Health And Family Welfare In India
THERE IS no doubt that improvement in the overall health of workers automatically raises the national output
. According to World Development Report (1993), improved health contributes to economic growth in four ways: it reduces production losses caused by worker illness, it permits the use of natural resources that had been totally or nearly inaccessible because of disease, it increases the enrolment of children in schools and makes them better able to learn, and it frees for alternative uses resources that would otherwise have to be spent on treating illness. The economic gains are relatively greater for poor people, who are typically most handicapped by ill health and who stand to gain the most from the development of underutilised natural resources.
The main focus of this paper is on health that is very critically linked with family welfare. Both of these are important components of the Human Development Index (HDI) that was first introduced by the United Nations Development Programme (UNDP) In 1990, and ever since then it has been enlarged and refined in terms of the changing world scenario in all the spheres that matter in the given context. Many new indices like, Gender-Related Development Index (GDI), Gender Empowerment Measure (GEM), and Human Poverty Index (HPI) have been formulated.
Human development can be viewed as the process of achieving an optimum level of health and well-being. It includes physical, biological, mental, emotional, social, educational, economic, and cultural components. Only some of these are expressed in the HDI, a composite scale that has three dimensions: life expectancy at birth, adult literacy rate and mean years of schooling, and income as measured by real gross domestic product per capita. Like all one-dimensional scales that attempt to measure multiple complex variables, it is flawed by inherent inaccuracies, but it is nonetheless a useful comparative measure of the well-being of a population.
Because "health" is in many ways an abstract concept, it cannot easily be assessed directly. Instead, indirect indicators such as a response to a question or a clinical observation are used. These may be combined into a numerical index, very much as economists use an index to summarise the performance of the stock market. Alternatively, health indicators may be presented in the form of a profile, in which different aspects of health are presented separately, rather as a car company might present a profile of a car's performance, handling, fuel economy, and size.
The criteria that have been used to evolve the concept of Human Development Index are very well described below:
1. It includes many more human choices (relating to long and healthy life, acquisition of knowledge, quality of life, pollution-free environment, gainful employment, peaceful community life, and so on) than only income (as in the case of Gross National Product);
2. It is simple and manageable in terms of the limited number of variables and proxy variables used in its computation;
3. t is based on a composite index rather than many indices. (This initially posed the problem of a common denominator, which was sorted out by introducing a scale between 0 and 1, indicating the actual progress in each indicator as relative distance from a desirable goal);
4. It covers both economic and social choices (on the basis that both move hand in hand) by incorporating appropriate indicators.
In terms of the HDI, India is one of the lowest countries in the whole world. But in recent years, there appears to be a marginal improvement in HDI in the context of India.
But, reality comes to the forefront when we look at the widespread deprivation and hardship, starvation deaths in the midst of plenty, unsafe environment, deteriorating public culture, limited and ineffective health facilities, poor infrastructure, deteriorating performances on a number of critical social indices like, the infant mortality rates, and safety hazards. The reason is that our political process has largely failed to deliver the basic social needs. We have, therefore, to shed our complacency, and we have to recognise the current euphoria about economic liberalisation. Market forces, no matter how efficiently they work, cannot alone tackle the issues involved. The State has to perform its basic role in the areas of social and human development.
Health and Family Welfare are assessed in terms of the number of registered medical practitioners, and the availability of hospital beds per 10,000 of population, the data for which are available for limited years. It is seen that over the years the medical facilities have steadily improved both in terms of the availability of medical practitioners and hospital beds. As compared to 1950-51, the number of registered medical practitioners per 10,000 of population has increased, though marginally, over the years. The same is the case with hospital beds per 10,000 of population.
Although the availability of these facilities shows an upward trend, yet these facilities, considered in absolute sense, are extremely meager and even negligible in a country with a massive population. An important point to remember is that illness care is not much of the responsibility of the State in India. A large proportion of people pay directly for the curative services which are delivered to them either by private sector physicians of western medicine, or by a large number of practitioners of indigenous and other systems. The provision of preventive and promotive health care services (which also include, to some extent, suitable housing, sanitation, safe drinking water etc.) is, however, the responsibility of the State. Some of the well-meaning health programmes the Government has launched so far are briefly mentioned below:
* An extensive net work of Primary Health Centers and Sub-Centers opened under the Minimum Needs Programme;
* Community Health Worker Scheme ( later called Village Health Guide) of the Seventies;
* The policy measures to integrate practitioners of traditional medicine into primary health care as contained in the National Health Policy of 1982;
* The Programme of Urban Basic Services (UBS) of the urban slums introduced in the early eighties;
* Signing of Alma Ata Declaration on Health for All by the year 2000 which led to the National Health Policy Statement of 1982;
* Launching of a number of disease-specific programmes to contribute to the health and productivity of the poor;
* Establishment of a National Illness Assistance Fund to achieve the objective of Health for Under Privileged;
* Launching of the National Surveillance Programme for Communicable Diseases;
* Launching of the Mental Health Programme;
* Development of rural health infrastructure under the Minimum Needs Programme;
* Launching of The Central Government Health Scheme (CGHS);
* The Major National Health Programmes aimed at prevention, control and eradication of communicable and non- communicable diseases should be made more effective.
* National Surveillance Programme for Communicable Diseases;
There is no end to such schemes, but the final effects of these schemes never reach the people for whom these are meant. There is a complete absence of the percolating effect. All this is due to poor governance and lack of complete bureaucratic control.
Besides the schemes that have been mentioned above, the Government should also look at the following:
* Provision of compulsory medical insurance supported fully by the Government, especially for the poor and low income classes;
* Extension of medical hospitals all over;
* Reducing the prices of life-saving medicines.
Tackling the major nutritional problems in India are Protein Energy Malnutrition (PEM), Iodine Deficiency Disorders (IDD), Vitamin A Deficiency (VAD) and Anemia.
We must remember that good health is the ultimate objective in life. Once there is good health, other things being given, it leads to the overall well-being of the family/household/ and also of the society.
by: Merinews
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