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Challenges of Healthcare in India
On the infrastructure front too the country’s record fails to cheer. For example, it has 1.5 beds per thousand patients as compared to 4.3 beds in China. There are only 59 doctors per 100,000 of the population in India compared to 200 doctors in developed countries. The dismal performance of governments — both in the states and the Centre in the field of general governance as well as in such specialised areas as building of infrastructure, developing and managing human resources etc — along with the unflattering statistics, make the healthcare situation in India quite dismal. The National Health Policy — 2002, takes cognizance of the fact that ground realities have undergone great changes since the last policy was formed in 1983. The NHP 1983’s attempts to systemize the healthcare network had met with limited success. Primary health centres and skilled health workers as well as volunteers — inadequate both qualitatively and quantitatively — have not been able to satisfactorily cover vulnerable sections of the population. Rural areas have been the worst affected. Dr Kumar notes that access to and distribution of benefits from, the public health system has been very uneven between the better endowed and the have-nots. The NHP 2002 has come up with a comprehensive roadmap to a healthier India by ensuring better access to healthcare by the poor. But, if this roadmap is to lead us anywhere, there is a need for massive resource mobilisation. We need large numbers of skilled doctors, nurses and paramedics. Hospitals, clinics and primary health centres should be placed within the reach of all sections of society. In order to make medical services affordable various options, including selective subsidies and health insurance, need to be considered. The author has examined the role — both present and future — of the private sector too, which, he envisages, would become increasingly prominent with the passage of time. But there is a need to put higher cost of private healthcare in perspective. Would there be spin-offs to the advantage of the disadvantaged? The book mentions universal health insurance, but who will foot the bill, and how? Can the income from medical tourism be gainfully reinvested in public health services? Most important, is there a national will to make quality healthcare available to all at affordable costs? In the chapter on futuristic approach Kumar appears to be upbeat about India meeting the healthcare related challenges. But the taste of pudding lies in eating it. Nevertheless, this book provides valuable inputs for our policy makers.
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India’s
healthcare superstructure is undergoing a makeover. But, right now it
does not present a pretty picture. Dr Kumar points out that India
records the largest number of oral cancer patients and diabetics in the
world. With 5.1 million HIV/AIDS cases (likely to increase threefold by
2015) it is second only to South Africa. With a world population share
of 16.5 per cent, it contributes 20 per cent of the diseases. It fares
no better when compared to Sri Lanka and even Bangladesh. Against Sri
Lanka’s infant mortality rate of only eight per thousand India’s has
68!. The under-5 mortality rate in India is 87 per thousand compared to
that of Bangladesh (69). The WHO attributes 60 per cent of all deaths in
India to chronic diseases.