Aust. J. Rural Health (2002) 10, 129–135
Blackwell Science, Ltd
CURRENT HEALTH SCENARIO IN RURAL INDIA
Ashok Vikhe Patil,1 K. V. Somasundaram2 and R. C. Goyal2
Association of Agricultural Medicine and Rural Health and 2Department of Community Medicine, Rural Medical College of Pravara Medical Trust, Maharashtra, India 1International
ABSTRACT: India is the second most populous country of the world and has changing socio-politicaldemographic and morbidity patterns that have been drawing global attention in recent years. Despite several growthorientated policies adopted by the government, the widening economic, regional and gender disparities are posing challenges for the health sector. About 75% of health infrastructure, medical man power and other health resources are concentrated in urban areas where 27% of the population live. Contagious, infectious and waterborne diseases such as diarrhoea, amoebiasis, typhoid, infectious hepatitis, worm infestations, measles, malaria, tuberculosis, whooping cough, respiratory infections, pneumonia and reproductive tract infections dominate the morbidity pattern, especially in rural areas. However, non-communicable diseases such as cancer, blindness, mental illness, hypertension, diabetes, HIV/ AIDS, accidents and injuries are also on the rise. The health status of Indians, is still a cause for grave concern, especially that of the rural population. This is reflected in the life expectancy (63 years), infant mortality rate (80/1000 live births), maternal mortality rate (438/100 000 live births); however, over a period of time some progress has been made. To improve the prevailing situation, the problem of rural health is to be addressed both at macro (national and state) and micro (district and regional) levels. This is to be done in an holistic way, with a genuine effort to bring the poorest of the population to the centre of the fiscal policies. A paradigm shift from the current ‘biomedical model’ to a ‘sociocultural model’, which should bridge the gaps and improve quality of rural life, is the current need. A revised National Health Policy addressing the prevailing inequalities, and working towards promoting a long-term perspective plan, mainly for rural health, is imperative. KEY WORDS: commercialisation of health, communicable diseases, health infrastructure, health policy, health seeking behaviour, rural health.
India is drawing the world’s attention, not only because of its population explosion but also because of its prevailing as well as emerging health profile and profound political, economic and social transformations. After 54 years of independence, a number of urban and growth-orientated developmental programs having Correspondence: Dr Ashok Vikhe Patil, President: International Association of Agricultural Medicine and Rural Health, c/o Pravara Medical Trust, Loni 413 736, Ahmednagar District, Maharashtra, India. E-mails: email@example.com or firstname.lastname@example.org Accepted for publication January 2002.
been implemented, nearly 716 million rural people (72% of the total population), half of which are below the poverty line (BPL) continue to fight a hopeless and constantly losing battle for survival and health. The policies implemented so far, which concentrate only on growth of economy not on equity and equality, have widened the gap between ‘urban and rural’ and ‘haves and have-nots’. Nearly 70% of all deaths, and 92% of deaths from communicable diseases, occurred among the poorest 20% of the population. However, some progress has been made since independence in the health status of the population; this is reflected in the improvement in some health indicators. Under the cumulative impact of various measures and a host of national programs for livelihood, nutrition and
AUSTRALIAN JOURNAL OF RURAL HEALTH
shelter, life expectancy rose from 33 years at Independence in 1947 to 62 years in 1998. Infant...
References: 1 Mukhopadhyay A, Srinivasan R, Bose A et al. Recommendations of Independent Commission on Health in India. New Dehli: Voluntary Health Association of India, 2001. 2 Park K. Communicable diseases. In: Banot B (ed) Park’s Text Book of Preventive and Social Medicine, 16th edn. Jabalpur: Banarsidas Bhanot, 2000: 172 – 5. 3 Deodhar NS. Health Situation in India: 2001, 1st edn. New Delhi: Voluntary Health Association of India, 2001. 4 Government of India. Ministry of Health and Family Welfare, Annual Report, 1995–96. New Delhi: Government of India Press, 1996. 5 Government of India. Ministry of Health and Family Welfare. National Population Policy. New Delhi: Government of India Press, 2000. 6 WHO. The World Health Report 1997. Conquering Suffering, Enriching Humanity. Geneva: World Health Organisation, 1997. 7 Rafkin, Susan B. Paradigm lost – toward a new understanding of community participation in health programmes. Link 1996; 14: 2. 8 Government of India. Report of the Health Survey and Development Committee. Simla: Government of India Press, 1946. 9 Government of India. Ministry of Health and Family Welfare, Annual Report, 2000–2001. New Delhi: Government of India Press, 2001. 10 Government of India. Bulletin on Rural Health Statistics in India, December 1999. New Dehli: Rural Health Division, Ministry of Health and Family Welfare, 2000. 11 Health Issues in the Parliament. Rajya Starred Question No. 489, 27 August 2001. Health for Million, Voluntary Health Association of India, 2000; 27: 5– 6. 12 Duggal R. Health Care Budgets in a Changing Political Economy. Economic and Political Weekly May 1997: 17–24. 13 Ghosh A. Health Care and Globalization – Case for Selective Approach. Economic and Political Weekly 24 February 1996. 14 Balasubramaniam K. Structural Adjustment Programs and Privatization of Health. LINK (Newsletter of the Asian Community Health Action Network) 1996; 14: 2. 15 Mukhopadhyay A. State of India’s Health, 1998. New Dehli: Voluntary Health Association of India, 1999.
The ‘magical’ year of 2000 AD has come to an end. ‘Health for all by 2000 AD’ remains as a distant mirage and the slogan has been rephrased as ‘Health for all in 21st Century’. Primary health care, as a paradigm, has been lost on the way. The failure of the ‘Alma Ata Declaration’ in fulfilling its objectives to shift resources from urban to rural scene, reiterates the urgency of looking for alternative strategies at the national and local level. To improve the prevailing situation, the problem of rural health is to be addressed both at the macro (national and state) and micro level (district and regional), in a holistic way, with genuine efforts to bring the poorest of the population to the centre of the fiscal policies. A paradigm shift from the current ‘biomedical model’ to a ‘sociocultural model’ is required, to meet the needs of the rural population. A comprehensive revised National Health Policy addressing the existing inequalities, and work towards promoting a long-term perspective plan exclusively for rural health is the current need.
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