In the context of primary healthcare in India, the only way to fulfill the objectives of equitable and comprehensive care is to democratize it. Discuss.

The Right to health is subsumed under the Right to Life in the constitution of India. There is enough evidence to show that Primary Health Care (PHC) approach is the most effective way to solve health and health system challenges. Ayushman Bharat Scheme aims to develop and convert PHCs into 1.5 lakh health & wellness centers.

Need for the democratization of primary healthcare:

  • Rural-Urban divide:
    • Rural areas are 76% short of specialists like physicians, as per All India Rural Health Statistics 2021.
    • 70% of doctors and hospital beds are present in urban areas, having 33% population.
    • Hence, PHCs can ensure equitable healthcare in rural India.
  • Presence of multiple health challenges (NFHS 5)
    • 5% of children are stunted.
    • 67% of children are anaemic.
    • The high maternal mortality rate of 103 per 1000 births.
    • This highlights the need for PHCs for comprehensive health services provisioning.
  • Primary healthcare centres are often inaccessible to remotely living tribal populations, especially in hilly regions, deserts, and forest areas.
  • In India, 62% of hospital beds are owned by the private sector.
    • The private sector is mainly located in urban areas.
    • This translates into the unavailability of healthcare for the poor.
    • As per the world bank, 600 million Indians are unable to access healthcare, which is the highest in the world.
  • High out-of-pocket expenditure, also eliminates its affordability for the poor. Highlighting the need for PHCs.

Thus, India must democratize and decentralize PHCs, so that it can achieve its targets under SDG-3 of health & wellbeing for all.

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