Namaste, a country’s prosperity rides on the health of its population.
Any idea how healthy the Indian patient is?
This week in India Loud & Clear
I take you to the rural health centres and health workers there.
You'll see blood-stained beds, ghost constructions,
missing doctors and underpaid health workers.
Is there a doctor here?
Where do we go for treatment?
We can be treated only when there is a doctor in the hospital.
And this is why the poor die.
We love statistics! There are countless indicators to rank any condition.
Including our own health. Any idea what’s our condition?
India’s position has slightly improved over the years,
but it’s still embarrassingly low for a nation with the image of a rapidly developing country.
Let's have a look at some shocking statistics on the state of health.
The healthcare story is not just about budgets and statistics.
The main reason is people's inability to access their right to healthcare.
Where will your baby be born?
Either Biwana or Akbarpur.
How far is Biwana from here?
Nine kilometers.
And Akbarpur?
20 kilometers.
So do you have any problem going to Biwana or Akbarpur?
Yes.
What?
There is no ambulance: we have to hire a vehicle.
If you get hospital facility here, what help will you get?
We can visit any time even in the night, it will save us time and money.
In 2018 the government launched the
Ayushman Bharat Yojana or National Health Protection Scheme.
This ambitious program is a mix of pre-exisiting schemes.
The government proudly claims this as the world’s largest health care programme.
So what services does the Ayushman scheme promise?
Health insurance to the countries poorest and a strong health infrastructure.
The scheme offers an insurance cover up to ₹ 5 lakh per family per year.
About 500 million Indians are covered under this.
But 700 million are still outside of this scheme.
Health costs keep people poor,
and push those just above the poverty line back into poverty.
You may be admitted in a government hospital
but most medicines have to be purchased from outside.
This expense is a killer.
Let’s look at some more shocking statistics.
800 million Indians don't have access to primary healthcare.
90% of India’s poorest has no health insurance.
70 percent of the household expenditure on health is on medicines.
55 million Indians were pushed into poverty in a single year due to cost of healthcare.
That’s more than the entire population of South Korea.
33 out of 55 million fell under the poverty line due to expenses on medicines alone.
Primary health care starts with basic facilities.
Meaning healthcare centres, doctors and health workers.
But what do you do when an unfinished construction remains a ghost hospital?
Pradhaan Ji, do you have a sub health centre in your village?
Yes, it is there.
How long has it been there?
It has been around 10 - 12 years.
On finding out we got to know that the building has not been handed over as yet.
The villagers are not getting any benefit from this.
Is there a hospital here?
Yes.
So how come there is no help from there?
What is the use when there is no doctor there?
The back bone of India’s rural health care are the social health workers, known as ASHA’s.
It's because of ASHA workers that health care services have reached every village household.
Although, they are putting all the efforts in their work, they are not paid enough.
How much money do you get?
We get ₹500 for keeping records, ₹300 for delivery, for blood test we get ₹15.
What is the total amount?
Not more than ₹1500 per month.
We have to cover 30 households, between 9am to 12pm, which is very difficult and timetaking.
We don't get time to do anything else.
We cannot go to our fields in the afternoon and if we do anything else,
the authorities will ask us to leave the job. ₹1500-1800 is a very meager amount for payment.
If we will get more money, then why will we go to any other place?
Healthcare flows where the money is.
Or is hit when the money doesn’t flow anymore.
Like in this well functioning and awarded Gumla district hospital in Jharkhand.
Here they face lack of patients as the centre stopped giving cash to sahiya’s for bringing in patients.
We are facing pressure about the lack of patients in the centre.
When we contact the anganwadis and sahiyas they tell us there are no patients.
However, the patients who walk into the centre say that there are malnourished children in the villages.
If the incentives for the sahiyas are restarted
by the govt then our community outreach to patients in rural areas will be better.
Health spending is not just a cost. It's an investment. Investment in poverty reduction,
jobs, productivity, inclusive economic growth, and healthier, safer, fairer societies.
The World Health Organization advises to spend at least 5% of a country's GDP on health.
This is the minimum budget needed to ensure universal health coverage.
We need a healthy system where every Indian is entitled to accessible,
affordable and effective health services.
This is alo part of the third goal of the Sustainable Development Goals.
With health absorbing just 3% of our public budget India doesn't reflect this idea at all.
What do you think?
Should our government prioritize health care in a much bigger way?
Let us know and write your comments below.
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See you again next week.