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Health services of India in rural areas non-existent

editorials Updated: Oct 31, 2016 20:16 IST

Hindustan Times
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Doctors under the banner of the state chapter of Indian Medical Association (IMA) in a march in protest of state government’s decision of sanctioning leave to doctors by Mukhia (village head) who were working in rural areas in Ranchi (Hindustan Times)

Rural India spends comparatively small amounts on healthcare in relation to alcohol, tobacco and fast-moving consumer goods, a new survey by Chrome Data Analytics & Media, a primary research and data analytics company, shows. Compared to healthcare, the study found that people in villages spend three times more on alcohol, four times more on tobacco and nine times more on fast-moving consumer goods (FMCG) such as packaged food, toothpaste, soaps, toothpaste, detergents and shampoo. This finding is at variance with the government data, which shows that medical expenditure during emergencies and hospitalisation push 63 million people into poverty each year. The survey data indicates that though the incidence of diseases in rural India is high, people do not spend much on treatment till the point of hospitalisation. The reason for this is that healthcare services are non-existent in most parts of India.

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India’s health expenditure is 4.1% of GDP, of which public expenditure, the amount the government spends on healthcare, is 1.04%. In real terms, of the per capita public health spend of Rs 957, the central government spends Rs 325 and state governments Rs 632. As much as 70% of healthcare expenses of the people are borne by them, and 70% of that is spent on medicines and diagnostics. So if people in rural India are not spending on medicines, it’s because they can’t find doctors to prescribe medicines or diagnostic centres to do the tests.

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Despite India’s healthcare industry growing at a compound annual growth rate of 15% through the global economic slowdown, health services in rural areas remain non-existent. The private sector provides nearly 80% of outpatient and 60% of inpatient care in India, but there are few private hospitals and clinics in peri-urban and rural areas. This forces people in rural areas to go to traditional healers and quacks or become almost completely dependent on public health services available at primary health centres, community health centres and district hospitals, which are fraught with inefficiencies because of absenteeism, vacancies and red tape. It’s a pity that FMCGs, tobacco and alcohol are available in remote parts of India, but finding medicines remains a challenge. India needs to urgently focus on strengthening its public health infrastructure, providing essential medicines and basic diagnostics in public facilities at the block level, and regulating and engaging private care and traditional medicine to provide basic health care to its rural areas. For if political will, financial resources and health infrastructure fail the rural population, India cannot deliver on its promise of universal health care for years to come.