Outlook English - Print Subscribers Copy Outlook English, 17 September 2018 | Page 20

poll Pulse
Health Button on EVM
Silver bullet or booster dose? Healthcare in three BJP-ruled states needs both
by Ushinor Majumdar
N
umbers, they say, only tell
half the story. But some sta­
tistics are staggering by them­
selves. Consider this: Madhya
Pradesh, Rajasthan and Chha­
ttisgarh together acc-ount for
nearly half the number of primary
health centres running without doc­
tors in the country. The big picture
is this: the three poll-bound states
have a medical emergency of a dif­
ferent kind. They need doctors to
attend to the immediate healthcare
needs of millions of people. While
healthcare—or the lack of it—is not
considered a major issue to influence
voting trends, primary healthcare in
these states offer a dismal picture
even going by India’s stymied public
healthcare facilities.
While the urban population in these
states have the luxury of flocking to
private clinics and chambers, people in
rural areas have to rely on public
healthcare. And the first point of con-
tact is generally the primary health
centre (PHC). Besides taking care of
immediate medical needs, proper func-
tioning of PHCs also have a bearing on
some major indicators—infant mortal-
ity rate (IMR), wasting and stunting of
children; anaemia, maternal morbidity
ratio (MMR) and fertility rate in women.
Compared to Kerala, considered one
among the best performing states in the
healthcare sector, Chhattisgarh, MP
and Rajasthan have failed to achieve
much in children’s health indicators
over a ten-year period. (See graphic)
It isn’t that these states have a short-
age of doctors. Between 2010 and 2017,
the number of doctors in MP increased
by 28.7 per cent, and in Rajasthan by
40.8 per cent, as per the National Health
Profile 2018. The jump is, in fact, higher
than the national average of 25.9 per
cent. However, the two states have been
unable to woo doctors to hospitals in
the countryside. In Rajasthan, the
number of PHCs without doctors has
20 Outlook 17 September 2018
increased from 70 in 2010 to 167 in 2017.
In MP, the figure increased from 211 in
2010 to 393 in 2017, while Chhattisgarh
has 390 such PHCs operating without
doctors. The shortage of specialist doc-
tors in various healthcare centres in the
three states is also high. There are new
central government-run AIIMS at each
of these states since 2012 but they oper-
ate with less than 50 per cent doctors,
according to a response by the Union
health ministry to a question in the Lok
Sabha in February.
“Human resource such as medical of-
ficers, specialists and staff are crucial
and we have been trying hard to woo
them to various centres. We have even
tried to emulate best practices from
other states such as Uttar Pradesh and
Karnataka but we have been unable to
staff up the healthcare centres as of
now,” says Dhanaraju S, director for the
National Health Mission in Madhya
Pradesh. He says even an incentive of
25 per cent extra salary for postings in
remote areas inhabited mostly by tribal
people has failed to attract doctors.
Health economist Amirullah Khan
agrees that attracting doctors to rural
areas is a major challenge. “It is difficult
Election-bound states, COM
Reluctance of doctors to serve in rural areas is hampering healthcare
Stunting*
Rajasthan
Chhattisgarh
MP
All-India
Kerala
Wasting*
2005-06 2015-16
43.7%
52.9%
50%
48%
24.5% 39.1%
37.6%
42%
38.4%
19.7%
Rajasthan
Chhattisgarh
MP
All-India
Kerala
2005-06 2015-16
20.4%
19.5%
35%
19.7%
15.9% 23%
23.1%
25.8%
21%
15.7%
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