Rural health: No lessons learned

The latest health statistics report shows that the rural healthcare system continues to be seriously plagued by shortfalls on two critical fronts — doctors and infrastructure

The Rural Health Statistics 2021-22 report, released by the government recently, present a dismal picture of the healthcare infrastructure in the country. The annual report provides data on health infrastructure, including manpower, as at the end of the financial year. These reports have been very useful and they have provided valuable guidance. They have helped to monitor the progress in the health sector with comprehensive information on all aspects of its functioning. Along with reports on other sectors, it has helped to identify the deficiencies in the present system in rural, urban, and tribal sections. The latest report shows that the rural healthcare system continues to be seriously plagued by shortfalls on two critical fronts — doctors and infrastructure. These are the two basic and most important parts of any healthcare system and inadequacies in them would seriously impact outcomes in the sector.

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There is a big shortage of medical staff at all health centres. In Community Health Centres, the shortfall is of the order of 83 per cent for surgeons, 82 per cent for paediatricians, and 79 per cent for general physicians. Operation theatres, X-ray facilities and laboratories are often non-functional even where they exist as the personnel that are meant to work them or accessories needed are not available. Less than half the Primary Health Centres function on an everyday basis. Of the 5,480 functioning Community Health Centres, only 541 have the required number of specialists. Sub-centres are the first point of contact for patients, with Primary Health Centres above them. Community Health Centres are still above them and function as referral centres. All the three are not only short-staffed and ill-equipped but overburdened, too. Sub-centres serve more than 5,000 people, Primary Health Centres cater to more than 36,000 people, and Community Health Centres serve more than 164,000 people. The staff strength in these centres actually decreased in 2022. The shortage was more in states with more healthcare needs, such as UP.

At every level, the system is unable to take care of the people who need care and depend on it. The statistics show that the right lessons have not been learnt from the Covid-19 pandemic. It is true that human infrastructure cannot be improved in the short term. But there should be no slackness in efforts to do so over the medium term. The country needs more medical personnel in all categories and it is important that they are incentivised to serve in rural areas. When most people of the country live in rural areas, which are not served by private hospitals, it is the government’s responsibility to ensure that people get the right medical facilities. Rural health is the standard of the health of the nation.