Healthy living conditions and access to good quality health care for
all citizens are not only basic human rights, but also essential
components of social and economic development.
India today, the health sector is simultaneously an area of deep crisis
as well as of tremendous opportunity for positive change. Government,
Private medical sector, and Community health activists seek to
massively reorganize health care services, but each with a different
vision and perspective.
Throughout India people are struggling
to defend their rights to healthy living conditions as well as access
to health care. Joining hands with some of these efforts, AID supports
village health workers in remote and rural areas, programs to train
government health workers to work more effectively and sensetively,
direct interventions in areas such as children's nutrition , eye-care,
malaria or mental illness.
Association for India's Development is proud to announce that Dr. Abhay Shukla will be our keynote speaker at the AID annual conference
, May 23-25 in Raleigh, NC. Dr. Shukla co-ordinates SATHI (Support for
Advocacy and Training to Health Initiatives).
Shukla has successfully demonstrated that health care programs can be
initiated as a citizen-based, low-cost and locally sustainable activity
by drawing upon the resources of existing community-based
organizations. By initiating health campaigns on a mass basis in Indian
rural and tribal areas, he has laid the foundation for a large-scale
democratically directed health movement.
Bringing many years of
experience in strengthening village level health care and taking up
national level policy initiatives, Dr. Shukla will share with the
concerned Indian community the strategic priorities to keep India on
course to achieve Health for All.
Challenges related to people’s health in India of the early 21st century:
* With massive inequities in health status and access to health care, in the early 21st century India appears like ‘two separate nations within one country’. India presents the paradox of persistently poor health indicators for a large proportion of the population despite high ‘growth rates’ and presence of large-scale health care resources (medical colleges, doctors, drug industry, public and private health care infrastructure). This points to the need for large scale reorganization, redistribution and rationalization of health related resources.
* The pattern of economic growth being followed has not managed to ensure access to basic determinants of health for the majority of the population, who are mostly people working in agriculture and the unorganized sector. Large scale malnutrition among both children and adults, widespread lack of access to clean drinking water and unhealthy environmental and workplace conditions are some examples of this.
* The debilitation of the public health system is linked with predominance of the unregulated private medical sector; India has one of the most privatized health care systems in the world. The private medical sector also tends to distort the public health system by creating unhealthy referral linkages, encouraging informal ‘outsourcing’ and drawing away the most skilled doctors and staff.
* Public health care often tends to be deficient in its responsiveness to patients felt needs, and suffers from weak inputs (e.g. lack of staff and essential medicines) along with lack of accountability. Private medical care tends to be unaffordable, often irrational in nature; there is the problematic influence of drug and medical equipment industries.
* ‘Poor health care at high cost’: Market driven irrationality in health care is leading to wastage of resources; profit oriented over-medicalisation for those who can pay combined with health care deprivation or very poor quality care for those who cannot pay.
* Today the need for health care system reorganization in India is being increasingly recognised. However, the current trends of privatisation oriented ‘Public-private partnerships’ and private medical insurance being offered as the ‘solution’ cannot ensure quality health services for the majority. There is a need to build upon the positive recognition of the need for change, and to move towards a rational, affordable, publicly organised system for universal access to health care.
* Rational, appropriate health care for all would include integration of modern and effective traditional medical practices, giving place to people’s positive health traditions and incorporating appropriate low-cost health technology.
* The lack of established health rights and patients rights leads to ordinary people becoming extremely vulnerable and disempowered with respect to the health care system. This needs to be remedied by establishing an overarching system of health rights.
For further reading
People's Health Manifesto. JSA, 2009 Download
People's Health Manifesto. JSA, 2004 Download
What Ails the Health System in India? Booklet by People's Health Movement , 2006. Download
Indian Journal of Medical Ethics
Unhealthy Trends: A Symposium on the State of our Public Health System (Seminar: May 2000)
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