Outlook English - Print Subscribers Copy Outlook English, 17 September 2018 | Page 21

behind with Rs 716 in MP, Rajasthan
2015-16. Despite the and Chhattisgarh also built the least
number of PHCs at 16
higher
expenditure,
account for
while the government
Rajasthan ranks second
says that 24 of its com-
from the bottom in nearly half the
munity healthcare cen-
composite healthcare number of PHCs
tres (CHCs) have been
score among 21 large running without
upgraded to ‘civil hospi-
states in India, the lat- doctors in the
tals’ between 2010 and
est health index re-
country.
2017. Building the CHCs
leased by NITI Aayog
may not be enough
show. MP is placed
three
ranks
above
Rajasthan. because very few of these centres in the
Chhattisgarh climbed one rung to the three states have all four specialists—
12th spot though large swathes of the surgeons, obstetrician and gynaecolo-
state, especially those with a tribal gists, physicians and paediatricians.
population, remain uncovered by the
best-laid healthcare plans.
ost people require a general
Between 2010 and 2017, the three
physician for basic healthcare
state gove rnments also appear to have
and not a super-specialist. In
built around 40 per cent of the 9,162
Chhattisgarh, they may need
new sub-centres in the country. a snake-bite venom or treatment for a
Rajasthan alone built 2,919 of these rat bite for which you need a doctor
while MP has built the least (323) dur- with an MBBS degree and not a su-
per-specialist. The AIIMS costs many
times more than a district (or a civil)
hospital to build and needs more spe-
cialised doctors, which are not easy to
find,” says Khan.
in PHCs; child health indicators flash red light on several counts
Perhaps, the poor state of public
healthcare facilities, both in terms of
Underweight*
Anaemia (6-59 months)
infrastructure and personnel, is the
reason why the central government fell
back on the private hospitals and clinics
2005-06
2015-16
2005-06
2015-16
for its ambitious Ayushman Bharat
Rajasthan
69.6%
60.3%
Rajasthan
39.9%
36.7%
Scheme, under which the government
Chhattisgarh
71.2%
41.6%
Chhattisgarh
47.1%
37.7%
will subsidise insurance premiums for
500 million people. The beneficiaries
MP
74%
68.9%
MP
60%
42.8%
can claim healthcare services at empan-
All-India
69.4%
58.5%
All-India
42.5%
35.7%
elled hospitals. Shifting to that model
Kerala
44.5%
35.6%
Kerala
22.9%
16.1%
and phasing out existing models can be
premature as the new scheme has a lot
Under-5 mortality rate**
Infant Mortality rate**
of loopholes (refer: Modicare Doesn’t
Address Glaring Concerns Of Past
Healthcare Plans, published in Outlook
2005-06
2015-16
2005-06
2015-16
last month). As per news reports,
Rajasthan
85
51
Rajasthan
65
41
Rajasthan was initially sceptical of
Chhattisgarh
90
64
Chhattisgarh
71
54
signing up for the programme since the
Vasundhara Raje government had
MP
94
65
MP
70
51
launched its own health plan in 2014. It
All-India
74
50
All-India
57
37
later fell in line.
Kerala
16
7
Kerala
15
6
When the three states, all with BJP
governments, go to the polls, the ruling
*up to 5 years of age
Rajasthan second
party will perhaps showcase Modicare—
**per 1,000
as the new insurance scheme is being
from
bottom
in
Source: Govt. data/NFHS
dubbed—to hide their collective failure
health rankings
in delivering the most basic healthcare
among 21 large
facilities to the people, especially the
states in India,
poor. How much will this influence
MP placed three
voters in the politically important
states is anybody’s guess. O
rungs above
to recruit both doctors and other staff
for these centres. Only a limited num-
ber of doctors graduate each year and
the number is controlled by the regula-
tor (Medical Council of India), which
has an incentive to stifle competition.
Doctors are also more attuned to set-
tling down in urban centres which have
better amenities and offer better living
standards. The only way to offer doctors
employment in rural areas is to give
them better housing and more pay. The
third issue is of the supply of medicines
and healthcare equipment,” says Khan,
who was earlier with the Bill & Melinda
Gates Foundation.
Some numbers have gone up without
actually leading to improvement in the
healthcare scenario. By 2015-16, both
Rajasthan and Chhattisgarh managed
to raise their per capita health expend-
iture above the national average of Rs
1,112. Rajasthan, however, is still lagging
“M
MON AILMENTS
Graphic by saji c.s.
17 September 2018 Outlook 21