Written by Dr Dharminder Nagar
For all the animated talk about India’s rapidly-growing, medical-tourism attracting healthcare sector and projections of it becoming a USD 280 billion industry by 2020, the fact remains that our health sector is bedevilled by major disparities when it comes to accessibility between urban and rural areas.
According to estimates almost 70% of the doctors in India are concentrated in urban centres, serving around 30% of the total Indian population. Urban India enjoys access to almost 65% of the country’s hospital beds despite having less than 30% of the total population.
At a time when technology and infrastructure make distances shorter, we still have a long way to go in building the bridges to cover the gaps in rural healthcare. Home to more than 60% of the national population, India can no longer simply dismiss its rural sector as the ‘sick child’, and needs to take essential steps in order to steer its healthy recovery.
One of the raging issues in the upliftment of health and sanitation in remote areas has been the sheer lack of trained medical professionals to cater to the everyday needs of the habitants, who are thereby deprived of the basic medical facilities necessary for survival.
Forget the rural hinterland, remote villages and tribal areas, quality tertiary healthcare is not available even to a bulk of urban population living outside a few glittering metropolitan cities. For example, in north India while Delhi NCR remains a hub of the best multi-specialty hospitals, even a 100 km move outside the region will leave you without a decent tertiary care hospital. This is evident from the fact that the Delhi NCR hospitals are crowded with people coming from Uttar Pradesh, Bihar, Haryana and even West Bengal.
A lot of people have to travel long distances to avail of life-saving treatments like dialysis. In the absence of quality cardiac care in smaller towns and villages, many people fail to survive a heart attack as they are required to travel long distances to nearby cities with decent healthcare facilities.
At Paras Healthcare, we have closely studied this discrepancy in India’s healthcare delivery. Resultantly, as a healthcare entity, we have planned our expansion keeping in mind this skew. Not only are we working to expand our footprint in smaller towns and cities of India which are bereft of quality healthcare, we are also working on parallel initiatives to fill in the gaps wherever possible.
While primary healthcare facilities continue to suffer from shortage of staff and absenteeism, private sector finds little incentive in investing heavily in rural areas. However, through some low cost but effective initiatives, the private sector can play a positive role in helping address the deficit of manpower in rural healthcare to some extent:
Telemedicine, as we know, refers to the use of information technology to provide medical consultation in far flung areas. It is intended to overcome geographical barriers, connecting users who are not in the same physical location with an aim to improve health outcomes. Remote populations, which often lack minimal physician presence can benefit to a large degree by telemedicine centres through which physicians can offer basic minimum consultation and medical advice. Notably, communicable diseases are among the leading afflictions affecting rural populations and basic consultation and hygiene advice can also go a long way in treatment and reducing their incidence.
We need more public private partnerships to involve the private sector in rural areas. These partnerships can offer incentives to doctors to offer services in rural areas for a small number of days of a year. With severe shortage of specialized cardiologists, nephrologists, neurologists and gynaecologists, rural populations often have to make with less skilled doctors or worse quacks. PPPs that can take skilled doctors of reputed hospitals to offer services in rural health centres and recommend patient transfer if needed, can play a role in bridging this gap.
Turning to smaller centres
It is understandable that for a private entity it doesn’t make much business sense to open tertiary care hospitals in villages. However, the needs for profit and social benefit can be balanced by opening hospitals in smaller towns and cities which cater to large surrounding populations. With this thought Paras Healthcare has opened the first private tertiary care hospital in Darbhanga, Bihar, a region where private participation in healthcare has been dismal. Through this facility we aim to serve large populations in and around Darbhanga, a bulk of them would be from rural areas who will now not need to travel long distances to Patna, Kolkata or Delhi in search of specialized treatment. Such endeavours also attract doctors who have left their state in search of greener pastures back to their roots.
Training local manpower
Notably, the deficit in manpower in rural areas is not just about doctors, it is about healthcare providers in toto. Even nurses, radiologists, pathologists and paramedics are hard to find. Launching training programs for nurses and paramedics in smaller centres is another important initiative that can help address manpower shortage to an extent.
At Paras HMRI, Patna, we have initiated such training programs. By incorporating locals into the extensive training programmes, the initiative ensures a long term solution to the low manpower in rural healthcare, with a motive to not only provide quick medical assistance by experienced professionals but a broad vision to empower the community. This encouragement to generation of rural employment is no surprise, considering the position of the company as the highest private employer in health industry.