Studies show that people from poorer sections
of society who have a greater need for medical attention receive less care than
people who are rich and have fewer needs. Public spending on health services
focuses and benefits the rich rather than the poor. This type of inequality is
known as inverse care and it is most prominent in countries where medical care
is more exposed to market forces. Countries where this exposure is curbed have
a reduced rate of inverse care. So it shows that the key to equality in health
care stems from reining in the
.
Low Investment in Preventive
Health Facilities
The absence of proper sanitation and waste
management facilities is one of the main causes of illness in most developing
nations, including India. Over 2 million people die each year from
preventable
diseases such as diarrhea, malaria and typhoid. With an increase in
the investments in sanitation, access has increased but it is still very low.
In 1980, rural sanitation coverage was estimated to be just 1% but by 2011 that
figure had increased to 31%. There are also severe disparities across the
states - some states such as Kerala have as much as 81% rural sanitation
coverage while Madhya Pradesh and Orissa have less than 10% coverage. The
Ministry of Rural Development launched the Total Sanitation Campaign (TSC)
to tackle sanitation
problems in rural
sanitation problems
in rural areas. The TSC focuses on
providing all primary and upper primary schools with drinking water and
well-maintained toilets. They also teach basic hygiene education to prevent
communicable diseases in children.
Poor Quality Public Healthcare
Public health facilities are inadequate and
unable to meet the demand of the country's burgeoning population. Urban areas
have more medical centres but they generally lack essential facilities and are
often understaffed. Rural areas have very limited medical facilities while some
areas do not have access to any clinics or hospitals. Due to the lack of
adequate healthcare in the public sector, the private health sector remains the
dominant healthcare provider catering to the needs of approximately 70% of the
urban and rural population.
High Costs of Healthcare
Due to the high cost of healthcare, poorer
people delay treatment and this aggravates their existing health problems. With
limited public healthcare options, people are forced to make large
out-of-pocket payments at the point of service. The high costs of health care
have led to "impoverishing care" which has become a common problem especially
among the urban poor and the middle class. Research indicates that
out-of-pocket health expenditure accounts for approximately one-sixth of the
country's poverty burden. It is estimated that 100 million people fall into
poverty each year only because of their healthcare costs.
Human Resources Shortages
India is the second most populous country in
the world. According to the United Nations, current growth rates indicate that
it will become the most populous country in the world in 2028. Ironically, our
country suffers from a severe paucity in human resources. The need for adequate
healthcare has become a major challenge and in order to meet the shortage,
India plans to establish 200 new medical colleges in the next 10 years.
Currently, the overall doctor-population ratio is just 1:1,800 and the
dentist-population ratio is an astounding 1:10,000. Another factor that has
contributed to the shortage of medical staff in the country is the high number
of emigrating doctors and nurses - today, there are approximately 80,000 Indian
doctors in the USA and 75,000 in the UK.
Health Care for the Urban Poor
Most of the larger cities in India have large
slum areas. Over 65 million people in India live in slums and it is estimated
that this number may increase to 104 million by 2017. Poor sanitation, the
accumulation of garbage, poor drainage systems and a lack of clean drinking
water are among the most prevalent problems in slums. These problems contribute
to a host of health problems such as diarrhea, cholera and typhoid fever. The
provision of adequate healthcare for slums is often left to NGOs and many of these
organizations have engaged health workers to teach slum dwellers the basics of
hygiene and disease prevention. There is a need for quantity as well as quality
improvement in the public health care sector but most states are unwilling to
increase the amount they spend on medical attention for the poor.
Health Care for the Rural Poor
The
rural population of
India has long suffered from poor medical health coverage. Many areas
rely heavily on the support of NGOs and volunteer-based organisations to meet
their medical requirements. These organisations conduct free medical check-ups
and set up specialist medical camps to improve patient care. Malnutrition health problems are also very
common and so health workers focus on educating people on the
importance of a balanced diet.
They are also taught the importance of immunization and family planning.
References :
1. http://www.communityledtotalsanitation.org/resource/toilet-coverage-and-sanitation-performance-india-states-2001-2011-0
2. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3724242/
3. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4385734/#ref3
4. http://www.nesri.org/programs/what-is-the-human-right-to-health-and-health-care
Source: Medindia
