Thursday, July 15, 2010


National health policy is highly discriminatory!!

It is not just a fact that with respect to overall health indicators India fails miserably, but the bigger challenge is the in-built discriminatory framework that is imbibed within the health related infrastructure. According to the Medical Council of India, presently, the allopathic doctor to population ratio stands at 1:1,722. However, this ratio does reveal a true picture of Indian health care system, but it does not reveal the actual distribution of the doctors which is abnormally uneven, across the nation. Such is the divide that 80 per cent of medical practitioners serve just 20 per cent of the Indian population. In order to understand this divide better, one needs to just glimpse through the doctor to rural population ratio, which stands at an alarming 1:30,000 against the all India ratio of 1:1,722! Even the state of basic health infrastructure follows a similar trend. Going by various media reports, in rural areas, the ratio of hospital beds to population is 15 times lower than that for urban areas, which leads to discriminatory access to health care services. Thanks to discrimination, a child hailing from a rural background has four times higher probability of dying of curable diseases, than his urban counterpart.

In order to address this highly skewed medical infrastructure, the Central government is planning to introduce a short term medical course at graduate level, specifically meant to serve the rural areas. On the hindsight, this move seems to help the rural health care system to a large extent. But then, such an initiative brings with itself several non-ignorable skepticisms. Under this scheme, a doctor will be trained for 3.5 year BRMS degree in a district hospital after graduation and would then be asked to work in rural areas. Given the state of district hospitals, which lacks basic medical facilities, leave aside an environment for medical training – is possibly the worst place for producing qualified doctors - especially when it comes to modern medication. With the best of medical schools facing faulty crunch, I wonder from where would the district hospitals manage faculties? Now the question is, why should the rural Indians be treated differently from their urban counterparts? The whole initiative is sound, if it is implemented universally and if it is not, then it is out-rightly discriminatory! And if the government is really serious of providing the adequate health interventions across the country, they have to essentially increase their budgetary allocations, create health infrastructure and make it mandatory for qualifying doctors to serve at least two years in the rural hinterlands. At the same time, the government should focus on long term goal and tap alternative medical systems and paramedical professionals. I wonder how one can ignore the fact that, when it comes to health, quality can’t be compromised at any point of time. As such, a large chunk of India's population is being treated by semi-qualified doctors and the consequences are widely visible. In the given environment adding semi-qualified personnel is not the solution in itself. That too assuming that these trained personnel would do their job sincerely in the rural hinterlands. I have serious doubts, as the precedence has not been promising.

All in all, there is no short cut, when it comes to health. And successive governments have for long been callous in their overall policy framework, pertaining to health, in particular. In effect it has shortchanged the lives of millions of rural citizens. If there is no difference with respect a life of a human being, irrespective of where he dwells, then their chosen government has no right to discriminate them!



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  2. Yes,I agree with you.I tarvel rural Bihar for my research related to arsenic contaminated aquifers.I feel sad to see the plight of poverty stricken arsenic exposed population in Gangetic plain.There is no body to advise them to protect their health from arsenic poisoning.

    Ashok Ghosh
    Professor Incharge,
    Dept. of Environment and Water Management,

  3. I am in partial agreement to this.. Prasoon sir is suggesting to make it mandatory for a doctor to server 2 years in a rural area! "Not fair". Even if we'll produce 20,00,000 more docs they will shift to cities or abroad. We have to cure the root cause.
    1. Obligatory duty of the state govt to put in place better health care infrastructure. (in complete agreement to above)
    2. Use of carrot instead of a cane for shifting doctors to rural areas. Working in rural areas to be made so lucrative (financially) that it will automatically lead to a "true" 1:1,172 ratio, which i believe is not bad if it covers entire india in a true sense.

    The reason docs fly away from indian cities to abroad is the same reason why docs shy away from rural to urban parts of India.

    Rohit Sharma
    IIPM Grad
    2003-05 FW

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