Shocking state of public health-care system in India

The mounting death toll of infants in Cuttack’s Sardar Vallabhbhai Patel Post Graduate Institute of Pediatrics Hospital — commonly known as the Sishu Bhawan — coupled with the dire situation in Melghat on the Maharashtra-Madhya Pradesh border, where about 450 infants die every year, is a stinging indictment of the state of health care in the country. 

Odisha’s Sishu Bhawan, the largest child hospital in the state, is a picture of neglect — suffering from infrastructural deficiencies. The rising death toll has brought to the fore Naveen Patnaik-led state government’s reluctance to address problems plaguing the health care sector. Now, it is left to the state and the Centre to jointly work out a solution and avert such a crisis in future. 

Melghat in Maharashtra, too, is a victim of state apathy for years. In the absence of doctors, the Korbu tribals resort to a scary practice called damma — where a crying infant is given burn marks with a sickle. Malnourishment is rampant here and even new generation parents, who are aware that damma is not a scientific cure to a bloated stomach, are helpless. This then explains how Maharashtra, considered the richest state in the country, has turned its back on the marginal and underprivileged, letting them die at such an early stage in life.

Currently, India spends only 1.04 per cent of its GDP on public health, compared to 3 per cent in China and 8.3 per cent in the United States. For a country, with the highest population growth rate, this minuscule percentage of government expenditure on something as essential as health leaves the vast majority of Indians vulnerable to death and disease. The high rate of infant mortality goes on to prove a criminal lack of primary health care centres and an overburdened referral system of hospitals. Little wonder that according to the World Health Organization, India ranks at a lowly 112th position among 190 countries, lower than strife-torn Iraq and Syria, and way below neighbouring Sri lanka. Two successive Union Budgets have steered away from the commitment to national health — in 2013-14, health care expenditure was slashed by nearly 20 per cent and was marginally increased in 2015-16. Consequently, the poor have found it increasingly difficult, if not impossible, to rely on government services. 

The spate of infant deaths comes on the heels of the NDA government’s recently announced plans to increase public health investment to 2.5 per cent of the GDP by 2020, with 70 per cent of it to be allocated to boost the primary health care system. Of the Indian states with high neonatal deaths, Madhya Pradesh and Assam are the worst, followed closely by Odisha. Even today, diarrhoea and pneumonia are the biggest killers of children in India, which claim 20 infants per 1000 live births. It flies in the face of the incumbent government’s stated objective of putting in place a universal health-care system.

A radical overhaul of the National Health policy has become an imperative, given the precarious conditions at the grass roots public health systems. A multi-pronged strategy that also takes into account basic amenities like clean drinking water, a nutritious diet and medicines should form an integral part of the government’s thrust on reducing infant mortality. Such a strategy should include not just the villages,  but also the sprawling urban slums and tenements, where children lose their lives to diseases which can be prevented at the outset.