CC-5 Regional Planning and Rural Development
UNIT 5- ACCESS TO RURAL
HEALTH CARE
DR. GAURAV SIKKA
ASSISTANT PROFESSOR
UNIVERSITY DEPTT. OF GEOGRAPHY
L.N. MITHILA UNIVERSITY, DARBHANGA
Introduction
Health forms an important index of human
development and in turn that of the development of
any society.
Health is defined as the state of complete physical,
mental, social and spiritual well-being and not
merely absence of disease and infirmity.
It is a major contributor to the level of quality of life.
Rural India consists of approximately 638,000
villages inhabited by more than 740 million
individuals. A network of government-owned and -
operated sub-centres, primary health centres (PHCs)
and community health centres (CHCs) is designed to
deliver primary health care to rural folks.
Rural Health Care Infrastructure
SUB CENTRE
One auxiliary nurse midwife
5000 persons in plains
Most peripheral contact point (ANM) / female health worker
3000 persons in hilly area and one male health worker
PRIMARY HEALTH CENTRE (PHC)
30,000 persons in plains Referral unit for 6 sub centres One medical officer supported by
20,000 persons in hilly area with 5-6 beds 14 paramedical staff
COMMUNITY HEALTH CENTRE
1,20,000 persons in plains 30 bedded Hospital/Referral Unit Four medical specialists
for 4 PHCs with Specialized supported by 21 paramedical and
80,000 persons in hilly area services other staff
Present Status- India
ITEMS Status
SUB CENTRES 158417
PHCs 25743
CHCs 5624
Total No. of Hospital Beds 7,39,024
Source: Rural Health Survey 2018
Present Status- Bihar
Task for all of you..
Problems of Primary Health Care
Healthcare is the right of every individual but
lack of quality infrastructure, dearth of
qualified medical functionaries, and non-
access to basic medicines and medical
facilities thwarts its reach to 60% of
population in India.
A majority of 700 million people lives in rural
areas where the condition of medical facilities
is deplorable.
Problem of Access: Physical reach is one of
the basic determinants of access, defined as “
the ability to enter a healthcare facility within
5 km from the place of residence or work”
(Munjanja, et al. , 2012).
A study in 2012 found that in rural areas, only
37% of people were able to access in-patient
facilities within a 5 km distance, and 68%
were able to access out-patient facilities
Humanpower crisis in healthcare:
A 2011 study estimated that India has roughly 20
health workers per 10,000 population, with
allopathic doctors comprising 31% of the
workforce, nurses and midwives 30%,
pharmacists 11%, AYUSH practitioners 9%, and
others 9%. (Rao, et al. 2002)
According to the rural health statistics of the
Government of India (2015), about 10.4% of the
sanctioned posts of auxiliary nurse midwives are
vacant, which rises to 40.7% of the posts of male
health workers. Twenty-seven percentage of
doctor posts at PHCs were vacant, which is more
than a quarter of the sanctioned posts.
The health landscape of India is dominated
by private players. 92 percent of health care
visits are to private providers of which 70
percent is urban population. However, private
health care is expensive, often unregulated
and variable in quality. Besides being
unreliable for the illiterate, it is also
unaffordable by low income rural folks.
Schemes
National Rural Health Mission
Launched in 2005, to provide accessible, affordable and
quality health care to the rural population
The thrust of the mission is on establishing a fully
functional, community owned, decentralized health
delivery system with inter-sectoral convergence at all
levels, to ensure simultaneous action on a wide range of
determinants of health such as water, sanitation,
education, nutrition, social and gender equality.
NRHM focuses on strategies for improving maternal and
child health through a continuum of care and the life cycle
approach. It recognises the inextricable linkages between
adolescent health, family planning, maternal health and
child survival. Moreover, the linking of community and
facility-based care and strengthening referrals between
various levels of health care system to create a continuous
care pathway is also there.
Role of Technology
GRAM VAANI
building a quality-of-care checklist for expectant
mothers (and their families) to answer using
mobile phones and rate on factors such as
whether they were treated with respect during
the delivery, whether they got entitlement for
institutional delivery, whether the transportation
provided was of good quality, etc.
Further info: [Link]
Working Model of Gram Vaani
