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health

lie in low educational status, poor func- tance to reach is a big discouragement
tional literacy, low accent on education to the health-seeking behavior of the
within the healthcare system, and low population.
priority for health in the population, Till now, many rural According to the rural health statis-
among others. communities across tics of the Government of India, about
Then there is the issue of access or 10.4% of the sanctioned posts of auxil-
the lack of it. Physical reach is one of the the country are without iary nurse midwives are vacant, which
basic determinants of access, defined as access to hospitals rises to 40.7% of the posts of male health
“the ability to enter a healthcare facility workers. Twenty-seven percentage
within 5 km from the place of residence and clinics. Those who of doctor posts at PHCs were vacant,
or work”. Using this definition, a study which is more than a quarter of the
found that in rural areas, only 37% of seek out treatment sanctioned posts.
people were able to access proper med- face long-distance Affordability or the cost of health-
ical facilities within a 5 km distance, care comes next. It is common knowl-
and 68% were able to access out-patient travel, and often settle edge that the private sector is the domi-
facilities. Even if a healthcare facility is for care at the most nant player in the healthcare arena
physically accessible, what is the qual- in India. Almost 75% of healthcare
ity of care that it offers is a question? convenient locations expenditure comes from the pockets of
Is that care continuously available? households, and catastrophic health-
While the National (Rural) Health Mis- care cost is an important cause of
impoverishment. Added to the problem
is the lack of regulation in the private
sector and the consequent variation in
quality and costs of services.
The public sector offers healthcare
at low or no cost but is perceived as
being unreliable, of indifferent qual-
ity and generally is not the first choice,
unless one cannot afford private care.
Then comes accountability or the lack
of it. The five as presented above pre-
sent challenges to the health and con-
sequently to the life expectancy.
As per the report quoted in Lok Sab-
ha on March 13, the life expectancy at
birth for male and female during 2013-
17 were 67.8 and 70.4 years respectively.
The State/UT-wise details are provided
at Annexure. However, State/UT-wise
average life expectancy of male and
female in the rural and urban areas of
the country may also be accessed from
the report SRS Based Life Table 2013-
17 available at the portal of Census of
India.
A cross-sectional multi-centric com-
sion has done much to improve the in- health workers per 10,000 population, munity based study of elderly popula-
frastructure in the Indian Government with allopathic doctors comprising tion aged 60 years and above conduct-
healthcare system, yet still many of the 31% of the workforce, nurses and mid- ed jointly by the Government of India
primary health centers (PHCs) lacked wives 30%, pharmacists 11%, AYUSH and WHO Country Office in India has
basic infrastructural facilities such as practitioners 9%, and others 9%. The revealed that diseases like hyperten-
beds, wards, toilets, drinking water fa- state-run health sector still is the only sion, diabetes mellitus, ischaemic heart
cility, clean labor rooms for delivery etc. option for much of the rural and peri- disease, poor vision, difficulty in hear-
Then there is the issue of absence or urban areas of the country. The lack of a ing, anaemia, arthritis, fall/fractures,
the human power crisis in healthcare. qualified person at the point of delivery bowel complaints, urinary complaints,
It is estimated that India has roughly 20 when a person has traveled a fair dis- depression, weight loss, asthma, chron-

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