ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

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Health Checkup

The Changing State of Health Centres in North India

The findings of a recent survey of public health centres in five north Indian states (Bihar, Chhattisgarh, Himachal Pradesh, Jharkhand and Rajasthan) are presented, in light of earlier surveys in the same areas from 2002 onwards. Contrary to a common narrative whereby public health services in India have “collapsed,” there is a general pattern of improving quality and utilisation over time. The pace of improvement, however, is far from adequate. The recent conversion of many health centres into health and wellness centres, in particular, has been largely cosmetic so far. In states like Bihar and Jharkhand, the standards of healthcare in public facilities remain abysmal. Hope lies in the experiences of states that have shown how decent standards of healthcare can be achieved in the public sector, notably Himachal Pradesh. Even in Chhattisgarh and Rajasthan, there have been valuable initiatives in recent years.

The authors are grateful to all the student volunteers who participated in the field survey and post-survey workshop for their excellent work and insightful observations, and also to ASTHA Sansthan (Udaipur), Aajeevika Bureau (Udaipur), Chaupal (Sarguja), Jan Jagran Shakti Sangathan (Araria), Gangaram Paikra, Pavitra Mohan and Sanjana Mohan for local support to the survey teams.

Indias healthcare system is hardly known for its excellence. Poor public health facilities coexist with a thriving but exploitative private sector. Torn between the two, many patients end up risking their health or their wealth, if not both. Quality healthcare is restricted to a privileged minoritythose who are able to demand decent services in the public sector or to pay for them in the private sector.

Having said that, there are signs of hope as well. Slowly if not surely, public health centres are providing a wider range of free services. In states like Kerala, Tamil Nadu and Himachal Pradesh (the usual social-policy leaders), most patients already have a real option of decent healthcare in the public sector. Recent experiences in Chhattisgarh, Odisha, and Rajasthan suggest that it is possible to make similar progress in other states as well. During the COVID-19 crisis, public health services in the entire country rose to the occasion (within its limits). Perhaps India is better placed to make a leap forward in this field than many tend to believe.

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Published On : 9th Mar, 2024

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