User:Anishsinghal

Health scenario in India …
India pledged along with other WHO member Nations, 'Health for All by the Year 2000' at Alma-Ata in 1978; and in the same year signed the International Covenant for Economic, Social and Cultural Rights, in which the State is obliged to achieve the highest attainable standard of health. However the health scenario in India is abysmal. In context of poverty, access to public health systems is critical. However, since 1990s, the public health system has been collapsing and the private health sector has flourished at the cost of the public health sector. Health policy in India has shifted its focus from being a comprehensive universal healthcare system to a selective and targeted programme based healthcare policy with the public domain being confined to family planning, immunization, selected disease surveillance and medical education and research. The larger outpatient care is almost a private health sector monopoly and the hospital sector is increasingly being surrendered to the market. The decline of public investments and expenditures in the health sector has further weakened the public health sector thus adversely affecting the poor and other vulnerable sections of society. Introduction of user fees for public health services in many states has further reduced their access to health services.

Health Scenario in India: 620 million live in rural India (NCAER) Bed-Population ratio 1:1333 (1991) Vs. ideal of 1:500 2 million beds are required as against 0.7 million available. 700 hospitals of 250 beds each are required every year. only 9% of 1 billion people are covered health schemes. only 0.9% of GDP for health (WHO recommends 5%) 5% of annual family income spent towards curative health care.

In India, annually 22 lakh infants and children die from preventable illnesses; 1 lakh mothers die during child birth, 5 lakh people die of Tuberculosis. Diarrhoea and Malaria continue to be killers while 5 million people are suffering from HIV/AIDS. End Stage Renal Disease (ESRD) is a life threatening condition which occurs when kidneys stop functioning. About 1,00,000 persons suffer from ESRD each year, of which only about 20,000 get treated. Diseases and malnutrition is widespread amongst the poorest quarter of the populace. Mortality is still relatively high and now the bane of AIDS is spreading fast.

Dental healthcare scenario in India – Indian hospitals are becoming known internationally for standards of health care delivery comparable to the best in the world. India has technology and as well as skilled super-specialists, coupled with sound infrastructure and professional management, nurses and paramedical staff, all of which make its health care sector of world-class standard.Dental treatment in India is becoming increasingly popular with foreign visitors for whom healthcare in their home countries is not reimbursed by national health schemes and therefore very expensive

Rural Health Care System in India – Under the mandate of National Common Minimum Programme (NCMP) of UPA Govt., health care is one of the seven thrust with main focus on Primary Health Care. The National Rural Health Mission (NRHM) has been conceptualized and the same is being operationalised from April, 2005 throughout the country.

Overview - The National Rural Health Mission is being launched for a period of seven years (2005-2012). The Mission shall cover entire country. The emphasis under NRHM is to improve primary health care, decentralization, intra and inter-sectoral convergence and community ownership. The budget outlay for National Rural Health Mission for 2005-06 is Rs. 6731.16 Crores.

Outcome -The following are anticipated Mission outcomes likely to be achieved after its implementation: • Provision of village level health provider (ASHA) in under served villages • Strengthening Sub- centers /PHCs • Raising CHCs to the level of IPHS • Institutionalizing District level Management of Health (all districts) • Prevention and control of communicable and non communicable diseases including locally endemic diseases.

Points against healthcare system –

Resources & Population - India is quickly overpopulating thus in spite of being gifted with abundant water & other goods, huge population is making it scarcer.

Poverty - India is home to the largest number of people living under two dollars a day.Poverty also begets child labour.Recently, to tackle this problem, the Indian Government has started a mass employment program to help employ civilians living in rural areas- "spoonful of reform for a sea of misery".

Low Literacy - The national literacy is yet just 65.2 per cent as per the Census in 2001. Literacy drive is spreading & it is hoped that it will eventually rise above 70%.

Solution – The time has come to reclaim public health and make a paradigm shift from a policy-based entitlement for healthcare to a rights based entitlement. For this healthcare has to become a political agenda. Telemedicine- is a method, by which patients can be examined, investigated, monitored and treated, with the patient and the doctor located in different places. Telemedicine covers a wide range of activities. In the past it was primarily teleradiology – the transferring of high resolution medical images, X ray pictures, ultrasound, CT, MRl pictures, live transmission of ECGs and echocardiograms. Today even a detailed clinical examination can be conducted remotely. Advantages- Doctors licensed to practice all over India, Maximum utilisation of limited resources Saves travel, time and money, Makes Geography History!! Enormous CME potential for GP, urban trainee and Teleconsultant, International grand rounds, Web casting conferences, Motivation for computer literacy among doctors.

Anish S. Singhal, ACPM Medical College.