Primary Health Care in India - Essay Example

Primary Health Care in India Prepared by Submitted to Organization Word Count 1559 Contents Introduction 3 Population Bearing the Disease Burden 4 Epidemiological Causes for Diseases Among Rural Poor and Women 4 Difference Between Health Care Problems in India and New Zealand 5 References 9 Introduction The important cause to the problems in Indian health care is the weakest structure of public health sector, when compared to the private sector. The significant reason for the health care problems is that the poor and marginalized people have none other option except going to the government hospitals, where the health care does not offer efficient treatment. The underfunding of public health sector resulted in inadequate health care in country. The centralization and rigid nature of planning in public health care and poor management is the main cause of health problems in India. As the funds for family welfare and disease control are less and large part of the organized public sector health care is to deliver curative care, the lack of prevention of diseases may result in out of control in checking the spread of them. The public health care infrastructure though is large it is not sufficient when compared to per capita number of physicians and beds for the population. Even the rate of outpatient visits to the government hospitals is poor due to lack of sufficient care. As the decentralization of state authority varies widely between states, the large cities only have significant financial authority. The lack of authority of local bodies on public health care systems as well as government hospitals resulted in failure of prevention of number of diseases and the people are ignorant even about prevailing diseases. According to World Bank reports in 1995, 1996, 1997b, 2000c, the high levels of poverty also exacerbated the poor health conditions as poor governance resulted in weak public health care infrastructure. Hence, public health care inefficiency as well as poverty and ignorance contributed to problems in India (Peters, David H. (Author), 2002). 1 Population Bearing the Disease Burden The important section of population in India that bears the burden of disease is poor and marginalized income people as well as the rural people, as they are not able to bear the cost of health care in private sector. Hence, they are forced to go to public health care systems that are not efficient in curing them and thus bore the burden of the disease. According Agnihotram V. et al (2004), the disease burden of rural Indian women, suffering with asthma and bronchitis that may lead to prematurity and heart attacks. In addition to that the lack of health infrastructure in Indian rural areas is resulting in maternal deaths concentrated in the age group of 20-24 years. It has been observed that the bleeding is main cause for maternal deaths and they occur more in rural areas and in the case of poor people. The diseases that exert significant burden on rural and poor people are tuberculosis, malaria and burns are important causes of death in reproductive ages. However, the rate of suicide and burn as well as anemia diminishes with age and hence it can be concluded more accurately that the burden of disease is more in case of young poor rural people mostly women in the above mentioned contexts. The nationwide health plans in India are not sufficient to prevent the deaths and burden of the disease to maximum extent (V Agnihotram, 2004). 2 Epidemiological Causes for Diseases Among Rural Poor and Women In addition to that the nation's public health care is not sufficient to avoid the epidemiological causes for diseases in India. The disease causing burden can be attributed to highest exposures of household roles that affect the children and women as well. As the public health care system is not enough equipped to avoid the above-mentioned exposure, the demographical conditions also play a role in increasing the burden of TB, asthma and blindness thus decreasing the confidence of the rural poor and women. Hence, air pollution is a major cause of increasing disease burden of vulnerable population in countries like India. The burden of disease is even increasing due to urban air pollution and as a result both rural as well as urban population is victims of it and the solution for it is not part of public health care system in India (Kirk. R. Smith, 1997). 3 Difference Between Health Care Problems in India and New Zealand Though the developing countries have health care problems, they exist even in wealthier countries like New Zealand, but their nature is different from that of the developing countries. In contrast to the demographic situation in India, New Zealand has eighty five percent of population in Urban areas. Hence, the health care taken for the people will be easier as the infrastructure will be better in Urban areas than the rural areas. Even the health care system in New Zealand is completely different to that of in India as it has completely different systems for the delivery of publicly funded health care giving it the dubious title of most restructured in the wealthier countries. The present health care system in New Zealand is known as district health board system that decentralizes the system so that the service providers are forced to compete with one another in offering health care to the people. However, that system is absent in India as there is no competition public health care system and the competition in private sector is not reasonable as clients do not have enough options to select the services. However, the problems in New Zealand's health policy is regarding ever expanding budget and service demand of prioritization of ration services. The significant problem is lack of integration between primary and secondary care as well as the public and private sectors. However, the problems are not regarding infrastructure but are regarding finance and control (Robin Gould, 2004).4 Hence, financing is an important problem for New Zealand health care but the problems are far different from that of India as the latter lack enough infrastructure and organization as well. However, the problems in New Zealand regarding health care were minimized when government introduced the community service card (CSC) in 1992 that resulted in access of benefits to the people according to their income levels. However, the community health card system did not solve the difficulties in Maori or Pacific Island region due to their changed economic circumstances. The adults of these communities used to visit the GPs due to low income levels and affluent groups did not use this system. Hence, it can be understood that the lower income people are benefited from community service card system. However, the rural or urban poor in India did not have this type of system and the government hospitals which offer free health and medical services to poor are ill equipped and are not in a position to cater the health and medical care needs of the poor people. Hence, the important contrast observed till now between a wealthier country like New Zealand and India is that the poor people in former have access to efficient health care services but the same in the later did not have that much access to efficient health care services. However, this contrast cannot be termed as complete are the poor people visiting GPs expressed dissatisfaction with the level of fees collected by GPs and they need health care systems that offer services at much lower price. In addition to that one can observe that the poor people in India are not able to afford financially for the medical services, but the same category in New Zealand are able to pay for the health and medical care services. 5 The introduction of health care schemes in New Zealand changed with the course of time and with country's economic development. The development of the country resulted in the improving access to services and the increase of service use as the government reduced the fees to access the health services. Hence, one can observe that the development in New Zealand resulted in reduction of fees for health services. According to Jacqueline Cumming, Nicholas Mays and Barry Gribben (2008), the fees for health care services fell particularly in access practices of higher need and higher per capita funded services. However, the fees for lower need, lower per capita funded services increased. This indicates that the increase of efficiency of health services with the development of the country as they are able to offer higher needs at lower prices. In addition to that recently, the fees of health services for patients aged above 65 years also decreased and that is due to socio-demographic and ethnic groups. The introduction of primary health care strategy in 2001 strengthened the role of primary health care to improve health and reduce inequalities in health. The development of new services resulted in rise of new organizations as well as primary health organizations. Hence, the development of the country and health care systems are correlated as the plan and provision of primary health care services depends on government funding. As PHOs are local, non-governmental, not for profit organizations, they are contracted by their local district health board to manage primary health services. As the government planned to allocate $2.2 billion over seven years from 2002 and it is higher than the allocations in previous decades, it can be concluded that the development in New Zealand resulted in increase of allocations. Though the same is true in case of India, the lack of health care infrastructure has nullified the effect of increase of allocation for health care services.6 References: References: Peters, David H. (Author). (2002). Better Health Systems for India's Poor: Findings, Analysis, and Options. Washington, DC, USA: World Bank Publications. V Agnihotram, 2004, Reviewing disease burden among rural Indian women, Ojhas, Mangalore: India. Retrieved on 22nd March 2009 from Kirk. R. Smith, 1997, National burden of disease in India from indoor air pollution, School of Public Health, University of California, Berkeley, Retrieved on 23rd March 2009 from Robin Gould, 2004, New Zealand, in 'Comparative Health Policy In Asia Pacific', edited by Robin Gould, Berkshire; Great Britain: McGraw Hill Education. Ministry of Social Development, 2004, Primary Health Care In New Zealand: Problems And Policy Approaches, Published by Ministry of Social Development of New Zealand, Retrieved on 24th March 2009 from Jacqueline Cumming, Nicholas Mays and Barry Gribben, 2008, Reforming primary health care: is New Zealand's primary health care strategy achieving its early goals, Australia & New Zealand Health Policy, Retrieved on 26th March 2009 from Read More