Disparity in the healthcare system in India
India is a country known for its diverse culture, traditions, festivals, religions and beliefs; but it is also known for its strict cast system, class rules and the ‘status ill treatment’. This disparity is based on these factors are quite common here and unfortunately it has also leeched into the healthcare system. India’s performance in health and well being underscores this disparity. India is ranked low in terms of overall health status compared to other countries.
As per the Oxford dictionary, Health is defined ‘as a state of being well in body or mind’. India had signed a signatory that stated health for all. By health for all is meant by the provisions of primary healthcare for everyone, irrespective of their ability to pay for it. This is inclusive of maternal and child healthcare, family planning, immunization, prevention and control of local endemic diseases provisions of essential drugs etc. The national policy approved by the parliament in 1983 indicates India’s commitment to the “Health for all” goal. But in the era of globalisation, liberalisation and privatisation, the major impact of economic reform in India is the reduction of government spending on public health and the withdrawal of government responsibility for the fulfilment of the people’s health needs.
In India, there is a sense of awareness about illnesses and the various programmes set up, however, the emphasis of these government health programmes are limited to family planning or population control. The basic healthcare remains unavailable to a large majority. The idea of the ‘Rural – Urban ‘divide has seeped into the public health services too. The differential treatment in terms of health is based on gender, class, caste and the socio economic status. In the rural areas, men were more likely to report morbidities than women. Individuals belonging to the lowest strata of standard of living are more likely to be reported for morbidities as compared to those in the highest strata of standard of living.
In India there are four major killer diseases – Lower respiratory, tract infection, diarrhoeal diseases, prenatal causes and vaccine. Children are the general targets here. The reason for more deaths in India due to these ‘Preventable diseases’ are corruption, unskilled doctors, in-affordability , lack of awareness, lack of access to services and inapt policies. Despite high economic growth rates, India is still highly unequal in terms of distribution of socio economic resources. Health inequity refers to those inequalities in health that are deemed to be unfair from some form of justice. Most of the health inequalities across social groups are unjust because they reflect an unfair distribution of the essential social determinants of health.
In the urban scenario, the condition is not any better. The urban poor still cannot afford the urban health facilities as they are expensive. The lack of economic resources restricts their access to the available private facilities. Poor environmental conditions in the slums make them vulnerable to lung diseases, malaria etc.
One of the biggest blots in the current health scenario is the failure to control communicable diseases. Despite the availability of technologies, due to various financial administrative, technical and logistic factors this success (technologically) was short- lived. The solution to this problem lies in the unequal society we live in today. The development, in terms of monitoring, and quality has been guided by this class consciences. Until we have a strong foundation of equity in our system, same regard for life and death, similar infrastructure for health and healing, interest in implementing control measures and policies and regular checkups, we are not going to change the situation. Health needs to be seen as a fundamental right and there is an urgent need to formulate a comprehensive programme. If all plan to work in a symbiotic way, this vision of better health status can turn into a reality.
National Urban Health Mission- June 2010
Health inequalities in India: The Axes Of Stratification (Harvard.edu/faculty/SU-Subramaniam)
Tehelka Magazine- June 30, 2012 Issue 26 Vol 9 – Healthcare is an unequal word.