ON RURAL INDIA'S HEALTH SYSTEM: THE HEALTH CHECKLIST
The frail(अनैतिक/कमजोर) nature of rural India’s health systems and the extraordinary patient
load on a few referral(निर्दिष्ट करना/परामर्श) hospitals have become even more evident(स्पष्ट/प्रत्यक्ष) from the crisis at the Baba Raghav Das Medical College in Gorakhpur. The institution has come under the spotlight after reports emerged of the death of several children over a short period, although epidemics(संक्रामक/महामारी) and a high mortality level are chronic(दीर्घकालिक/स्थायी)features here. Medical infrastructure in several surrounding districts and even neighbouring States is so weak that a large number of very sick patients are sent to such apex( शीर्ष) hospitals as a last resort(अंतिमचारा/आश्रय). The dysfunctional(बेकार/निष्क्रिय) aspects of the system are evident from the Comptroller and Auditor General’s report on reproductive(प्रजनक) and child health under the National Rural Health Mission for the year ended March 2016. Even if the audit objections on financial administration(प्रशासन) were to be ignored, the picture that emerges(निकलना/उभरना/प्रकटहोना) in several States is one of inability(असामर्थ्य) to absorb the funds allocated, shortage of staff at primary health centres (PHCs), community health centres (CHCs) and district hospitals, lack of essential medicines, broken-down(जर्जर/छिन्न-भिन्न)equipment and unfilled doctor vacancies. In the case of Uttar Pradesh, the CAG found that about 50% of the PHCs it audited(लेखापरीक्षण) did not have a doctor, while 13 States had significant levels of vacancies. Basic facilities in the form of health sub-centres, PHCs and CHCs met only half the need in Bihar, Jharkhand, Sikkim, Uttarakhand and West Bengal, putting pressure on a handful of referral institutions such as the Gorakhpur hospital.Templates(आदर्श/नमूनासाँचा) for an upgraded rural health system have long been finalised and the Indian Public Health Standards were issued in 2007 and 2012, covering facilities from health sub-centres upwards(ऊपर की तरफ़). The Centre has set ambitious(महत्वाकांक्षी) health goals for 2020 and is in the process of deciding the financialoutlay(व्यय) for various targets under the National Health Mission, including reduction of the infant mortality rate(शिशु मृत्यु दर) to 30 per 1,000 live births, from the recent estimate of 40. This will require sustained(निरंतर/लगातार) investment and monitoring, and ensuring that the prescribed(निर्धारित करना) standard(प्रामाणिक) of access to a health facility with the requisite(अपेक्षित/आवश्यक)medical and nursing resources within a 3-km radius is achieved on priority. Such a commitment(वादा) is vital(महत्वपूर्ण) for scaling up reproductive and child health care to achieve a sharp reduction in India’s deplorable(दयनीय/निन्दनीय) infant(बच्चा) andmaternal(मातृक) mortality levels, besides preventing(रोकना) the spread of infectious diseases across States. It isimperative(अनिवार्य/आत्यावश्यक) for the government to recognise the limitations of a market-led mechanism, as the NITI Aayog has pointed out in its action agenda for 2020, in providing for a pure public good such as health. We need to move to a single- payer system with cost controls that make efficient strategic purchase of health care from private and public facilities possible. Bringing equity in access to doctors, diagnostics and medicines for the rural population has to be a priority for the National Health Mission.
load on a few referral(निर्दिष्ट करना/परामर्श) hospitals have become even more evident(स्पष्ट/प्रत्यक्ष) from the crisis at the Baba Raghav Das Medical College in Gorakhpur. The institution has come under the spotlight after reports emerged of the death of several children over a short period, although epidemics(संक्रामक/महामारी) and a high mortality level are chronic(दीर्घकालिक/स्थायी)features here. Medical infrastructure in several surrounding districts and even neighbouring States is so weak that a large number of very sick patients are sent to such apex( शीर्ष) hospitals as a last resort(अंतिमचारा/आश्रय). The dysfunctional(बेकार/निष्क्रिय) aspects of the system are evident from the Comptroller and Auditor General’s report on reproductive(प्रजनक) and child health under the National Rural Health Mission for the year ended March 2016. Even if the audit objections on financial administration(प्रशासन) were to be ignored, the picture that emerges(निकलना/उभरना/प्रकटहोना) in several States is one of inability(असामर्थ्य) to absorb the funds allocated, shortage of staff at primary health centres (PHCs), community health centres (CHCs) and district hospitals, lack of essential medicines, broken-down(जर्जर/छिन्न-भिन्न)equipment and unfilled doctor vacancies. In the case of Uttar Pradesh, the CAG found that about 50% of the PHCs it audited(लेखापरीक्षण) did not have a doctor, while 13 States had significant levels of vacancies. Basic facilities in the form of health sub-centres, PHCs and CHCs met only half the need in Bihar, Jharkhand, Sikkim, Uttarakhand and West Bengal, putting pressure on a handful of referral institutions such as the Gorakhpur hospital.Templates(आदर्श/नमूनासाँचा) for an upgraded rural health system have long been finalised and the Indian Public Health Standards were issued in 2007 and 2012, covering facilities from health sub-centres upwards(ऊपर की तरफ़). The Centre has set ambitious(महत्वाकांक्षी) health goals for 2020 and is in the process of deciding the financialoutlay(व्यय) for various targets under the National Health Mission, including reduction of the infant mortality rate(शिशु मृत्यु दर) to 30 per 1,000 live births, from the recent estimate of 40. This will require sustained(निरंतर/लगातार) investment and monitoring, and ensuring that the prescribed(निर्धारित करना) standard(प्रामाणिक) of access to a health facility with the requisite(अपेक्षित/आवश्यक)medical and nursing resources within a 3-km radius is achieved on priority. Such a commitment(वादा) is vital(महत्वपूर्ण) for scaling up reproductive and child health care to achieve a sharp reduction in India’s deplorable(दयनीय/निन्दनीय) infant(बच्चा) andmaternal(मातृक) mortality levels, besides preventing(रोकना) the spread of infectious diseases across States. It isimperative(अनिवार्य/आत्यावश्यक) for the government to recognise the limitations of a market-led mechanism, as the NITI Aayog has pointed out in its action agenda for 2020, in providing for a pure public good such as health. We need to move to a single- payer system with cost controls that make efficient strategic purchase of health care from private and public facilities possible. Bringing equity in access to doctors, diagnostics and medicines for the rural population has to be a priority for the National Health Mission.
1.Frail(अनैतिक/कमजोर)
Synonyms:- delicate, fragile, fallible, imperfect, weak
2.Chronic(दीर्घकालिक/स्थायी)
Synonyms:- persistent, long-term, incurable, immedicable, continuing
3.Requisite(अपेक्षित/आवश्यक)
Synonyms:- essential, necessary, requirement, needed, required
4.Deplorable(दयनीय/निन्दनीय)
Synonyms:- distressing, pitiful, condemnable, vicious, execrable
