PROBLEMS WITH DELIVERING HEALTHCARE IN RURAL INDIA

Health is an important component for ensuring better quality of life. Large masses of the
Indian poor continue to fight hopeless and constantly losing the battle for survival and health.
The war begins even before birth, as malnourishment of the mother reduces life chances of
the foetus.

In rural India, where over 50 percent of families are living in poverty, it is not only food

security but also ill-health, which causes serious distress. Even after 50 years of

Independence, we have an infant mortality of 87 per 1,000 with most babies dying due to

diarrhoea and other minor diseases related to portable water, hygiene and sanitation.

Presently, over 25 percent of villages do not have assured source of drinking water for at least

4-5 months in a year and about 75 percent of the water sources are polluted and do not meet

the World Health Organization Standards.

Less than 10 percent of the rural population uses toilets and such lack of sanitary conditions

and shortage of clean drinking water are directly affecting the health of most of the rural

people. While the world is concerned with emerging diseases like AIDS, rural India is still

highly affected by the age-old problems of TB, malaria and diarrhoea on the one hand, and

facing new challenges posed by environmental pollution mainly due to contamination of air

by automobiles and industries, and water by agro-chemicals on the other. In such situations, it

is difficult to ensure progress and sustainable living without additional problems related to

community health.

Also the biggest problem is lack of awareness. People in rural areas are habituated to

domestic cures for their ailments and are very apprehensive about using medicines. They only

visit a doctor as the last resort after having tried everything they have been advised by

relatives and neighbours. Sometimes, this leads to worsening of their condition and the doctor

prescribing surgery or expensive medicine. This leads them to conclude a fear of going to a

fancy hospital, rather than getting an education about the disease. 

Poor health in rural people suppresses their energy and enthusiasm to work hard for earning

their livelihood. In the absence of primary healthcare, it is difficult to initiate any

development programme. Inspite of this, because of the sectorial approach, health is not

considered as an integral part of the development programme.

In case of Piramal-E Swasthya, the healthcare services landscape in the state of Rajasthan
reflected the reality in India. Despite having public medical services villagers were still
following self-medication, traditional healers or private practitioners as they sought to heal
patients by balancing body’s three humors through herbs, massage and exercise. Purists
claimed that modern medicines have more harmful side effects compared to natural remedies.
Although the public facility was cheaper, lower income patients chose not to use it because it
was often closed or inconvenienced the patients who had to travel to get care. Villagers were
willing to pay a premium for more convenient access to providers, although the quality of the
care may have been suspect. Despite their small size, these communities were a complex
quilt of languages, religions and culture with intricate caste, class, age and gender
differences.

Many villages were lacking on basic infrastructure facilities and were disconnected from
urban centers due to poor transport as there were few doctors available for people. Due to
which health indicator in India were worse in rural areas where life expectancy was 12 years
because of limited access to licensed medical care. Even at higher salary doctors were not
ready to serve in rural area as they were looking at the life style of their family which was in
bad condition comparing with cities. One major problem is that average rural Indian spent as
much as 10% of income on healthcare, with medicines accounting for 15% and travel to
providers 20% of total expenditures.

For ensuring good health, there is a need to change the mindset of the donors and extension
workers involved in rural development programmes. Primary healthcare should become the
necessity for every individual, rather than treating it as a separate component of development.