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Medical institution-The newer challenges ahead

The Indian healthcare scenario presents a spectrum of contrasting landscapes. At one end of the spectrum are the glitzy steel and glass structures delivering high tech medical care to the well-heeled, mostly urban Indian. At the other end are the ramshackle outposts in the remote reaches of the other India trying desperately to live up to their identity as health sub centers, waiting to be transformed to shrines of health and wellness, a story which we will wait to see unfold.

The challenges in delivering healthcare to the everyone which must include the socially disadvantaged, the economically challenged, and the systemically marginalized.

There are many challenges.

  • Awareness or the lack of it. How aware is the Indian population about important issues regarding their own health? Studies on awareness are many and diverse, but lacunae in awareness appear to cut across the lifespan in our country. The message is clear – we must strive to raise awareness in those whom we work with and must encourage the younger generation to believe in the power of education for behavior change.
  • Access or the lack of it. Healthcare services as being factors in determining access. Barriers to access in the financial, organizational, social, and cultural domains can limit the utilization of services, even in places where they are available.
  • Absence or the human power crisis in healthcare: Any discussion on healthcare delivery should include arguably the most central of the characters involved – the human workforce. Do we have adequate numbers of personnel, are they appropriately trained, are they equitably deployed and is their morale in delivering the service reasonably high? It is time for a policy on health human power to be articulated, which must outline measures to ensure that the last Indian is taken care of by a sensitive, trained, and competent healthcare worker?
  • Affordability or the cost of healthcare. Quite simply, how costly is healthcare in India, and more importantly, how many can afford the cost of healthcare? It is common knowledge that the private sector is the dominant player in the healthcare arena in India. Almost 75 percent of healthcare expenditure comes from the pockets of households, and catastrophic healthcare cost is an important cause of impoverishment
  • Accountability or the lack of it. Being accountable has been defined as the procedures and processes by which one party justifies and takes responsibility for its activities.

In the healthcare profession, it may be argued that we are responsible for a variety of people and constituencies. We are responsible to our clients primarily in delivering the service that is their due. Our employers presume that the standard of service that is expected will be delivered. Our peers and colleagues expect a code of conduct from us that will enable the profession to grow in harmony. Our family and friends have their own expectations of us, while our government and country have an expectation of us that we will contribute to the general good. A spiritual or religious dimension may also be considered, where we are accountable to the principles of our faith.

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