of the condition of hospitals in the rural areas is
apparing. There are no beds, medicince and mained
doctors in most of the hospitals, you are shashi
or sury a write a letter to the Editor of a local
doly voicing your concerns and auso provide your
suggestiona.
Answers
Explanation:
Abstract
Despite the implementation of National Rural Health Mission over a period of nine years since 2005, the public health system in the country continues to face formidable challenges. In the context of plans for rolling out “Universal Health Care” in the country, this paper analyzes the social, economic, and political origins of the major challenges facing public hospitals in India. The view taken therein holds the class nature of the ruling classes in the country and the development paradigm pursued by them as being at the root of the present problems being faced by public hospitals. The suggested solutions are in tune with these realities.
2. Structure and Methodology
After setting out what the author believes to be the main challenges facing public hospitals in India, different secondary sources of information were relied upon to authenticate these challenges. Apart from this, reliance has also been placed on the observations made by the author during his monitoring visits to various health facilities, primarily in the states of Uttarakhand and Uttar Pradesh, while working as a consultant with the National Health Systems Resource Center, a technical advisory body of the Government of India under the Ministry of Health and Family Welfare.
Having thus delineated the major challenges, relying on evidence from relevant literature, different social, economic, and political sources of these challenges have been profiled. The suggested solutions for rectifying some of these social, economic, and political sources have been formulated as per the analysis made in the review and as per the author’s understanding. However, it is admitted that the suggested solutions are in deference to the present system’s ability to allow changes in the given social, economic, and political structure of the society.
Further, an attempt to comprehensively review the challenges facing a public hospital does not afford the advantage of ostensible clarity that comes with taking up a single focus for study. Alternatively, a compartmentalized approach tends to lose sight of the essentially interrelated nature of different challenges that confront a public hospital in India today. It is our considered opinion that there cannot be a solution that is strictly limited in its scope to a particular aspect of the problem under consideration, without impinging on other aspects. Hence, this is a comprehensive review.
3. Main Challenges Confronting a Public Hospital
In our opinion, the main challenges confronting the public hospitals today are as follows:
(1) deficient infrastructure,
(2) deficient manpower,
(3) unmanageable patient load,
(4) equivocal quality of services,
(5) high out of pocket expenditure.
3.1. Deficient Infrastructure
The format of the public health structure in the country draws directly from the recommendations of the Bhore Committee Report, 1946. However, the public health infrastructure has evolved lags far behind in matching the content and the spirit of the committee’s report. The committee proposed the implementation of its recommendations in two distinct phases—“three-million plan” and the “ten-year plan.”
The “three-million plan” laid down the required health infrastructure to provide for the health needs of an average district in India having a population of three million. This was to be implemented over a period of three to four decades. Anticipating resource constraints, both in terms of manpower and money to make such an infrastructure available in a short time, the committee recommended a shorter “ten-year plan” to be implemented first. Table 1 gives a comparison between the “ten-year plan,” the “three-million plan,” and the public health infrastructure available at present in the country.
i know it is too long
but hope it is helpful