Current statistics of healthcare in Bengal: causes for concern and factors behind degradation
Current statistics of healthcare in Bengal: causes for concern
Amartya Sen lists factors behind failing ‘health’
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Current statistics of healthcare in Bengal: causes for concern
Dec 21, 2008. The Telegraph.
Nine in 10 primary health centres in Bengal lack all-weather motorable access roads and hundreds remain without electricity or water, according to figures released by the Union health ministry.
The state has spent less than 15 per cent of the Rs 489 crore that it has received from the National Rural Health Mission to improve health services in rural areas, the ministry has told Parliament.
The figures, outlining the state of primary health centres (PHCs) across the country, show that 15 states have provided electricity and water to 100 per cent of their PHCs.
Bengal’s PHC statistics are closer to those of Bihar, Chhattisgarh and Uttar Pradesh. Not one of its 922 PHCs has an operation theatre and only 410 have a labour room.
Public health experts say the lack of all-weather roads, electricity and water would make a PHC virtually non-functional.
“How does a clinic without electricity or water deliver immunisation — one of its most basic functions?” asked Nilangi Sardeshpande, a public health specialist at Sathi-Cehat, a non-government organisation in Pune monitoring the National Rural Health Mission.
The lack of roads would prevent patients to be moved to a better-equipped health centre, she said.
But experts say the figures aren’t surprising because of lack of clarity in some states on implementing the rural health mission.
Some improvements have clearly taken place — rural health centres appear better staffed — but there are wide variations across states and some states have gaps, Sardeshpande told The Telegraph.
Not a single PHC among the 3,660 in Uttar Pradesh has a labour room or an operation theatre.
Despite transfer of rural health funds from the Centre, many states have yet to make use of the money, said Nitin Jadhav, member of a community-based monitoring group of rural health services in Maharashtra.
The Centre released about Rs 489 crore to Bengal between 2005 and 2008, but the state has an unspent balance of about Rs 419 crore — which means it has used only about 14 per cent of the money.
The health ministry figures show that not a single state has used all the funds disbursed under the rural health programme.
Mizoram has spent the highest proportion — 84 per cent of the Rs 47 crore it received over the past three years.
Bihar has spent just 12 per cent of its share of Rs 331 crore.
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Amartya Sen lists factors behind failing ‘health’
Dec 30, 2008. The Telegraph.
Economist Amartya Sen today said there was a lack of commitment by governments in using healthcare resources effectively and lack of accountability among doctors and health officials.
“The primary deficiency in healthcare is the inability to commit to resources available,” Sen said, delivering a lecture at NRS Medical College and Hospital.
Only 1.1 per cent of India’s GDP is allocated for health, lower than in most countries, the Nobel laureate said.
“Have we given up on equity in health?” he asked while pitching for more funds for primary healthcare.
According to a United Nations Development Project (UNDP) report on public expenditure on health in 2007-08, India’s allotment is lower than that of Bhutan (4 per cent), Sri Lanka (2 per cent) and Ethiopia (2.7 per cent).
“Even the amount of money spent is not spent very well,” Sen said.
He pointed out the lack of accountability among government health officials and doctors in state-run hospitals. “Sometimes, when one visits a rural primary health centre, the officials are not present. Doctors ask patients to go to private doctors.”
According to Sen, the dearth of funds was compounded by the inability to use the resources available, which “prevented attracting more funds”.
He said the best way to improve the situation was to earmark more funds for primary healthcare.
While underlining that education was still deficient in India, Sen said healthcare was more neglected.
Education can, however, cure some of the maladies. Sen said: “Education can make someone read about health, (the) problems of smoking and get information about other health issues.”
The number of nursing and paramedical staff has to be increased and more doctors posted in rural areas.
Poverty — income poverty and poverty in public health —and lack of public sanitation and drinking water are huge problems which should be addressed by the government, he said.
Trade unions will have to change their mindset and work for the larger benefit of the people, Sen said. “(The) inability of unions to think broadly has to change. Bengal has one of the longest histories of Left politics with the Leftist government in power for the last 30 years. But even during the high point of Left politics, the unions were responsible for their members only.”
Sen also slammed those who blamed American imperialism for most problems. “The US imperialism does not prevent us (from) having more rural doctors and nurses and spending more than 1.1 per cent of GDP in (the) health sector.”
Malnourishment in India, he said, was higher than in most countries and people were dying because of lack of basic healthcare.
The Chandrakant Patil Memorial Health Dialogue was organised by the Liver Foundation, formed by doctors and social activists to raise awareness on liver diseases and public health, and the Pratichi Trust, set up by Sen for research on health and education in India.
