India is a land of paradox. It has some of the best health care facilities in the world and emerged as the favourite destination for medical tourism. It is one of the largest exporters of drugs and trained medical personnel to the world. But a significant part of its own population is deprived of even basic medical facilities. Only 43.5% of children are fully vaccinated, infant mortality rate is 57(per 1000) and 56% of children of age under three are underweight (NFHS-III) and 25% of total TB patients in the world are in India. New public threats are emerging due to changes in life style for example India is now estimated to have around 120 million persons with hypertension and 40 million with diabetes (WHO). The emerging diseases and increasing population with migration of qualified manpower are going to put tremendous pressure on India’s public health system which is already in overstretched. Shortage of funds, physical infrastructure & medical personnel, poor quality of services, rampant corruption, poor governance, and lack of convergence among different vertical programmes further worsens the problem.
Though India lacks the financial and human resources to eradicate all disease and provide universal health but the major problem is that existing resources are not optimally utilized due to absence of leadership with solid managerial and public health skills. The lack of public health expertise resulted in poorly designed health programs which were ineffective and inefficient. Health programs were independently implemented instead of adopting inter-disciplinary approach; design and delivery of health programmes doesn’t factor social, economical and geographical barriers like poverty, illiteracy, regional and gender disparities; available resources were either underutilized or poorly utilized for example, in the year 2008-09 out of Rs 373 crore allotted by Government for human resource development for health but only Rs 74.64 crore were utilized; similarly grants provided by other countries, bilateral and multilateral were also underutilized.
Hence the first priority for improvement in public health system should be to develop pool of qualified manpower with good managerial skills. Considering that developing human resources is a long term process, Government should estimate the future requirenments of qualified manpower and accordingly work on developing pool of qualified manpower.
Hello there,
ReplyDeleteI read your article and much resonate with your thinking for qualified public health professionals in the country. India in the last 15 years has displayed tremendous capacity in developing rich resource base of capital and manpower in many critical areas of economy. I think that the learning’s from them would tremendously help in improving otherwise neglected public sphere of health and education. But again, creation of resources will not only ensure solving the challenges of gaps created by the failure of 60 years of bad health care and education system. Also, the country strongly needs to relook and rebuild its structures & infrastructure that would address the fundamental challenges of ‘supply chain’ & ‘resource prioritization’ around these critical issues.
Dear Rajnish,
ReplyDeleteI have been following your blog for quite some time now, but to give you my honest feedback,i find it a good read if i am preparing for an interview in the development sector but not as a person who is still to be initiated in to the sector.
I do not find "masala" in it, that will keep me glued to your blog or keep me wanting for more. I would be happier if you thorw on us some of the interesting stories that you must be encountering while all those "developmental travels" that you undertake. This is just a suggestion.
Regards
Amrit