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Rural Healthcare Needs Urgent Fixing

Providing affordable services to the people is the need of the hour. Ambulances, mobile check up vans and healthcare kiosks can help achieve this

For all the gratified talk about India’s health sector and the medical tourism hub it has turned the country into, the truth remains that our healthcare system is inequitable. Even today, a large section of our population has to travel more than 100 kms to access basic healthcare. Data collected by National Sample Survey Office in 2010 found that 86 per cent of all trips taken for medical purposes were from rural areas. According to estimates, urban centres are home to almost 70 per cent of the doctors and 65 per cent of the country’s hospital beds despite having less than 30 per cent of the total population. Government figures suggest that as on March 31, 2017, only 4,156 posts for specialists were filled in Community Health Centres as against the requirement of 22,496. Patients in rural areas face several hurdles to healthcare that limit their ability to avail the care they need.

Pradhan Mantri Jan Arogya Yojana or Ayushman Bharat programme, which promises to benefit 10.74 crore poor and deprived families, has raised much hope. However, to establish an affordable and accessible healthcare ecosystem in the country, the need is for a wider approach that includes creating the required human resource and raising awareness among rural Indians.

Barriers healthcare access in rural areas: Poor health literacy does not allow a patient to comprehend either the health information or the instructions given by healthcare providers. In most cases, due to the lack of knowledge, rural residents are reluctant to visit healthcare facilities as they don’t have the confidence to communicate with professionals. At the same time, it also translates into low awareness about chronic diseases and symptoms. It is, therefore, important to have a functioning primary healthcare service closer to the doors of rural people.

Long distance commutation: According to a NATHEALTH-PwC report released in 2017, 50 per cent of the beneficiaries travel more than 100 km to access quality medical care. About 70 per cent of India’s health infrastructure is concentrated in the top 20 cities. Long distance commutation increases costs and inconvenience and often results in discontinuation of treatment. For people living with chronic diseases such as hypertension diabetes and heart disease among others, who require frequent visits to outpatient healthcare facilities, this can have serious consequences on their health.

Workforce limitations: India faces a shortage of doctors and allied healthcare professionals. This scarcity is even more glaring in rural areas where it severely limits access to healthcare and negatively impacts health outcomes. Poor medical infrastructure in these areas also acts as an impediment in attracting qualified and trained professionals. The Government’s ambitious Ayushman Bharat scheme, which envisages establishing of 150,000 health and wellness centres, cannot succeed without addressing the human resource gap in rural areas.

Way forward: 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 in rural areas, improving working conditions for healthcare professionals and provide them with ancillary infrastructure to carry out basic duties. Taking trained AYUSH practitioners on board and equipping them with the ability to diagnose and refer conditions at primary level can also temporarily fill the human resource gap.

Re-skill primary healthcare doctors: Doctors in rural areas should also be constantly re-skilled to make them abreast with the latest developments in medical field. With growing and improving understanding of diseases and treatments, modern healthcare system demands constant upgrading of skills and continuous medical education. The doctors in primary healthcare setup must be updated and be able to cope with evolving disease patterns and epidemics and make right diagnosis and provide quality treatment. It is important, therefore, to make CMEs mandatory for them.

Innovative approaches to healthcare: 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 rural people. Ambulances, mobile check up vans, healthcare kiosks and use of telemedicine are ways to achieve this.

Healthcare start-ups are doing their bit by opening kiosks across various States that provide basic healthcare services to villagers every day. These kiosks are digitised healthcare clinics that use telemedicine to help under-served communities get access to doctors. These kiosks have a nurse, who conducts physical examination and connects with the online doctor by live audio or video feed through a technology backed platform. The services are provided at subsidised rates. Many such initiatives and platforms must be launched to further the goal of universal healthcare.- Daily Pioneer