Lack of rural healthcare system during a pandemic?

14/06/2021

Compared to the first wave in 2020, the second wave of 2021 saw a sharp increase in the number of infections and deaths in rural parts, which account for 65% of the country's 1.3 billion population. Given the precarious state of health infrastructure in rural areas, the National Center for Disease Control (NCDC) has asked the government to prioritize testing and immunization in these areas. The Indian rural healthcare system has been developed as a three-tier system of health care infrastructure in rural areas.
Primary health care system in sub-center and one health worker female or ANM and one health worker male whereas Primary Health Center (PHC) has one medical officer in charge and 14 subordinate paramedical staff with 6 sub-centers one referral unit for 4-6 beds and despite having 30 bedded hospital/referral unit for 4 PHCs with specialized services in a large institution Community Health Center (CHC) we faced huge problems.
Only 11% of sub-centers, 13% of primary health centers (PHCs), and 16% of community health centers (CHCs) in rural India meet the Indian Public Health Standards (IPHS). Only one allopathic doctor is available for every 10,000 people and one government hospital is available for 90,000 people. In many medical institutions, innocent and illiterate patients or their relatives are exploited and allowed to know their rights. Most of the centers are run by unskilled or semi-skilled paramedics and doctors are rarely available in rural setup. In an emergency, patients are sent to the care hospital of their acquaintance where they become more confused and easily deceived by a group of health workers & middlemen.
The non-availability of basic medicines is an ongoing problem of rural health care in India. The number of nurses in many rural hospitals is far less than required. Existing health centers in rural areas are under-financed, use low-quality equipment, are short in supply of medicines, and lack qualified and dedicated human resources. Medicines are often not available in rural areas. The supply of basic medicine in rural areas is erratic. This problem has deepened when people are returning to their villages due to the lockdown imposed in the metros.
There is a need to provide affordable medical facilities to people living in rural areas and encourage medical colleges to encourage students to visit rural areas and understand the health needs of the poor and downtrodden. A doctor in government service must compulsorily serve in rural areas before getting his first promotion.
Young doctors at the grassroots level need to be sensitive towards patients and their families. The private sector needs to work with altruism, commitment, and missionary zeal to provide modern and affordable health facilities in rural areas and bridge the urban-rural divide. Medical associations should campaign to educate people to prevent lifestyle diseases that are slowly entering rural areas as well.
A pandemic like COVID-19 reminds us that the public health system is the main social institution in any society. The government has made several efforts to bridge the gap in the public health system through schemes such as the National Medical Commission (NMC) Act, 2019, Pradhan Mantri Bhartiya Janaushadhi Pariyojana, Pradhan Mantri Jan Arogya Yojana, etc. However, substantial investment time is needed to build a health system that can withstand any kind of public health emergency.
(Research scholar, poetess, freelance journalist, and columnist, Ubba Bhawan, Shahpur Road, Opposite Kumhar Dharamshala, Arya Nagar, Hisar (Haryana)-125003)

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