Kailash P Sharma
Healthcare is the right of every individual but lack of quality infrastructure, dearth of qualified medical functionaries, and non- access to basic medicines and medical facilities thwarts its reach to 60 percent of population in India. A majority of 700 million people lives in rural areas where the condition of medical facilities is deplorable. Considering the picture of grim facts there is a dire need of new practices and procedures to ensure that quality and timely healthcare reaches the deprived corners of the Indian villages. Though a lot of policies and programs are being run by the Government but the success and effectiveness of these programs is questionable due to gaps in the implementation. In rural India, where the number of Primary Healthcare Centers (PHCs) is limited, 8 percent of the centers do not have doctors or medical staff, 39 percent do not have lab technicians and 18 percent PHCs do not even have a pharmacist.
India also accounts for the largest number of maternity deaths. A majority of these are in rural areas where maternal health care is poor. Even in private sector, health care is often confined to family planning and antenatal care and do not extend to more critical services like labor and delivery, where proper medical care can save life in the case of complications.
The rural health-care system in Jammu and Kashmir is composed of three tiers. Sub-centres are manned by trained health workers and auxiliary nurse midwives, with each centre covering up to 5000 people. Primary Health Centres, which act as the first point of contact between village communities and a medical officer, are supposed to have a doctor supported by 14 paramedics and other staff. Community health centres are meant to have four medical specialists (a surgeon, physician, gynecologist, and pediatrician) supported by 21 paramedic and other staff as well as 30 beds and facilities such as an operating theatre and radiology room.
As doctors posted in rural areas of Jammu and Kashmir are leaving their rural posting through deputations for Government Medical Colleges based in the cities, the rural health centres have reached a bleeding point. While briefing CM Mehbooba Mufti on the shortage of doctors in the rural areas, the Health Secretary of the State said that against a maximum upper limit of 293 doctors, 879 are presently on deputation to the Medical Education Department which includes two Government Medical Colleges and other departments. The CM at a meeting of secretaries issued directions to plug holes so that deputation quota doesn’t exceed 10 per cent, which is fixed under the norms.
The overall health scenario of the J&K state is expecting for proper planning and management. The Govt is putting lot of efforts for health improvements in the system but rural focus is still not enough. The another area which needs attention is service sector. Emergency care including trauma and disaster management service is available only in Srinagar and Jammu cities while towns and rural areas have hardly these services. Most of times patients while being shifted to these centres die on the way. Rural folks, Gujjars, Bakarwals, residents of remote areas have limited access under National Health Programmes. Lack of drugs and selling of sub-standard drugs are other issues in medical services.
Govt should push for faster actions on following aspects :
* Immediately issue the required medicines in all rural PHCs, dispensaries etc and open Pradhan Mantri Aushdyalas with free or subsidized medicine .
* Deploy doctors in rural hospitals and introduce the second shift after 2 PM.
* Special care facilities for trauma and critical patients.
* Integrate the Government and NGOs units to help relieve the burden on the public health system using mobile technology.
* Health Minister, and Secretary Health should take immediate assessment of the rural health condition and then decide and act. Today, they have little idea of ground condition. They should frame a high level committee who would monitor progress.
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