Why India's public-health system needs urgent attention

New Delhi, Sept 21: India's public-health system needs urgent attention, investment -especially in the rural areas - and attention, reveals an IndiaSpend analysis.

There is an 83 percent shortage of specialist medical professionals in community health centres (CHCs), according to the Rural Health Statistics-2015, released by the Ministry of Health and Family Welfare.

The CHCs constitute the secondary level of health care and provide specialist care to patients referred from primary health centres (PHCs), four of which feed into each CHC, serving roughly 80,000 people in tribal, hill or desert areas and 120,000 on the plains.

An ideal CHC is a 30-bedded hospital providing specialist care in medicine, obstetrics and gynaecology, surgery, paediatrics, dental and ayurveda, yoga and naturopathy, unani, siddha and homoeopathy (AYUSH), according to the Indian Public Health Standards prescribed by the Ministry of Health and Family Welfare in 2012.

In the 2015 Union Budget, the government cut India's healthcare budget by 15 percent -- a widely criticised move. The government recently announced it would raise the budget for healthcare, sanitation and child development programmes and sought parliamentary approval, according to reports.

Data

There is also an 83-percent shortage of surgeons in the CHCs across India. Arunachal Pradesh, Kerala, Manipur, Meghalaya and Tamil Nadu are some of the states that have no surgeons in their CHCs.

Then there is a 76-percent shortage of obstetricians and gynaecologists in CHCs nationwide. India bears the world's greatest burden of maternal, newborn and child deaths, according to the World Health Organization (WHO).

While infant mortality rate declined from 83 per 1,000 live births in 1990 to 44 per 1,000 live births in 2011, and maternal mortality ratio reduced from 570 per 100,000 live births in 1990 to 212 in 2007-2009, both indicators remain high compared to other BRICS countries like Brazil, Russia, China and South Africa, said the WHO.

Such statistics mean that specialised healthcare treatment in rural India is difficult, which has driven rising numbers of people to costlier private healthcare.

In rural India, 58 percent of hospitalised treatment was carried out in private hospitals, while in urban India the figure was 68 percent, according to the Key Indicators of Social Consumption on Health 2014 survey, carried out by National Sample Survey Office (NSSO).

For non-hospitalised treatment, 72 percent of health needs in rural areas were treated by the private sector -- including private doctors, nursing homes and private hospitals and charitable institutions, the survey said.

IANS