Health Care in India-Present SutiationSince Independence, improvement in health care services in the country has been one of the most important objectives of public policy. India being a vast country with high population the task was not easy, as the health care base at the time of independence was extremely poor. A lot of money has been spent in the health care sector but the results have not been upto mark. Reach of health care systems is still poor and skewed and various health indicators are much below the globally fixed standards. After grossly missing the targets set under the UNsponsored and supported programme called “Health for All by the Year 2000”, the government of India has recently come out with another ambitious programme called the National Rural Health Mission(NRHM) to take care of the problem in a holistic manner.
With ever growing population, health care and family welfare, along with education, have been quite high on the agenda of social development in the country. It was in the decade of 1990s that the mortality rate in the country reached a plateau and the country faced the dual disease burden. While communicable and waterborne diseases continued to be a problem area, the changing lifestyles of the people in urban areas posed a new challenge of non-communicable diseases including the diabetes, cardiac-related problems and hypertension.
The existing health care system suffers from various problems and deficiencies. There is inequitable distribution of health care institutions and the technical and para-medic manpower. Despite the fact that about 25,000 doctors in modern medicine are produced every year in the country, along with similar number of other practitioners and paramedics, there still exists huge shortage of trained and skilled manpower in the institutions providing primary health care, particularly in the rural areas. The problem is even more pronounced in remote and tribal areas.
What are the Reasons for Poor Health Care in India I think one major reason for poor health care in the country is the emphasis on curative health care at the cost of preventive health care. Traditionally, health care in the country is perceived as part of social responsibility of the State, rather than as a paid service. But with economic and demographic changes that are sweeping the country, the focus is gradually shifting to the paid services. For a change, capital investment in health care and super specialty health care is being seen as a good investment option. But the government has to incentivise the private sector to invest in health care sector in rural areas to supplement the government effort.
There are alarming disparities in the country among the States so far as the health care indicators are concerned. The Approach Paper to the Eleventh Five-Year Plan (2007-12) has pointed out several such disparities and divides in Indian economy. As per the Approach Paper, though the Infant Mortality Rate (IMR) in the country has improved from 80 per 1000 live births in the year 1990 to around 60 in the year 2003, the IMR in the worst State was 83, while the same in the best State was just 11 in 2003. This shows skewed distribution of health care availability and access in the country. Similarly, under- nourished children are about 47 per cent of the population in the country, but the best State of the Indian Union has only 20 per cent children as undernourished while the worst State has about 58 per cent undernourished children.
All the above statistics indicate that the high levels of growth have not helped in securing equitable distribution and access to health care facilities in the country over the years. Greatly concerned by the lack and disparity in the availability of health care facilities, the government of India, in 2005, came out with a new initiative to tackle the problem of rural health in a holistic manner. Called the National Rural Health Mission (NRHM), this new flagship programme aims at providing accessible, affordable and quality health care to the rural masses, especially the vulnerable sections of Indian society.