According to a new study, India‘s poor spending on public healthcare systems and concentration on promoting private healthcare has resulted in major inequities in access to healthcare, particularly during the Covid 19 pandemic.
According to the Oxfam research, “Inequality Report 2021: India’s Unequal Healthcare Story,” states seeking to alleviate existing inequalities and spending more on health reported less confirmed cases of Covid-19.
“What we’ve discovered has two sides to it. The first is that states like Telangana, Himachal Pradesh, and Rajasthan have had less confirmed cases of Covid in recent years, such as discrepancies in access to health care between the general category and SC and ST populations. States with higher GDP expenditure on health, like Assam, Bihar, and Goa, on the other hand, had higher recovery rates of Covid patients,” said Apoorva Mahendra, an Oxfam India researcher and one of the report’s authors.
Kerala is hailed as a success story in the fight against the pandemic, according to the research.
“Kerala invested in infrastructure to build a multi-layered health system that aims to give community-level first-contact access to basic services and expanded primary healthcare coverage to enable access to a variety of preventive and curative services. The number of medical facilities, hospital beds, and doctors has been increased” The report noted.
According to the survey, persons with higher incomes and access to health facilities had to visit hospitals and Covid centers less frequently than those with lower incomes. It was also observed that those from lower-income groups suffered five times greater prejudice when they were found to be Covid-positive than those from higher-income groups. In comparison to 18.2 percent of people in the ‘general’ group, over 50% of people from SC and ST populations had difficulty obtaining non-Covid medical facilities.
The vaccine campaign against Covid-19, according to the paper, ignores the country’s digital divide: before the epidemic, just 15% of rural families had access to the internet, and smartphone users in rural India were nearly half of those in urban regions. According to the study, more than 60% of women in 12 states have never used the internet.
“Our analysis finds that existing socioeconomic inequalities precipitate inequalities in the health system in India,” Amitabh Behar, CEO, Oxfam India, said. “Thus, (people in) the general category performs better than the Scheduled Castes (SCs) and Scheduled Tribes (STs); Hindus perform better than Muslims; the rich perform better than the poor; men are better off than women, and the urban population is better off than the rural population on various health indicators.”
Between 2004 and 2017, the average medical spending per hospitalization case tripled, making it tough for poorer and rural households, according to the report. According to the survey, one rupee out of every six rupees spent on hospitalization was borrowed; while urban households relied on savings, rural households relied on loans. It was argued that the requirement to borrow further discourages the marginalized from seeking health care. In 2015-16, just around a third of households in the country were covered by a government insurance scheme, according to the report.
“India’s inadequate public healthcare spending has left the poor and marginalized with two unpleasant options: substandard and weak public healthcare or pricey private healthcare,” the research stated. Indeed, India’s out-of-pocket health spending is 64.2 percent greater than the global average of 18.2 percent. Exorbitant healthcare costs have driven many people to sell their homes and go into debt.
Inefficient Female Literacy
Other socioeconomic factors also influence access to health, which has influenced the pandemic’s result, according to the paper. For example, women in the general group have a literacy rate that is 18.6% higher than SC women and 27.9% higher than ST women, implying that women in the general category not only have a better grasp of the health facilities available but also have stronger reading skills.
Sikhs and Christians have the highest female literacy rate, at over 80%, followed by Hindus at 68.3 percent and Muslims at 64.3 percent, according to the research. Despite progress in child immunization, the rate of immunization of girls remains lower than that of boys.
The study discovered that children in urban areas receive more vaccinations than children in rural regions and that SCs and STs receive less vaccination than other caste groups. The high-wealth quintile’s kid immunization rate is substantially greater than the low-wealth quintile’s. According to the research, more than half of all youngsters in the country still do not receive nutritional supplements.
According to the study, the percentage of moms who received full prenatal care dropped from 37% in 2005-06 to 21% in 2015-16. Urban areas have nearly twice as much antenatal care as rural areas, and Muslims have the lowest immunization rates – even lower than the SC/ST groups.
Poor infrastructure & Lack of beds
Public health infrastructure investment is so low that the number of beds in the country has actually decreased, from 9 beds per 10,000 people in the 2010 Human Development Report to only 5 beds per 10,000 people today. According to the 2017 National Health Profile, there was one government allopathic doctor per 10,189 people and one state-run hospital every 90,343 people. India also has the fewest hospital beds per thousand people among the BRICS countries, at 0.5, putting it behind less developed countries like Bangladesh (0.87), Chile (2.11), and Mexico (0.98).
According to the survey, rural India homes 70% of the population and has 40% of hospital beds.
(News input: The Indian Express)