Introduction:
One of the salient features of the Indian Constitution is the effort to establish a welfare state.
The Preamble and the Directive Principles of State Policy make it amply clear that our goal is a welfare and socialist state through democratic means.
This means that the government is expected to work for the welfare of the people in the spheres of education, health, employment, basic infrastructure etc.
Health – A state of complete physical, mental and social well being, not merely the absence of diseases or infirmity is called health.
Apparently, being healthy means having no disease.
But actually it is much more than that.
The factors that contribute to ill health like accumulation of stagnant water in the surroundings, lack of basic sanitation facilities, dirty surroundings, polluted air, etc. need to be eliminated for ensuring good health.
If people do not get clean water and food and live in cramped conditions without ventilation; they are prone to illness.
Following factors are required to ensure good health:
Access to clean drinking water
Access to basic sanitation facilities
Cleanliness in surroundings
Clean air
Nutritious food
Note:
Swachh Bharat Abhiyan is a national campaign by the government of India, covering 4041 statutory towns, to clean the roads, streets and infrastructure of the country.
It was launched on 2 October 2014 at Rajghat New Delhi.
It was earlier known as Nirmal Bharat Abhiyaan.
Healthcare in India
We need appropriate healthcare facilities to prevent and treat diseases.
Facilities include health centres, hospitals, ambulance services etc.
From the aspect of human resources, qualified doctors, nurses and good health professionals and workers are needed.
India has a large number of doctors, clinics and hospitals.
The knowledge and experience in running a public healthcare system is considerable.
The public healthcare system, hospitals and clinics are run by the government and it caters to a large section of the rural population. Even the medical technology has advanced very well.
India is being known globally for its medical tourism.
In spite of the above achievements,
We are not able to provide proper health care facilities to all.
People in rural areas have to travel long distances and wait in long queues at government hospitals. Most doctors settle in urban areas.
Half of all children in India are undernourished.
Public health services – An activity or service that is meant for all people of the country and is mainly organized by the government is called public health services.
The word ‘public ‘in public health services means that they provide healthcare to all citizens through hospitals and health centres set up by the government.
Moreover, the money/resources required to run these is obtained from the ‘public’ in the form of taxes.
A public health service is a chain of health centres and hospitals run by the government.
They are linked together so that they provide services in both rural and urban areas and provide services for routine and small illnesses and also provide specialized services.
Village Level: At the village level there are health centres where there is usually a nurse and a village health worker.
They are trained in common illnesses and work under the supervision of doctors at the Primary Health Centre.
Primary Health Centre (PHC):
Such a centre covers many villages in rural India.
A PHC has a General Physician, a Gynaecologist, Orthopaedics, a Dentist, an Ophthalmologist and a Paediatrician.
Thus, many specialized treatments are available at PHCs.
Community Health Centre (CHC):
Such health centres are present at block and subdivision levels.
They have more facilities in terms of specialization of doctors.
District Hospital:
At the district level it is the District Hospital that supervises all the PHCs and CHCs.
These hospitals have more facilities compared to a CHC.
Large cities have many government hospitals.
A public health care system:
Is meant to provide quality health care service either free or at a nominal cost so that even the poor can seek treatment.
Is supposed to take action for preventing diseases like TB, malaria, cholera etc.
This involves campaigns involving the people to create awareness about some diseases and methods to prevent them.
For example; creating awareness about how stagnant water in buckets, tyres, drains, flower pots, water coolers etc acts as a breeding ground for mosquitoes; hence spreading dengue and malaria.
According to our Constitution it is the primary duty of the government to ensure the welfare of the people and provide health care facilities to all.
The government must safeguard the Right to Life of all people.
If a hospital cannot give timely medical treatment to a patient, it means the right to life is not being safeguarded.
Private health services – An activity or service that is organized by an individual or company for their own profit is called Private health services.
As the name suggests, private health facilities are not owned/controlled by the government.
Since these are privately owned they charge a lot of money.
Hence poor people cannot afford these facilities.
There are a number of private health facilities in India.
Many doctors run their own private clinics.
Urban areas have large number of doctors also providing specialized services.
There are many hospitals, nursing homes, and diagnostic centres that are privately owned
There are many large companies that run many hospitals and are engaged in manufacturing and selling medicines.
Medicine shops are found in every corner of the country.
Equality: Healthcare Perspective:
In India we find that the private facilities are increasing but the public facilities are not. Hence mainly private services are available to people.
The disadvantage of this is:
Location
These are mainly concentrated in the urban areas.
High cost
Since these are run with a profit motive they charge exorbitantly.
Hence poor people cannot afford the same.
In order to earn profit these private services engage in many malpractices.
They unnecessarily recommend many tests and even hospitalization even in cases that can be treated with simple medicines.
Medical expenses
Only 20% of the population can afford to pay all their medical expenses.
Even those who are not very poor are not able to pay the same since these are prohibitively costly.
Therefore many people have to borrow money (which starts a vicious circle) or sell their possessions for paying for their medical requirements.
For those who are poor, every illness causes a lot of anxiety and stress.
They also tend to fall ill repeatedly.
This is because of the following reasons:
Malnourishment: The poor people are undernourished. They do not get to eat a balanced diet and hence miss out on the recommended daily quota of carbohydrates, fats, vitamins, minerals, iron, calcium etc.
Lack of basic facilities: The poor people do not have access to clean drinking water. They stay in dirty and ill ventilated, congested areas. These increase their chances of falling ill, manifold.
Other aspects that contribute to ill health:
Apart from financial aspects, even the mindset of people is responsible for their ill health.
For example; women are a downtrodden section of the society.
Their health is often neglected and they are not taken to the hospital promptly.
Many tribal areas have few health centres and they are not run properly.
Even private health services are not available.
How to improve?
It is clear from the above that the health of many people in our country is not in a good condition.
The government has to take steps to improve the healthcare services especially aiming at the poor and underprivileged sections of the society.
Improvement in the basic amenities and social conditions of the people will go a long way in improving their health conditions.
Building toilets in the rural areas as a part of the Swachh Bharat Abhiyan is a step in improving the health of the people.
Even spreading awareness regarding the need for toilets, through television and radio; mainly targeting the rural uneducated sections will considerably help in improving the health and sanitation of the people.
Indian scenario: The Kerala experience
Some major changes were made by the Kerala government in 1996.
The panchayats were allocated forty per cent of the state budget.
This enabled the panchayats in planning and providing for their requirements well.
This helped the village to make sure that proper planning was done for water, food and women’s development and education.
Following steps were taken to improve the situation:
Water supply schemes were checked.
Proper working of schools and anganwadis was ensured.
Steps were taken to solve the specific problem of the village.
Health centres were improved.
Despite these efforts the following problems remained and needed to be addressed:
Shortage of medicines and hospital beds
Insufficient number of doctors
International scenario: The Costa Rican approach
Costa Rica is amongst the healthiest nations in South America.
This could be possible because of an important decision made by the Costa Rican government.
Many years ago; Costa Rica decided not to have an army.
It was assumed that instead of wasting the money on armed forces, it was more important to spend that on public health, education and on other basic needs of the people.
The Costa Rican government believes that a country needs to be healthy to ensure development.
The government pays a lot of attention to aspects; like safe drinking water, sanitation, nutrition and housing.
Health education is an essential part of education at all levels.
Keywords:
Medical tourists: This refers to foreigners who come to this country specifically for medical treatment at hospitals that offer world-class treatments at lower cost than their home countries.
Communicable diseases: Diseases that are spread from one person to another through food, water, air etc.
OPD: It stands for outer patient department. It is where people are first brought in the hospital for treatment without being admitted to a special ward.
