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Social Inequality in Access to Public Health Care

HEALTH FOR ALL: INDIA CHALLENGES

Social Inequality in Access to Public Health Care

The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, caste, religion, cultural belief, economic or social condition. The Indian Healthcare has made rapid strides in recent years both domestically and in Global markets. India spends 5.7% of its GDP on Healthcare and provides employment to 4 Million people. Over the last few decades India’s large public infrastructure and national disease control programmes have succeeded in eradicating major diseases. There is also a significant improvement on our key health indicators - life expectancy, infant mortality, health & hygiene and morbidity besides the control of TB, Malaria and AIDS.

Yet in reality, more than 4.6 billion people living in developing nations do not have access to modern medical attention. In September 2000, 189 countries of the United Nations embraced the new millennium by adopting the Millennium Development Goals targeting global healthcare, poverty, and hunger. Three out of the eight goals targeted by 2015 are directly linked to the advancement of health development. Rural healthcare and urban healthcare, and between socio-economic groups and between the most disadvantaged areas are mainly lacking of health care facilities.

The challenge now is to provide universal healthcare. This is the stated objective of the 2002 National Health Policy, which aims at providing acceptable standards of good health to the general population. It seeks to achieve this by upgrading the existing infrastructure, establishing new infrastructure in deficient areas and improving access to the public health system. To this end, the Government launched the National Rural Health Mission in 2005 “to carry out basic architectural correction in the health care delivery system”.

The 3rd India Health Summit with the theme “Universal Healthcare: India Challenges” on 21-22 November 2005 at Hotel Hyatt Regency, New Delhi,  organised by Cember of Indian Industry in association with Indian Healthcare Federation, bring the people to assess different aspects that may contribute to the enhancement of universal health care access. Most importantly, it is crucial to address the equality of health care access and closing the gap between developed and developing nations, and gap between different regions and population groups within country.

The summit would be addressed by Shiela Dikshit, Chief Minister of Delhi; Prasanna Hoda, Secretary, Ministry of Health; Analjit Singh, CMD, Max Healthcare; Dr Mohan Chellappa, MD, John Hopkins; Sachin Pilot, Member of Parliament; Dr Prathap Reddy, Chairman. Apollo Hospitals Group; Radha, CEO, Sri Ramachandran Medical College & Research Institute and Dr Hamad Abdul Rahman Al Madfa, Minister of health, UAE, amongst many others. 

In matters of health care, the Scheduled Tribes are disadvantaged due to physical isolation from the mainstream population around which principal health facilities and services are located. Moreover, they are scattered and sparsely distributed within their territory making it difficult to access even free services. On the other hand, the Scheduled Castes have always been residing in villages settled by the dominant groups of population and hence do not suffer from such physical isolation. Health institutions are as close to them as to the other population, the dominant or upper castes. Hypothetically, access to public health care should be as good as or at par with the non-scheduled population. However, the Scheduled Castes face social discrimination on account of traditional restrictions on access to public facilities including health services.

Another thing in the debate is on governments to increase accessibility of medical treatment is to rely on the funds released by Global Health Fund. For example, India received close to $100 million to fight HIV/AIDS and $30 million for tuberculosis. With the available resources, governments need to recognize how to allocate the funds in order to making effective policy decisions on public health and health care service capacity building. Other possible solutions are to look into the Millennium Development Goals of 2015, and establish effective programs according to the target goals in order to minimize the gap of medical accessibility between developed and developing nations.

 

Harpal Singh, CII felt that the name 'Medical Tourism' should be rechristened 'Medical Value Travel' which means that those who come to India for healthcare would get health that would add value to their money. He said that one of the main aims is to dispel the notion that healthcare in India is available only for the rich and the urban population while others are deprived of it.

 

To promote this inclusiveness, special sessions will be organized at the Summit, on universal healthcare, rural healthcare and urban healthcare to narrow the health gap in childhood and throughout life between socio-economic groups and between the most disadvantaged areas and the rest of the Country Topics included in this review start with the early years and then focus on lifestyles, use of primary health services, health status and mental well being, and finally social differences in mortality. The NFHS data and studies clearly shows that a higher percentage of SCs and STs in India do not have easy access to public health care facilities. These evidences also showed in maternal care, the SCs/STs-Others disparity persisted in a large number of states.

Giving this information to journalists at a press briefing organized by CII today, Dr. Naresh Trehan, Chairman, CII Health Committee and Executive Direcotr, Escorts Heart Institute& Research Centre, said that it had been estimated that if 'Healthcare for All' had to become a reality by 2010 India would need an investment of Rs. 1 trillion.  A study conducted by CII and Escorts Heart Institute revealed that if India has to meet the target of taking healthcare to all parts of the country, it would need Rs1 trillion or US$150bn, which was short by about 60%. "This is a challenge as well an opportunity for NGOs and foreign investors to join hands", he said. In order to make this a reality the CII Health Summits is a way to update ourselves, Dr. Trehan added.

 

He declared that the target of the Third Summit was to set up a Task Force to bring the healthcare system all over the country on a cohesive level and deal with issues of accreditation and Quality standards by 2006. The third task before the Summit was to make hospitals aware of their ethics and their duties for which an Ethics Committee had been set up, to deal with all aspects of health problem across the country.


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