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Battling development challenges

Access to quality healthcare is a basic human need, besides being a fundamental right and a public mandate. India has poor health statistics, even when compared with some developing countries.

india Updated: Nov 07, 2008 01:41 IST

Access to quality healthcare is a basic human need, besides being a fundamental right and a public mandate. India has poor health statistics, even when compared with some developing countries. But for the vast majority, the key barriers are not lack of technology, but lack of access to healthcare.

The facilities in urban India are inadequate with only 1,083 family welfare centres for more than 180 million urban poor. A report by the Associated Chambers of Commerce and Industry of India says at least 300 additional urban health and family welfare centres are needed annually to cater for 215 million urban poor by 2020.

Historically, India has spent far too little on health mainly because of low national income. But rapid economic growth does not guarantee better healthcare. The income growth is accompanied by increase in chronic diseases, such as diabetes mellitus, cardiovascular disease and orthopaedic disorders. These diseases do not only translate into health repercussions, but also into economic and financial costs.

The basic non-pharmacological measures can be avoiding central obesity, consuming unrefined foods, abstaining from smoking, keeping salt intake low and exercising daily. Despite the notion that these are diseases of the affluent, much of the burden of chronic diseases and their risk factors is concentrated among the poor. While the non-poor spend around four per cent of their annual income on healthcare, the poor expend about 25 per cent.

Collaboration among various sectors, organisations and thought-leaders can bring about a change. It is within the private sector’s ambit to enhance the accessibility to medical assistance for the urban poor.

Also, there should be steps to make medicines and other essentials affordable at urban healthcare centres, renovation of hospitals and dispensaries and establishing public-private partnership to ensure the urban poor’s access to healthcare services.

Community involvement is another key. The government and communities must work together to establish a viable food economy to which the poor can gain access, promote environment-friendly urban agriculture, create infrastructure for a healthy environment and disseminate information on good nutrition practices.

Much of what we know about chronic diseases will be greatly enhanced by research on the relationships among known risk factors, but also by a better understanding of the complex interactions of obesity, diabetes, urbanisation and vascular diseases and the beneficial implications of low-cost combination drug therapy for vascular disease and diabetes.

It is critical that information about risks is effectively communicated to and then used by the public.