82.2%). Overall, there was a shortfall of 81% specialists at the CHCs vis-a-vis the requirement for existing CHCs. As per information furnished by Medical Council of India (MCI), the total number of doctors registered (allopathic) in the country till 31st July, 2011, is 8,56,065 out of which approximately six lac are presently active practitioners. The current doctor-population ratio has been worked out to be approximately 1:2000. This is the figure furnished by the government of India in 2011. In 2012, according to the World Bank, India had 0.7 doctors per thousand people. Which would imply about 2 doctors per 3000 people. Whereas United Kingdom (2012) has 2.8 doctors per 1000 persons, Sweden (2010) has 3.8 doctors per 1000 persons and China (in 2012), with a higher population and larger area than India has 1.8 doctors per 1000 persons. Moreover, these are India’s overall figures- the difference in the ratio between Urban and Rural India is increasingly alarming.
In this context, India faces the twin epidemic of continuing/emerging infectious diseases as well as chronic degenerative diseases. The former is related to poor implementation of the public health programs, and the latter to demographic transition with increase in life expectancy.
We know that Economic deprivation in a large segment of population results in poor access to health care. At the same time, poor educational status leads to non-utilization of scanty health services and increase in avoidable risk factors.Both are closely related to life expectancy and IMR.
What is a matter of great concern that expenditure on health by the Government continues to be low. It is not viewed as an investment but rather as a dead loss!. States under financial constraints cut expenditure on health.
Amartyo K Sen has said ‘Growth in national income by itself is not enough, if the benefits do not manifest themselves in the form of more food, better access to health and education’.
Given the scenario, Prevention, and early diagnosis and treatment, if feasible, are the most cost-effective strategies for most diseases. Promoting healthy life style from early life is a ‘no cost’ intervention which needs to be incorporated in school curricula. There is need for increasing public awareness of the benefits of healthy life style .
Components of healthy life style can be safely attributed to-
• Abstinence from tobacco use
• Regular physical exercise
• Balanced nutritious diet rich in vegetables and fruits, and low in fats and refined sugar
• Avoidance of pre & extramarital sex
• Yoga and meditation
• Avoidance of alcohol and substance abuse
Rabindra Kumar Jena, Member of Parliament, Loksabha , Balasore (Odisha)
Courtesy: http://www.wisdomblow.com/?p=6010
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