On 12th May, a 21-year-old nine-month pregnant tribal woman from Palghar district died due to a sunstroke while walking for 7 km to the primary healthcare centre (PHC) which was far away from the village, as reported by Times of India. She walked 3.5 km to the highway, caught an auto to Tawa PHC as she was not keeping well, and walked 3.5 km back in the scorching heat. Later in the evening, she developed health complications and was transferred to Dhundalwadi PHC and transferred again to Kasa Sub-divisional Hospital (SDH) which said they could not treat her due to her ‘semi-morbid condition’. At the SDH, due to a lack of specialist doctors and an ICU, she could not be saved. This is one such incident that happened recently that brings light to the destitute rural healthcare in India. The lack of rural healthcare professionals, facilities, or even healthcare centres is proof of the inaccessible healthcare situation in rural India. Although most districts have hospitals and PHCs, people have to travel long distances just to get to the centres. Doctors who treat the villagers and tribal people, themselves are not qualified or experienced enough to treat patients.
In 2019, an estimated 1.5 million people died in rural India due to a lack of healthcare facilities. The Economic Survey of 2021 shows that a large proportion of deaths was due to the poor healthcare system. The question that arises is, why is the rural healthcare system in India underdeveloped even after the implementation of so many government schemes? Schemes like the National Rural Health Mission have shown progress but the progress is still minimal due to slow implementation. Due to poverty, unreachable treatment centres, no experienced medical professionals, the lack of incentives given to doctors posted on site, and a shortage of resources like medicine, equipment, etc, rural healthcare has not improved much. Ayushman Bharat program aimed at improving access and quality of primary rural healthcare by strengthening 1,50,000 sub-centres and PHCs. Even though there are rural healthcare centres, 7715 vacancies and 1484 shortfall of doctors in PHCs in rural areas (Table E.15 of MoHFW Statistics Report 2019-20) make it evident how rural healthcare centres are in dire need of doctors. According to the statistics report released by the Ministry of Health and Family Welfare, the vacancy for doctors and healthcare professionals in rural India was a massive 67.96% in 2021. This is a major issue as rural healthcare centres cannot provide treatment unless there is availability of qualified staff including a primary care general physician, nurses, and qualified staff to work and provide care. The patients from rural India are largely below the poverty line and the amount of money they use from their own pockets to pay for treatment is high. This is one of the reasons why patients would not want to receive treatment because even after travelling great distances for it, they end up spending more money on travelling and treatment which would leave nothing for them.
It is definitely a huge challenge to make primary healthcare accessible to every village but it needs to be done to provide primary care for everyone. Rural healthcare must be improved significantly and given utmost priority. Higher investment and budgetary allocations must be provided by the government to bring optimal improvements including the employment of healthcare professionals in the already existing rural healthcare centres. Creating awareness in people in rural areas to opt for treatment rather than ignoring symptoms and illness is also essential. Training doctors and nurses for rural healthcare needs to be initiated like how Christian Medical College, Vellore runs community-based health services and smaller outreach clinics in slum areas of Vellore which act like training sites for doctors and nurses as well. General improvement of the rural infrastructure itself can lead to improvement in the health conditions of people. Connectivity to PHCs and hospitals is a major obstacle that needs to be overcome as soon as possible or transport facilities must be provided for every village/district. Strengthening primary healthcare in rural areas will make a significant impact on the lives of people living in rural areas and hence, must be upgraded as soon as possible.
