Rural health care needs fixing, and now
Recently, the two consecutive waves of COVID-19 and Mucormycosis have left us shattered but during the second wave of the pandemic, it is our rural people who are struggling the most.
India’s health infrastructure is lagging behind in rural areas
- Low primary healthcare centres (PHCs) to village ratio: The second wave of the novel coronavirus pandemic has exposed the inadequate and poor health infrastructure in the rural areas.
- The fact shared by Union Minister of State for Health and Family Welfare suggest that 29,337 primary health centres (PHCs) are required in the rural areas of the country.
- India has 25,743, a shortfall of 3,594 units which implies that we have one PHC for 25 villages in India.
- Shortfall of health specialists in Community Health Centres (CHCs): India has 5,624 community health centres (CHCs) against the requirement of 7,322.
- The data on CHCs, which act as a referral centre covering a population of 80,000 people to 1.20 lakh people, show that, there is a shortfall of 81.8% specialists at CHCs as compared to the requirement for existing CHCs.
- Low patient-hospital bed ratio: According to the Human Development Report 2020, India has eight hospital beds for a population of 10,000 people, while in China, it has 40 beds for the same number of people.
- Lack of maintenance of network of health care: India not been able to maintain the vibrancy and vitality of the network of health care which resulted vast rural populace remains deprived of critical health interventions.
- Gap between allocations and actual government spending on PHCs: India’s hospital-centric model has always focussed on sick-care at the tertiary level, which increases the overall burden of access, diseases and cost of health care.
- Inadequate doctor-patient ratio: Nearly 30,000 doctors, 20,000 dentists and 45,000 nurses graduate from medical colleges across India every year but the doctor-to-patient ratio in India is only six for every 10,000 people.
Importance of healthcare infrastructure in rural areas
- Continuous supply of healthcare needs: The key role of healthcare facilities in the rural areas is to provide regular and comprehensive healthcare needs guided by the World Health Organization (WHO)’s principle of Universal Health Coverage.
- Support to financial hardships of rural population: It aims to ensure that all people have access to needed health services (including prevention, promotion, treatment, rehabilitation and palliation) of sufficient quality to be effective.
- PHCs act as effective management structure: The PHCs have proved to be an effective management structure enabling people’s participation in ensuring better functioning of rural health services.
- Early diagnosis saves healthcare-related resources: It is necessary to treat the disease(s) at the primary level in its first stage to create a healthy India because it will help us save a lot of money and the resources being spent at tertiary level health care.
Measures to be adopted to address health infrastructure in rural India
- Increase in primary healthcare centres (PHCs) to village ratio: India should have one expanded PHC for every 10 villages along with the provision of some beds and other minimum necessary facilities.
- Government’s engagement with rural community: It is of utmost importance that governments everywhere engage with all kinds of rural community organisations such as panchayats, gram sabha, notified area committees, municipal bodies and nongovernmental organisations in minimising the adverse impact of the pandemic on rural life.
- Proper maintenance of healthcare network: The chain of SHCs, PHCs and CHCs can very well take care of the multiple health needs of our people.
- They should have the health data of people in their respective areas because it will enable them to identify likely to slip into the secondary or tertiary care zone.
- Regular organization of health camps: It will help us identify those on the verge of developing tuberculosis, hypertension, diabetes or any diseases likely to be caused because of their socio and economic conditions.
- Rural healthcare centres should be equipped with necessary resources: A CHC or referral centre equipped with specialists will do wonders if made to work efficiently.
- Every CHC is supposed to have at least 30 beds for indoor patients, operation theatre, labour room, X-ray machine, pathological laboratory, and standby generator’ and other wherewithal.
- Cloud-based health management platform: It would not only connect people to doctors and facilitate follow-up consultations but also rope in the nearest medical stores to ensure people received the prescribed medications.
Road ahead
- It is high time that all stakeholders need to revisit and refurbish India’s health infrastructure in the rural areas and build them in a better manner.
- The health is a State subject, but all those living in the rural areas are not only the responsibility of the States or the Centre but also a collective responsibility.
- It is necessary to see and ensure that the money being spent improves facilities and contributes to people’s ease of life because it is hugely challenging as a task but we have to firm up our strategies, their execution and by rigorous auditing.
- Combining healthcare data with other parameters related to transport and housing, for instance, could be used to generate healthcare plans and deploy healthcare services in real time to those who need it the most.
- The approach to service delivery has to be aimed at providing a functional referral link between urban and rural services in order to establish a ‘continuum of care’.
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