Even after 75yrs of independence, the country's Health-scape has been riddled with so many short-comings. Meager allocation of funds, wrong priorities, skewed distribution of healthcare centers, medical colleges and human resources along with the most notable problem of health illiteracy and the largest pool of BPL people.
"Affordable and reachable care with Right treatment @Right time" is the target.
What steps can be taken to make health facilities accessible to the poor?
In today’s time, both pollution and population are increasing at an alarming rate, which has lead to multiple health issues. The poor among all are the worst affected. To improve the quality of health among the poor, educating (HEALTH EDUCATION & PROPAGANDA) the poor is the first step. Diseases such as jaundice and diarrhea are caused by consumption of unclean water. The government should ensure that the quality of water supplied in the areas where the poor live is clean and healthy. Since the poor cannot afford expensive medical treatments, free medical check-up camps should be organized for them on a regular basis so that early detection can help in minimizing the risk of disease. Charitable hospitals should also be opened for them. The government should also extend support to the poor for the treatment of life-threatening diseases.
Free medical assistance to BPL citizens
Provision of basic health facilities should be part of the Fundamental Rights. The poor are mostly deprived of advanced medical facilities as the expenses of medicines and other treatments are beyond their reach. It is very common and saddening that owing to lack of funds, the poor have to lose life. So, it is one of the prime responsibilities of the state and Centre government to ensure and provide medical assistance to the poor and the needy. The poor, who earn below the minimum listed income by the government, should be enlisted by the state governments and must be provided medical cards so that at the time of need, they can show the card in any hospital and avail proper treatment. Special hospital or clinics should be also established for their treatment. In state budgets, a part should be reserved for providing medical help to the poor. Free routine check-up camps should also be organised regularly so that they may be able to detect a disease in advance and get treated for the same. The poor must be educated through counselling and seminars on maintaining their health. If the government has been successful in eradicating polio, it has the capability to provide the poor FREE treatment.
Provide free food to the poor in every hospital
To live a healthy life, one should not have to empty the pockets. It is an established fact now that we are not living in a healthy environment and that has made us prone to many diseases. Among all, the poor are the worst sufferers as they have very little or no capacity to spend on medical treatment, especially if they have been detected with serious medical problems. It is the duty of the state and the Centre government to open special hospitals that cater only to the needs of the poor who live below the poverty line. Charitable hospitals should also be opened where the treatment can be sponsored by either NGOs or philanthropists. Free food and assistance must also be provided to the poor patients in every hospital.
Take facilities directly to target populations
Access to healthcare is important for overall physical, social, and mental health status; disease prevention; detection, diagnosis, and treatment of illness; and quality of life. But rural residents often encounter barriers to healthcare that limit their ability to obtain the care they need. In order for rural residents to have sufficient access, necessary and appropriate healthcare services must be available and obtainable in a timely manner. Even when an adequate supply of healthcare services exists in the community, there are other factors to consider in terms of healthcare access. For instance, to have good healthcare access, a rural resident must also have financial means to pay for services, means to reach hospitals and clinics located at a distance, and the ability to take paid time off of work to use such services. Problem arises when the poor do not have the ability to communicate with healthcare providers as they poor health literacy. There are number of ways through which equal healthcare facilities can be provided to the poor and the needy. The government should come up with the facility of door-to door mobile check-up van. It can also take facilities directly to target populations with clinics located in the nearby areas. Setting up a healthcare access task force with local hospitals and other community stakeholders will ensure timely treatment of diseases. Awareness seminars for the poor must also be held regularly.
Make them aware of healthcare policies
In a country like India, there is a huge inequality of wealth distribution amongst the poor and the rich. A major part of India’s population live below the poverty line (BPL) and are deprived of the basic human necessities, including healthcare. Thus, it is the responsibility of the government to ensure the safety of health of its BPL citizens. There are many government hospitals in various cities that ensure cheap and affordable treatment for the poor, but effective implementation is rarely observed in such institutions. Besides making effective policies, government must ensure its effective implementation. Since most poor people are not even aware of such policies, they are exploited by the concerned authorities in the process of receiving affordable healthcare facilities. To put an end to such malpractices, NGOs and state governments must hold regular seminars for the poor to educate them of the healthcare policies and schemes available for them. There is usually a lot of paper work and other formalities which the kin of the patients have to fill, but at the time when medical facilities are required, the illiterate poor find it difficult to ask for help. Even if they succeed in fulfilling the formalities, they are not in the condition to pay for emergency treatment. People’s trust in free medical facilities is built only if the government ensures high quality facilities even for the poor. To ensure distribution of medical help amongst the poor, government must ensure cheap and quality services to the patients and also make them aware of the policies to avoid exploitation.
Encourage mobile clinics in rural areas
Government should encourage coming up of more mobile clinics which can provide primary and preventive care services from vans, trucks or buses equipped with necessary technology to provide clinical services in rural areas. Student-run clinics, affiliated with medical schools, must also be set up by state governments in areas where hospitals are not built. They not only give medical students experience in providing preventive care to vulnerable populations, but can also easily be located in extremely impoverished areas to provide people with free and easily accessible care.
Health insurance schemes for BPL families
The poor in underdeveloped countries tend to have less access to health services. Government in such countries must make health policies centric to the rural population. Primary health centers should deal with routine problems such as fever, cold, cough, pain and infections while the advanced centres should be separately set up to deal with critical diseases. The government should enter into tie-ups with private pathologies and test centres to undertake routine to all types of high cost tests. There should be uniformity in the basic structure and services provided to all, especially the poor. The state governments must also ensure adequate supply of health facilities for rural areas. Understaffing, temporary staff and wide spread absenteeism should be stooped through filling of posts by able and reliable doctors and nurses. “Health for all” should be the motto of residents of every city. Mobile health vans should be provided adequately. Above all, the government must make health services affordable to the poor. Health insurance schemes for BPL families should be started to ensure universal health.
Mobility, automation will enable access to care
It’s said when ‘I’ is replaced with ‘we’, illness becomes wellness. This is certainly true for many low-income and elderly people who need help to get vital care. Mobility, simplicity, and automation will enable the efficient spread of care between hospitals, clinics and homes, and empower the care providers, including doctors, nurse practitioners, and relatives of patients with appropriate technology. As a matter of human dignity, everyone is entitled to health care. Like any basic element of life, health care sustains us and should always be accessible and affordable for everyone where they need it, when they need it, no exceptions and no interruptions. Ways have to be found out to generate trained human resource to provide healthcare services. This can be done by commissioning new medical colleges, providing monetary and non-monetary incentives to doctors to work, improving working conditions for healthcare professionals and provide them with ancillary infrastructure to carry out basic duties. With growing and improving understanding of diseases and treatments, modern healthcare system demands constant upgrading of skills and continuous medical education. Primary healthcare setup must be updated and able to cope with evolving disease patterns and epidemics and make right diagnosis and provide quality treatment. There has to be a system of insurance established so that poor people can get a claim on problem and can get relief. To bypass the problems of human resource and infrastructure shortage, we need to create innovative and low cost solutions and technologies that can enable us bring healthcare closer to the homes of the poor and needy populations. Ambulances, mobile check up vans, healthcare kiosks and use of telemedicine are ways to achieve this.
Proper allocation of funds primary necessity
Health is one of the most important issues in today’s world. In today’s time, when everything has become easily accessible with technology, one should not have shell out huge amounts of money to obtain treatment for diseases. It is undeniable that medications for some diseases are expensive and the poor can’t afford these. Efforts should be made to provide good health facilities to the poor at affordable prices. The Central government should make necessary arrangements for establishing public hospitals for the poor. Proper allocation of the funds to healthcare sector is the primary necessity. There is a need of strong coordination between the Centre and state governments so that all funds are utilised in an effective manner. We have to recognise the needs and difficulties being faced by the poor in the area of health and then take appropriate measures to help them with the best medical facilities.
Affordability of treatment, medicines a major issue
Many poor people are not even aware of the health policies and funds in city hospitals provided by government and non-government organisations. Awareness regarding such policies is must. The more the people know about these services, the more empowered they could be to prevent themselves from chronic conditions. Government should also start mobile clinics for the poor and the needy. Conducting surveys on how much the poor are aware of the facilities should help to eliminate such problems.
There are many reasons why poor people are not able to get good medical facilities. The primary reason is the high fees of private doctors. The government should build more government hospitals so that the poor can get medical facilities easily and at affordable prices.
Increase investment in healthcare sector
Primary health facilities are the basic need of everyone in society. Gone are the days when services of doctors were socially justifiable. Nowadays, hospitals have become a business and profit making organisations. After the introduction of liberalisation, privatisation and globalisation by the government in 1991, the health sector has been badly affected. Treatment in private hospitals is out of the reach of the common man, let alone the poor. As a far as the situation of government and civil hospitals is concerned, their reliability is losing its meaning day-by-day owing to the lack of proper basic amenities and expert doctors. There are reliable government hospitals, but getting treatment there is also a dream for the poor. Government regulation of deduction of the ESI is mandatory in many cases but even there, employers fail to create awareness among their employees about the benefits available to them under this scheme. Cost of various treatments, including subsidised rates, should be made transparent so that general public, especially the poor, can become aware about the benefits given to them by the government. Investment in the healthcare sector should be increased in the budget. Pharmaceutical companies should also be ordered to sell medicine at reasonable prices to the poor.
A sizeable proportion of the population, especially the poor and the needy, doesn’t seek health care mainly because of the high cost of medical care, lack of education and the unwillingness to lose a day’s wage in order to reach the nearest medical facility. The need of the hour is to adopt a pronged approach to bring quality healthcare services to the doorsteps of the needy, and promote healthcare awareness and contemporary healthcare seeking behaviour among the underprivileged. Besides, a provision of free medicines, surgery and free diagnostic tests in public health centers must be there to reduce the high out-of-pocket expenditure. In addition, it’s important to conduct a detailed survey to gain information human resources such as the number of doctors and paramedical staffs, physician shortages; accessibility of health facilities (distance from villages to primary health center); closed hospitals and related information at the facility level such as type of treatment being given, the amount reimbursed, source of financing. Moreover, stress should also be laid on skill upgradation, capacity development and capability reinvigoration, and limiting the scope for practice of illicit and unqualified practitioners.
Working of the ESIC needs streamlining
The first step to ensure equal healthcare facilities is educating the poor as they are not even aware of the medical schemes available exclusively for them. It is the duty of the authorities to enlighten the poor about such schemes. NGOs should also come forward to educate the poor on the same. The private hospitals can also play a vital role in providing health facilities to the poor in the form of free check-up camps and organising awareness lectures. The Employees’ State Insurance Corporation is a big name, but it is still not able to render its services to the poor and the needy. The working of the ESIC needs to be streamlined. All these measures will surely be a great help for the poor to improve their health.
To provide health facilities to the poor and the needy, more government hospitals must be opened in the city so that the poor can get timely and affordable treatment. The healthcare policy of the government must also be strengthened so that the needy can afford treatment of serious ailments. Special sessions must be organised for them to aware them of various healthcare facilities offered by the government to the poor. In government hospitals, medicines should be provided for free to the poor. The residents, on their personal level, should refrain from throwing garbage on the roads as accumulated garbage becomes a major source of disease carrier. Slum dwellers must also be educated to keep their areas clean to prevent spread of diseases.
Combat the view govt hospitals ‘not reliable’
It is not uncommon to hear financially deprived citizens complain about the less-than-satisfactory medical services at government hospitals. The refrain is that since the medical facilities at government hospitals are poor, it is best to avoid the government hospitals. Whether or not the services are actually so bad is altogether different – the public perception is that the medical facilities at ‘sarkari’ hospitals are poor and inadequate.
In order to make medical facilities accessible to the poor, a two-pronged approach is required. First, the perception that the medical facilities at the government hospitals are ‘not reliable’ needs to be combated. Second, the services actually must be improved.
Besides, steps may be taken to improve and strengthen the other systems of medicines such as the ayurveda and homeopathy. It is equally imperative to create the public awareness about the government efforts to improve various systems of medicine. The public trust in government hospitals and civil hospitals needs to be established.
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