Rural Healthcare - Challenges & Solutions

RURAL HEALTHCARE

 CHALLENGES & SOLUTIONS

BETRAYAL is a strong word but I use it as I wish to convey my sense of despair at the abysmal state of healthcare infrastructure in rural Uttar Pradesh.

The healthcare infrastructure is in a serious state of disrepair (only where it is not totally absent)

Healthcare services are nearly as important as any service that the state can extend to its citizens. Healthy citizens are productive, happy and industrious. This in turn creates Human Resource capital for a state, translating into increased prosperity for the people & state. A healthy state is a happy state.

I present here a small overview of the state of healthcare infrastructure in the most populous state of Uttar Pradesh. With a population of about 22,00,00,000 people, Uttar Pradesh presents a challenge of astronomical proportions. Yet things have been allowed to deteriorate to a point where 90% of the state's population is left with any credible access to optimal levels of healthcare

 

HEALTHCARE CHALLENGES

PHC & SUBCENTERS	2% INCREASE IN 25 YEARS [UPTO 2015]
POPULATION OF THE STATE	51% INCREASE IN 25 YEARS [UPTO 2015]
[Source: Rural Health Statistics]

PUBLIC HEALTH CENTERS & SUBCENTERS – THE FIRST POINT OF PUBLIC CONTACT

	1997-2002	2002-2007	2007-2012	2012-2017
UTTAR PRADESH	3,808	3,660	3,692	3,497

NUMBER OF P.H.C. HAS REDUCED BY 10% IN THE LAST 20 YEARS

As is clear from the above tables, while population of the state has grown many fold, the healthcare infrastructure has simply not been able to keep pace. Successive governments & administrations have been remiss in their responsibility towards the people. Budgetary profligacy & administrative lethargy have allowed the situation to detotriate to such a point where more than 90% people are left at the mercy of unregulated and unscrupulous quacks.

Do we keep worrying about the sorry state of affairs or do we pull up our socks and do something to change the situation?

So -

·         What are the options?

·         What is the way forward?

·         Do we just throw some more money, more men, more resources into the healthcare machinery and keep on doing what we have been doing for last seven decades?

OR

Do we act smart and harness the Information & Communication Technologies to bring the POC (Point of Care) closer to the patient & make physical infrastructure less important in the healthcare matrix of the state?

I will put my chips on the last option.

It's the smart thing to do. Using technology to improve diagnostic, therapeutic and recuperative outcomes is one thing. But using technology to take the POC direct to the end user has a favorable impact on all the above aspects of healthcare. POC is a critical aspect of overall healthcare matrix. In the current scenario, the POC is the government healthcare facilities - the PHC, CHC, District Hospitals, etc. This physical infrastructure can often be a detriment to access to healthcare. Distance between a patients place of residence and the medical center pose a serious issue. The poor patient may often, not be able to afford to visit the medical center. Even if he can, continued visits for follow up treatments dissuade many to discontinue treatment and opt out of recuperative care services. This in turn adversely impacts the therapeutic outcomes.

Creating physical infrastructure is a daunting task and doing it in a short duration is next to impossible. Even if the government manages to achieve this task, can the human capital to staff and manage it all, be arranged. There, simply, are not enough doctors!!!!!!!!

Combining telemedicine with POC-diagnostics significantly -

·         Enhances the benefits to the patient,

·         Increases the utilization of existing technically qualified, specialists doctors

·         Reduces cost of health services,

·         Removes the unscrupulous middle men, quacks and elaborate physical infrastructure.

·         Increases patient compliance

One more added benefit of the use of ICTs is creation of significant new jobs. The potential of creating new jobs is quite good.

POC admins, Diagnostic Technicians, ICT managers, Dispensers etc are just some of the new jobs that will be created in the rural areas. Besides improved health outcomes, rural economy will have a new segment to push it forward towards growth.

Vineet Saxena