Answer of the week

Q-Recent incident at Gorakhpur, UP remind us of the grim state of health facility in the country. Highlight the issue faced by health sector in India and what should be the way to improve such situations?

Sol-Gorakhpur is the recent incident where more than 70 children died due to allegedly non supply of oxygen on failure of payment by govt to contractor. This is the result of failure of governance and basic issue that health sector is facing which are as follows

1.lack of skilled doctors

2.low investment...exaggerated by underutilisation of sanctioned funds

3.lack of access to public health care..pushes poor to proverty

4.no effective regulatory mechanism for public and private health care

5.profitisation of health service delinking it from emotional and ethical part of practice

6.1/2 of srilanka,1/4 of china and 1/6 of thailand public spending..

7.70% out of pocket expenditure..highest in world

8.present insurance coverage segrate primary from secondary..which is bad

9.unorganised sector not well covered under health schemes

10.poor governance and management, countries like russia and south africa spend more amount on health w.r.t india but have less life expectancy or slightly better for russia,whereas bangladesh and sri lamka spend less amount(% of gdp) still have better health indicators.2008 study shows correlation btw expected corruption and child motality.

Steps required:

1.holistic health care

2.more integrated with emphasis on primary sector(so far neglected under insurance scheme) and max out of pocket ezpenditure is on primary incling medicine which is not covered under health insurance...then thru gatekeeper approach to secondary..by utilising in primary many problem will nt need to gi to secondary

3.can use tamil nadu health corporation model,where corporation is independent body free from govt restriction and trying to fix all three responsibility,flexible and accountability....in otherwise present case govt adminstrtn emphasise mainly on responsibility..not other 2....similar independ body is working in uk for health care

4.emphasis on prevention

5.integrated comprehension policy like millenium village project in rural africa with resources constraints gievn good results 

6.giving more teeth to the National Accreditation Board for Hospitals and Healthcare Providers and enforcing the Clinical Establishments Act of 2010, 

Government has taken various steps like New Health Policy, promoting alternative medicines, insurance schemes etc to improve the situation. Such efforts need to be taken on more fast track manner and India can become more inclusive in providing health services.