Rural Health Care Needs Fixing, And Now

Context: A takeaway from the pandemic is that India needs to revisit and refurbish its health infrastructure in rural areas.

Shortfalls in the rural healthcare system

• Huge infrastructure gap: 29,337 primary health centres (PHCs) are required in rural areas of the country; India has 25,743, a shortfall of 3,594 units – Only one PHC for 25 villages is present in India.
  • We have 5,624 community health centres (CHCs) against requirement of 7,322.
  • CHCs, which act as a referral centre covering a population of 80,000 people to 1.20 lakh people, show that, overall, there is a shortfall of 81.8% specialists at CHCs, as required.
  • 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- Human Development Report 2020:
• Vast populace remains deprived of critical health interventions: According to worldometers.info, out of the 139 crore population of India, at least 91 crore people are living in villages (more than 65%).
• Intensifying disease burden: Most people are unaware of NCDs, and public healthcare institutions in rural areas not equipped to address the changing trend.
  • As per an estimate of WHO, Non-Communicable Diseases (NCDs), including cases of cardiovascular disease, chronic respiratory problems and cancer, cause nearly 41 million (71%) of all deaths globally and about 5.87 million (60%) of all deaths in India.

Way forward

• Guiding vision - World Health Organization (WHO)’s principle of Universal Health Coverage: “Ensuring that all people have access to needed health services (including prevention, promotion, treatment, rehabilitation and palliation) of sufficient quality to be effective while also ensuring that the use of these services does not expose the user the financial hardship”.
• Call for infrastructure up-gradation: In fast-changing health scenario, we should have one expanded PHC for every 10 villages along with the provision of some beds and other minimum necessary facilities.
  • Capacity building of PHCs and CHCs: They should have the health data of people in their respective areas and conduct regular health camps to identify those on the verge of developing tuberculosis, hypertension, diabetes or any diseases likely to be caused by their socio and economic conditions.
  • Every CHC to have at least 30 beds for indoor patients, operation theatre, labour room, X-ray machine, pathological laboratory, standby generator and other wherewithal.
• Uphold collective responsibility: Mobilise all stakeholders including State and Central governments, local bodies, private sector etc. As Bertrand Russell has put it, “It’s co­existence or no existence.”