Experts: NRHM answer to healthcare ills

The two-day deliberation organised by the Institute of Public Health and the Antwerp-based Institute of Tropical Medicine, highlighted the underinvestment in health as well as gaps in government schemes, improper implementation. However, things were improving with the implementation of NRHM in the last five years. The budget allocation under NRHM had definitely increased, was the unanimous view.

Dr Dileep Mavalankar of the Indian Institute of Public Health, Gandhinagar, described the current healthcare system in the country as a ‘jugaad’ - a day-to-day arrangement for getting by.

There was poor management with neglect of human resource cell in health system, no government oversight, and lack of alignment of curricula with the current public needs. Lack of political commitment was one of the reasons.

However, all was not bleak. Amarjeet Sinha, a central services officer said that in view of the  70 per cent shortage of anesthetists and gynaecologists in the country every year in rural areas, the government had launched an 18-week Life Saving Anaesthetics Scheme (LIAS) in certain medical colleges, where general doctors were trained to administer anaesthesia to patients during emergency situations.

The Centre has also taken steps to create public health cadres in every state by allowing government doctors to pursue a one-year PG course in public health to ensure that apart from medical doctors, managerial skills were also introduced across all levels of healthcare.

Dr Bart Criel of Institute of Tropical Medicine spoke on the current WHO Health report that revealed that the poor had to incur out of pocket expenses to avail basic health, despite several government schemes.

“The report says that a person in India spends about US $50 on health, of which 80 per cent is out of pocket expenses. So, exemptions often don't work for poor people,” he said. However, financial barriers were not the only problems - distance, gender, stigma, language, attitude of healthcare workers - all played a role in making healthcare inaccessible.