The foundation: Understanding India’s Health care system, a nations stigma and disparities
Karnataka, India | May 11, 2018
As Karnataka’s Legislative assembly election takes place, streets fill with excited citizen’s eager to vote. An election that takes place every five years, where many come together to share their rights and take action. Local newspapers and advertisements vividly overtake the streets and bring forth opportunities for development and change on India’s societal affairs. Among them an article shared on Financial Times, titled “India’s healthcare: does Modi have the right cure?” looks into India’s PM Modi’s prospective healthcare plan “Modicare”, to be implemented soon. With the urgency to address India’s rising incidents of communicable diseases; this national scheme proposal was presented in aiming to tackle this health crisis. 500m people belonging to India’s poorest low income households, will be awarded up to 500,000 Rs on insurance to annual hospital expenses. This should cover in-patient care to private and public hospitals expenses. However, there are many questions experts and skeptics are raising on the long term success of this scheme due to current limitations in the system. By assessing availability, affordability, and accessibility among all broad systematic factors, advanced quality treatment, high raise in costs, and disproportions of personnel, infrastructure and supply systems. – can be shown to be projected versus the reality of the matter of India's state. The issue is in the low health expenditure by the government and the possiblity to commit to estimated cost demands for this scheme.There are many disparities occurring right now revolving healthcare. Proper distribution of manifested goods for the public is at a fragile expanse. Such disparities bring many limitations to many minority groups, children and women being among them. India still lags far behind other developing countries as to tending to the health needs of its citizens. Because of that neglect, India’s outcomes in indicators such as maternal and infant mortality are poorer than many other countries at similar, or lower levels, of development (Kazmin, 2018). Infectious diseases (like HIV/AIDS) are also a high burden in India among all communicable diseases.
This article highlights a relevance in my experiences in certain observations I’ve made about India’s health system while my time here. In Mysore City, Karnataka, there are about 5 private health centers in the block where I am currently residing. However, PHRII, The Public Health Research Institute, a private health center, caters health supply through mobile clinics to women in low socio economic statuses and rural areas. Thus leading me to explore significant disparities and gaps within proper distribution, accessibility and availability of these services among minority groups like women and children. Among most geographical disparities lie religious and social stigmas. To many communicable diseases like HIV/AIDS, it makes it even harder for proper distribution and care to take place. Particularly my experience here so far, has led me to explore the depths of these issues with an attempt to understand why maternal and infant mortality and communicable diseases rates are so high; the cause and the effect.
Although “Modicare” as the article mentions, aims to close the gaps between lower income families and their access to health care, there are still many questions by experts and doctors within India’s health questioning its infrastructure. Nearly 70 per cent of India’s total health spending’s come from families, causing straining household budgets and creating severe inequities in access to care (Kazmin, 2018). While upper-class families are checking into the private well-equipped super specialty hospitals, and the poor are relegated and forced to attend low care, overstrained public facilities. Experts ask whether this scheme will address and contribute to the shortage of personnel, affordability and accessibility to health care. Patients travel long distances to reach dilapidated government hospitals or wind up in tiny, unregulated private “nursing homes” where many upcharge and raise their costs (Kazmin, 2018).
At least 5 per cent of population — are forced back into poverty each year by unexpected, catastrophic medical emergencies. For many Indians, lack of appropriate primary care for early diagnosis of diseases and timely treatment leads to more serious and costly crises later (Kazmin, 2018). However, governmental infrastructure on health care distribution is just one piece in a puzzle. Besides poor governmental infrastructure there is social stigmas in ideas and values linked to health care access within minorities. These are among some of the hidden issues within the effectiveness of these health schemes. According to Dr. Praveen Kulkarni, a professor of preventative medicine and a public health expert, says women in minority groups are less likely to deliver and seek services in public hospitals besides accessibility and availability, because of cultural, socioeconomic, and religious factors. Many of these social stigmas deprives women and children in minority groups to proper awareness and education of health schemes. Cornelius, Erekaha, Sam-Agudu, and Okundaye (2018) conducted a study on HIV-Positive Women in Rural North-Central Nigeria. Eleven focus groups on PMTCT (prevention of mother-to- child transmission) showed that for HIV-positive women, stigma from family members, providers, and the local community affect their ability to obtain care and remain ART-adherent. This is much similar to what is happening in India today. Many women are living under the rule of societies stigma and discrimination thus affecting their awareness and perspective on the health they are entitled to.
Understanding this global issue in health care will facilitate a deeper understanding as to why social stigmas and disparities exist within the community. Exploring this complex manner has allowed me to grasp a clearer understanding into why there are minority groups like women and children and why there is a shortage of supply, hence, a growth in communicable diseases like HIV. I believe looking into social stigmas and health care disparities within a societal context will allow for a more concreate solution to surface. More can be done on one particular health issue if it is addressed from the root.
Cornelius, L. J., Erekaha, S. C., Sam-Agudu, N. A., & Okundaye, J. N. (2018). A Socio-Ecological Examination of Treatment Access, Uptake and Adherence Issues Encountered By HIV-Positive Women in Rural North-Central Nigeria. Journal Of Evidence-Informed Social Work, 15(1), 38-51. doi:10.1080/23761407.2017.1397580
Kazmin, A. (2018, May 8). India's Healthcare: Does Modi have the right cure? Retrieved from https://www.ft.com/content/a37648b0-4e00-11e8-8a8e-22951a2d8493