What will I learn in this lesson?

Objectives

 understand how the government makes decisions to improve

the health of the people
 learn about the concepts of health and healthcare in India
 know about the types of healthcare facilities - private and public
 see how politics affects who gets what services (in terms of
public healthcare), with examples from Kerala and Costa Rica

Overview

 Health is our ability to remain active in our work  and daily lives.

 India has a huge network of public (government-run) and
private hospitals and medical colleges, yet many people even
today have to do without clean water, nutritious food, and
proper healthcare services.
 The government must must help everyone get equal access to
necessary healthcare services.

Introduction

 People in democratic countries such as India expect the

government to work for their welfare, usually by providing
services such as affordable houses, basic education, good
healthcare, productive employment, etc.
 In this lesson, we look at what governments do for people's
welfare, particularly in providing healthcare services to the
people.
Health

 Usually, being healthy means being free from diseases. But in the
modern world, health also means doing active work and being in
good spirits. 
 People often fall ill if they do not have clean drinking water or
nutritious (healthy) food, if they live in polluted places, or if they
are under a lot of stress.

The Indian Healthcare System

 India is the fourth-largest producer of medicines in the world,

but India also has one of the largest populations in the world,
and a lot of resources and planning are needed to provide all
Indians with good healthcare services.
 Many people even today don't get enough clean water to drink,
clean toilets and neighbourhoods to stop the spread of diseases,
and nutritious food.
 And although many Indians become doctors and nurses, most of
them take up jobs in the cities. So the people in the villages
either don't get good healthcare, or have to travel long distances
to get medical treatments.
 India also gets a lot of medical tourists for their treatments,
which results in further shortages of medical services to the
poor.
 In order to prevent and treat illnesses, we need proper
healthcare facilities such as health centres, hospitals,
laboratories for testing, ambulance services, blood banks, etc.
 India has a lot of knowledge and experience in the field of
healthcare, and its public  (run by the government) healthcare
system looks after many people across India.
Systems of Healthcare

Public Healthcare

 The public healthcare system is a network of clinics and

hospitals run by the government in both rural and urban areas.
Its health workers (nurses) are trained under the supervision of
the doctors at the primary health centres.
 It is called a public system because it has to provide healthcare
to all of the nation's citizens, and also because the public health
centres get their funds from the taxes paid by the general public.

 Another important function of public healthcare is to prevent the

spread of diseases such as tuberculosis, malaria, etc. This can be
done only when the government and the people of the country
work together towards being healthy.

Private Healthcare

 As the name suggests, the private healthcare system is not

owned by the government, and India has many private
healthcare facilities such as clinics, hospitals, laboratories,
colleges, etc.
 Many doctors practise in their own private clinics, and many also
provide specialised treatments. In fact, there are now many large
companies that run networks of hospitals or manufacture and
sell medicines on a large scale.

Inequalities in Public Healthcare

 Although India is a democracy, not all Indians get equally good

healthcare.
  This is because the population of India is huge, and also because
most new medical staff and facilities are in the cities, whereas
most Indians live in villages.
 Also, most healthcare systems in towns and cities are privately
run for a profit, and are too expensive for many people; barely
20% of the population can afford all the medicines they need.
 According to one study, 40% of the patients in hospitals have to
borrow money or sell their possessions to pay for their medical
expenses.

Solutions and Conclusion

 In a democratic country like India, it is the responsibility of the

government to provide proper healthcare facilities to all its
citizens.
 Basic medical facilities should be available to everyone,
everywhere, and not just to rich people in the cities.
 A country's government and people have to work together to
improve the health of the nation.
The Kerala Experience

 In 1996, the government of the state of Kerala gave 40% of its

budget to the rural Panchayats, and the freedom to plan and
provide for the needs in their villages.
 This led to some positive changes as the money was used for the
betterment of all the facilities in the village. For example: proper
planning was done for water supply, education, working of
schools, etc.
The Costa Rica Approach

 Many years ago, the Costa Rican government took a very

important decision of not having a national army. This meant
that all the money which was used to manage the army could be
used for other, more useful projects such as health, education,
and meeting other basic needs of the people.
 The Costa Rican government took this step because it believes
that a healthy population is the most important factor in the
development of any country.
Some reads

 The National Rural Health Mission (NRHM) was launched in

April 2005 by the Government of India. The goal of the NRHM
was to provide effective healthcare to rural people with a focus
on 18 states which have poor public health indicators and/or
weak infrastructure.
 Elderly population still growing and is forecast quadruple to 221
million in 2050. This is likely to compound the healthcare
challenge facing India in the coming years.
 In 2012 India was polio-free for the first time in its history.This
was achieved because of the Pulse Polio Programme started in
1995-96 by the government of India .
 828 million urban residents live in slum conditions worldwide.
 37% of 161 countries do not have national standards or
recommended lists of medical devices for different types of
healthcare facilities or specific procedures.
 Completing three full years without reporting any case of polio,
India celebrated a landmark achievement in public health on 11
February 2014 – the victory over polio.
 Foreigners in increasing numbers are now coming to India for
private healthcare. They also come from Europe and North
America for quick, efficient, and cheap procedures. A shoulder
operation in the UK would cost £10,000 done privately. In India,
the same operation can be done for £1,700.
 Universal healthcare, sometimes referred to as universal health
coverage or universal care refers to a healthcare system that
provides healthcare and financial protection to all of a country's
citizens.
 Indians are three times more prone to heart diseases than
Europeans; Heart attack is the No.1 killer there.
 Indians need 2.5 million heart surgeries a year, but only 90,000
of them actually happen. And India produces just 80
cardiologists a year against 800 in the US.

Classroom Activities
Below are some activities to be conducted in the classroom to enable
interaction between students.
Discuss and Debate

 Is modern medicine better than traditional medicine?

 Does India, considering its large population, have a good
healthcare system? Give reasons for your answers.
 Should healthcare be free?
 Do we need to improve the quality of care in government
hospitals?
 Are there enough free health clinics to serve the needs of the
poor?
 Is it ethical for medicine and healthcare to be businesses?
 Does nutrition play a significant role in health promotion and
disease prevention?
 Compare and contrast: Healthcare system in developed and
developing countries.
 Ideas to help good healthcare services reach everyone.
 Discuss the different problems India as a developing country has
and what can be done.

Agree or Disagree

 In India, private hospitals are more than government owned

hospitals.
 India has the best healthcare system in the world.
 Homeless people get good and on-time healthcare.
 Doctors prefer to live and work in urban areas than in rural
areas.
 Many people in India do not get even basic healthcare.
 Only rich people should have good healthcare facilities.
 Private hospitals usually have patients who are rich.
 Public hospitals are cleaner than private hospitals.
 Communicable diseases are diseases that spread from one
person to another, usually through water, food, air, etc.

Ideas for Action

  Take a trip to a public hospital and then to a private hospital.
What differences did you notice?
 Perform a skit in your school on some public issues such as
water, transport, health,etc.
 Prepare a list of actions governments should take to improve a
national healthcare systems.
 Ask your teacher or use the Internet to find out about the top ten
countries with the best healthcare systems.
 Ask your parents or teacher and prepare a time-table for
vaccination of children in your neighbourhood.
 Find out what qualifications your family doctor has, and what
those qualifications mean.
 Find out the names and uses of the medicines you find in your
home. Are there any that are expired? Tell your class about how
to check medicines for expiry dates.
 Prepare a chart on Healthy Habits and put it up in your
classroom, library, or school's corridor.

Food for Thought

 Private healthcare system is expensive because..

 My last experience when I visited a doctor was...
 Voting is important, because..
 The present Prime Minister of India is..
 The government should take care of everyone's health, because...
 Some medicines have to be imported from foreign countries,
because...
 Children and old people need more medicines and healthcare,
because...
 Many doctors want to work in private hospitals but not in public
hospitals, because...