As discussed in the first article in this short series, India faces multiple domestic healthcare challenges even whilst it positions itself as a global leader within the burgeoning and lucrative meditourism industry. Nationwide, our citizens are facing an increasingly difficult time locating safe and affordable healthcare, with out-of-pocket medical expenses far outstripping the healthcare coverage offered by government and/or private sources. Unfortunately, the healthcare system has been designed to cater to urban centers, its residents, and its (wealthy) visitors. As Sandeep Singh and Sorabh Badya reported last year in the South Asian Journal of Cancer, the majority of India’s citizens live in rural areas, a fact which means that more than 75% of the population must travel more than 100 km to receive medical care for which between 70 and 80% of the cost will be borne entirely by the consumer. The high cost of healthcare when coupled with the time and expense necessary for many Indians to access services in the first place, means that many of our sickest citizens delay life-saving treatments and avoid preventative care altogether. The only other alternative available to India’s rural poor is to seek out treatment at private healthcare facilities which are often unregulated and which may not offer safe or effective care.
India’s rural healthcare challenges contribute greatly to the nation’s ongoing vulnerability to both communicable and non-communicable diseases, many of which are preventable through strategies like early healthcare intervention and vaccinations. To demonstrate the scope of this problem, researcher Ashok Panagariya recently reported that less than half of all children in India receive their full slate of vaccinations and only half of India’s mothers receive three or more ante-natal checkups during and immediately following a pregnancy. Statistics such as these are both frightening and frustrating: frightening because so many medical, social, and economic problems can be solved with easy and affordable access to healthcare practitioners; frustrating because India will continue to see an increase in disease outbreaks as long as we continue to make it near-impossible for our rural citizens to engage in preventable care for themselves and their families.
The government’s five year plans have highlighted rural healthcare as a problem in multiple reports and yet little has changed for the millions of men, women, and children who cannot easily access doctors, nurses, laboratory facilities, pharmacies, and other essential medical services. Reports by the government’s National Rural Health Mission have demonstrated that the nation’s failing healthcare infrastructure is largely to blame for the limited or non-existent access to preventative medicine, hospital beds, and medical specialists. And, while the reasons for these problems are myriad, and include issues such as few investment incentives for the private sector to invest in rural regions and general inefficiency within government healthcare systems, one of the most major challenges is one of the simplest: a lack of doctors willing to work in underserved rural areas. We will address this troubling problem in our next article, where we will discuss doctor shortages in both rural and urban areas of our nation.