Aug 4, 2007

Public Health Policy

This post has been written as a response to this post. Do check the comments section of that blog too.

We must look to the government on this one. Frankly, the civic community of India as of now is too poor to keep pace with the medical technology and the accompanying costs.

Problems

1) Infrastructure - The Primary health centres barely function, not to talk about Sub Centres
2) Doctors - Too few. The government cannot train enough doctors and cannot pay the trained doctors to come work in CHCs, forget the PHCs.
3) System - For all the guidelines that state govts have for monitoring, the current systems seem not to work (this may be a non problem - ie if decent doctors with good infra available- the community will ensure that the health centres are utilised)

Solutions

1) Investment - A big push like the one in Sarva Siksha Abhiyaan is needed. ICDS is useful, but it doesn't covers the community's overall health
2) Health Workers Training Program- At the SC and PHC level, Health workers may be trained and utilised. - This will be basically an exercise in expectations management - Devise a practical training and education program for producing general physicians- dont call them doctors and expect them to work on contract in lieu of lower pay than the one you have for doctors.
3) As i said, the systems are in place, but since hardly anything works now, you cannot apportion blame to any one stakeholder which allows everyholder to have slack. General awareness and communication of all the facilities and govt schemes available may be one step forward as of now


As you can see, the solutions seem very simplistic, but i dont think we lack in identifying the solutions here. Our basic shortcoming is the lack of capacity - Investment wise, Technolgy wise, and Community sense wise, which has made it such a big problem. I believe that its not that the health spending in India is through Private sector, its just that the govt has failed to fulfill its side of the bargain

PS-
SC- Sub Centres at Village/Mouza Level
PHC- Primary Health Centres - at Block level
CHCs - Community Health Centre - at Sub District Level
ICDS - Integrated Child Development Scheme- Basically- Looking at the health of children, pregnant women and new mothers