Economics (NCERT) Notes

8.7 Critical Appraisal of Health Sector

Health Infrastructure in India

• There is greater scope for the role of government in the health sector.

• India’s expenditure on health sector as 4.7 per cent of the total GDP. This needs to be increased substantially.

• India has about 17 per cent of the world’s population but it bears a 20 per cent of the global burden of diseases (GBD).

• GBD is an indicator used by experts to gauge the number of people dying prematurely due to a particular disease, as well as, the number of years spent by them in a state of ‘disability’ owing to the disease.


GBD and India

• In India, more than half of global burden of diseases (GBD) is accounted for by communicable diseases such as diarrhoea, malaria and tuberculosis.

• Every year around five lakh children die of water-borne diseases.

• The danger of AIDS is also looming large.

• Malnutrition and inadequate supply of vaccines lead to the death of 2.2 million children every year.


Urban-Rural and Poor-Rich Divide

• Though 70 per cent of India’s population lives in rural areas, only one-fifth of its hospitals (including private hospitals) are located in rural areas.

• Rural India has only about half the number of dispensaries.

• Out of about 6.3 lakh beds in government hospitals, roughly 30 per cent are available in rural areas.

• There are only 0.36 hospitals for every one lakh people in rural areas, while urban areas have 3.6 hospitals for the same number of people.

• States, like Bihar, Madhya Pradesh, Rajasthan and Uttar Pradesh, are relatively lagging behind in healthcare facilities.

• In rural areas, the percentage of people who have no access to proper healthcare facilities has increased over the last few years.


Medical Doctors

• In India, around 380 recognised medical colleges produce about 44,000 medical graduates every year, the shortage of doctors in rural areas persists.

• One-fifth of these doctor graduates leave the country.

• Most others opt for private hospitals, which are mostly located in urban areas.


Poor and Medical Care

• The poorest 20 per cent of Indians living in both urban and rural areas spend 12 per cent of their income on healthcare, while the rich spend only 2 per cent.

• When the poor fall sick, they may have to sell their land or even pledge their children to afford treatment.

• Poor are often driven to private hospitals as Government hospitals don’t provide good medical care, which make them indebted forever.


Women’s Health

• Women suffer many disadvantages as compared to men in the areas of education, participation in economic activities and healthcare.

• Child sex ratio in the country deteriorated from 927 in 2001 to 914 in 2011.

• Close to 3,00,000 girls aged below 15 years are not only married but have already borne children at least once.

• More than 50 per cent of married women in the age group of 15–49 years have anaemia and nutritional anaemia caused by iron deficiency, which has contributed to 19 per cent of maternal deaths.

Abortions are also a major cause of maternal morbidity and mortality in India.


Steps to Improve Healthcare

• Decentralise public health services

• Provide education and efficient health infrastructure

• Create awareness on health and hygiene

• Provide efficient healthcare systems

• Use IT and internet infrastructure in providing medical care

• Improve primary healthcare

• Bridge the divide between urban and rural healthcare in India

• Make healthcare more accessible and affordable

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