Unhealthy system

Updated: Feb 1 2006, 05:30am hrs
The absence of three factorsequality, quality and accountability mars both the public and private health care system in the country, says the India: Social Development Report. We couldnt agree more. The report, by the Council for Social Development, stresses the need to improve quality, efficiency and accountability of the countrys health sector, in both the public and private domain. And not without reason. The health of a nations citizens has an important bearing on its development.

Consider equality. There are differences arising from poverty, malnutrition, poor maternal health, infant mortality and susceptibility to communicable diseases, to gender and even regional inequalities. As the report notes, the rural-urban disparity is still very high: the infant mortality rate (IMR) is only 40 in urban areas, as compared to 69 in rural areas. As for regional disparities, on the one hand, there are states like Orissa, Rajasthan and UP, with health indicators worse than those in low income countries. On the other, theres Kerala, whose health scene is quite good compared to middle income and even some high income nations. There is also the rich-poor divide, with the poor having much higher levels of mortality, malnutrition and fertility than the rich.

This can change only if we improve health delivery systems. This naturally means not only quality health care, but some basic access to health care for the poor. This isnt likely unless India is able to increase its spending on public health, which is just 0.9% of GDP, lower than even low income countries (1%) and sub-Saharan Africa (1.7%).

Which brings us to another lacuna in our health care system poor infrastructure and inadequate number of personnel. The study says the number of hospital beds here is a mere 0.7 per 1,000, compared to the world average of 3.3. The number of doctors per 1,000 population for the world is 1.5, while the figure for India (1) is on par with the average for low income countries. In the public sector, it is just 0.2. These dismal numbers must change to make a difference in the quality of life for our people.