By Satish Singh
Oxfam India has recently released a report on the inequality prevailing in the healthcare sector, the implications of which are shocking and frightening. According to this report, people from the general category are in a better position than the scheduled caste and scheduled tribe families in terms of availing healthcare in the country. The condition of Hindus is better than that of Muslims. The rich are getting better health care than the poor. Even though there has been discussion of bringing equality between men and women for a long time, but in terms of availing health services, men are still far ahead than women. According to this report, there is an unequal distribution of healthcare in the country even by regions. For example, the urban population is getting better access to health services than the rural population.
The Oxfam India report states that in the absence of health insurance, the health condition of the vulnerable and disadvantaged sections is worse. The scope of insurance schemes offered by the state and central governments is very limited in the country. The data found under Right to Information shows that only 19 infected with the corona virus have been treated under the Central Government’s Ayushman Bharat scheme.
Poor people die before reaching the hospital due to lack of timely treatment, as there is still a lack of primary health centres in rural areas. One reason for this is also the lack of infrastructure in rural India. Still all the villages of the country are not connected by road. Villagers are also deprived of electricity and water facilities. Due to the corona pandemic, people from economically and socially weaker sections have died more in recent months, as well as increasing inequalities between people at the social and economic level.
The Oxfam India report says that 65.7 percent of the general category households have improved toilet facilities in the past months. Now they do not have to share toilets with anyone, whereas only 25.9 percent scheduled tribe & scheduled cast households have such facility. In addition, more than 12.6 percent of the children in Scheduled Caste households did not have physical growth as compared to the general category households. The number of children who die before the age of 5 is three times higher in the homes of 20 percent bottom of the population compared to the 20 percent top of the population.
The Oxfam India report also found that the availability of food in hospitals under the Integrated Child Development Service is 10 per cent lower in Muslim households than in Hindu households and 8 per cent less in Muslim households than in Hindu households.
The second wave of the Corona pandemic has exposed the shortcomings of India’s public health service in a big way. According to the 2017 National Health Profile, there is only one government allopathic doctor for every 10,189 people and one government hospital for every 90,343 people. India has 0.5 beds in hospital for every 1000 population, which is less than India’s less developed countries like Bangladesh 0.87, Kenya 1.4, and Chile 2.1.
The Oxfam India report shows that over the years the expected efforts have not been made to strengthen the government health infrastructure. Between 2010 and 2020, the number of hospital beds for every 10,000 population has decreased from 9 to 5. India ranks 155th out of 167 countries in terms of hospital beds availability and has only 5 beds and 8.6 doctors for a population of 10,000.
According to the Oxfam India report, only 40 percent of the beds are available in the country for rural areas of the country where about 70 percent of the country’s population lives. During the second wave of the corona pandemic due to weak health infrastructure, 1 out of 2 patients infected with the corona virus was from rural areas. Although India’s overall health indicators have improved over the past few decades, the same cannot be said to be substantial. Better health systems have helped increase life expectancy, but due to inequality in gender, caste, and income levels, it has benefited only a limited number of people. Oxfam India report says that the rich live an average of 7 years and 6 months longer than the poor, while a woman in the general category lives an average of 15 years longer than a woman belonging to the depressed class. There has also been a significant improvement in the infant mortality rate over the years. Nevertheless, the infant mortality rate is higher among Dalits, Adivasis and other backward classes as compared to the general category.
According to the Oxfam India report, every year 60 million people become poorer due to the expenditure on the health sector. However, India ranks 154th in the world in terms of health expenditure, which is fifth from the bottom. In the Union Budget presented for the financial year 2021-22, the Ministry of Health and Family Welfare has made a total allocation of Rs.76,901 crore for the health sector, which is 9.8 percent less than revised estimate of Rs 85,250 crore. This estimate had been made for the financial year 2020-21.
Oxfam India report articulates that states that spend more on health have a smaller number of patients infected with corona virus, while states that spend more on health have bigger number of patients recovering from corona virus than other states.
Oxfam India report shows that the health care situation in India is very bad, to fix it, the government will have to strengthen the health infrastructure on a priority basis. However, a major reason for the unequal distribution of health services in India is also the social and economic structure of the country. For this reason, the condition of Scheduled Castes, Scheduled Tribes, women, rural population etc. in the country is also bad in other respects. Therefore, the government has to make efforts for the inclusive development of the country. Together, everyone at all levels of the society has to be made aware to remove the social evils and inequality prevailing in the society.
(Author is Chief Manager at State Bank of India, Mumbai. The views expressed are personal opinion of the author. He can be reached at satish5249@gmail.com and singhsatish@sbi.co.in.)
