Health promises and the helter skelter

Health promises and the helter skelter

After a long wait of 6 years, Bhola and Sarita had their first child and they named her, Jyoti. In just three months of her existence, Jyoti had become the lifeline for the couple. Their mundane life in Birgaon village of Jamtara district in Jharkhand, had suddenly turned lively. Things started changing, when Jyoti, still less than a year old, caught fever. When her condition deteriorated, she was taken to the nearest government hospital. Doctors diagnosed her with Pneumonia and prescribed the medicines. Within a day after coming from hospital, Jyoti breathed her last and for Bhola and Sarita, the whole world around them collapsed in a thud.

Jyoti and lakhs of newborns like her are at the peril of perishing from the face of the earth, only because health care delivery in India is in shambles. Newborns in countries like Libya and Nigeria have better chances of survival than the ones born in India, a recent Lancet study on Healthcare Access and Quality, observes. When Narendra Modi led BJP government rose to power in 2014, riding on a huge wave of popularity and support, even the cynics had a dash of hope, the hope that budgetary spending on healthcare will receive a boost, the hope that spending on their healthcare wouldn’t be a reason for their poverty, the hope that India’s future will be healthy and productive.

Kya Hua Tera Vada?

As the government completes its 3rd year at the Centre, it’s a good time to pause and analyse their performance against all the promises BJP made to the electorate in the field of healthcare. Election Promises Tracker, a team of young citizens connected by their love for democracy, published an independent report tracking the progress of the promises. Out of the 20 promises analysed in health sector, the government has fulfilled only two promises and adequate progress has been made in another two. Work in rest of the promises is either ‘yet to start’ or the progress has been inadequate.

One of the biggest concern in health has been perennial scarcity of budgetary support. India is currently spending only 1.3% of its GDP on health, which is the lowest among the BRICS nations (South Africa – 4.2%, Brazil – 3.8%, Russia – 3.7%, and China – 3.1%). In its 2014 election manifesto, BJP made a promise to the nation that they will ‘initiate National Health Assurance Mission’, providing universal health coverage to all. As per a Planning Commission report, if India is to achieve universal health coverage, it needed to spend at least 2.5% of its GDP on health by 2017. The figures don’t lie, current spending is nearly half of what was required. Government’s effort in this regard has been dismal.

Around 6.2 crore people (nearly 7% of total population) are pushed below poverty line due to high health spending. In this context, BJP’s promise of ‘reducing the out-of-pocket (OOP) spending for the common man’ struck a chord with voters. One clear way to achieve this was to provide medicines at affordable prices to the common man. When the current government re-branded the existing Jan Ausadhi scheme and promised to open 3,000 Jan Ausadhi stores by March, 2017, people heaved a sigh of relief. Quality generic drugs are available at these stores, which are subsidised by government. However, till date, only 1300 such stores are operational in the country. India ranks alarmingly low at 183 out of 192 countries in terms of percentage out-of-pocket spending out of total health expenditure.

The urban middle class populace has little idea of the dangling rural health infrastructure in the country since it resorts to private medical facilities for itself. However, the pain of people in rural India is excruciating and is evident from the fact that nearly 48% of the overnight trips made by people from rural India (25% in urban area) are for medical purposes, according to data collected by National Sample Survey Office. It wasn’t rocket science to solve this problem, as it required more health centres and workers in rural areas. BJP made a promise to ‘focus on rural health care delivery’ in 2014. Cut to 2016, the number of sub-centres (catering to a population of 3000-5000), where no health worker is present has increased in the last 3 years. As per Rural Health Statistics, 2016, the number stands at an appalling 5,258! Government has been able to add only 960 Primary Health Centres (PHCs) in the last 3 years, leading to a total of 25,354 PHCs in the country. There is a shortfall of more than 4,000 PHCs. Clearly, the word ‘focus’ has been either misunderstood or misused by the government. The apathy for healthcare delivery can be understood by the government’s decision to slash the budget of TB by more than 4000 crore despite around 5 lakh people dying of the disease each year.

Hope is a Good Thing

Government fails miserably in its intent and efforts to fulfil its own promises made to the electorate. Its efforts in fulfilling the promises of ‘initiating a new Health Policy’ or ‘increasing the public investment to promote Yoga and AYUSH’ are miniscule in front of the plethora of challenges which plagues the healthcare system. India’s so called demographic dividend is contingent upon the productivity and health of its citizens. We can’t become a superpower carrying a burden of disease-ridden, unhealthy people.

The current government is going to be at the helm of affairs for two more years. It has enough time and mandate to ensure that its promises are delivered. The likes of Bhola and Sarita and millions like them are hopeful that things will change and government will take the right steps to ensure better healthcare access to the citizens. Jyoti deserves to live, play, and thrive. Let her.

Disclaimer: The opinions expressed in this article are the personal opinions of the author. The facts and opinions appearing in the article do not reflect the views of NEWSD and NEWSD does not assume any responsibility or liability for the same.

Robin Keshaw
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Robin Keshaw is a member of the founding team of Election Promises Tracker, an initiative that tracks the governments’ performance in various fields against their election promises. The work can be accessed at www.electionpromisestracker.in

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