HEALTH OF THE NATION

The nation’s approach to health needs to go from ‘reactive’ to ‘proactive’

One important indicator of a developed nation is the health of its citizens. For India, which is aspiring to enter the ‘developed nations’ club’, it is important to emphasise healthcare. It is a major challenge. Not only are we still struggling to fight the diseases that were the scourge of the medieval, but the new age diseases are also threatening us. So, it is a double whammy. On the one hand, diseases like Tuberculosis, Malaria, Cholera (and other communicable diseases) continue to affect large sections of our population, particularly the poorer segments. The diseases of the modern times like Cancer, Coronary Heart Diseases, Diabetes etc. are spreading their tentacles over the people. Then, there is the rising challenge of mental health as Depression strikes a large number of people. An objective assessment would suggest that all is not well on the health front. It is important to focus on this aspect of our nation which we must cope with through a more comprehensive approach. ‘Health for all’ was an important Millennium Development Goal, which we faltered over. There is a need to have another look at the whole concept of health. A widely accepted definition of health given by the World Health Organization (WHO) says that it is a state of complete physical, mental and social well-being and not just the absence of disease or infirmity. Indices of the recent past suggest that Indians are visiting hospitals in greater numbers. The number was 31 per thousand in the urban areas as per the NSSO data of 2004. In 2014, this number rose to 44. The figures exclude hospitalisations due to child birth. This, of course, is not the whole story, given the economic and social reasons that determine the reach of the affected people to hospitals. The public expenditure on health remains low, at 1.4 per cent of GDP. The investment in health research is just one percent of total public health expenditure. This has caused a stark rise in the out-of-the-pocket expenditure of the people on healthcare. It is 6.9 per cent in the rural areas and 5.5 per cent in the urban areas. How to tackle this issue of health is thus a tricky question and calls for greater concern. There is need to understand that good health is not just absence of disease and health cannot be a function of health care. Good health denotes freedom from illness as also freedom from vulnerability to illness so that it allows a person to realize one’s potential. There is need to focus on preventive care and help people acquire robustness and resilience so that they do not have to depend on health care for maintaining health. Rather than depending on reactive healthcare there is need for proactive healthcare. With commercialisation of healthcare and rise of corporate hospitals proactive healthcare is taking a back seat as return on investment and not health of the people becomes the objective. It is therefore imperative on the part of the government agencies to aggressively create health consciousness in the people through marketing campaigns. Lifestyle changes and focus on health habits may yield rich dividends with little expenditure. Rather than marketing healthcare, there is need to market health given the fact that lack of awareness and ignorance of the common people causes more diseases than the microorganisms. Health, hygiene and habit are intricately linked. And there is need to establish this link through awareness campaigns.