Health Care in Developing Countries-Need For Finance, Education or Both?
Health Care in Developing Countries-Need For Finance, Education or Both?
Health Care in Developing Countries-Need For Finance, Education or Both?
Thomas
Health care in developing countries- Need for finance, education or both? Varghese Thomas
Editor in Chief, Calicut Medical Journal ________________________________________________________________________________ Freedom of speech, freedom of movement, freedom to work and the right to enjoy a healthy life are enshrined in the constitutions of most of the countries as fundamental rights of its citizens. However this freedom does not always guarantee enjoyment of good health for the poor citizens of many countries including India. The developed countries have in place many systems by which health care is provided to their needy citizens. It may be state owned health care delivery as in the case of NHS in UK or managed care services offered by health insurance firms as in the US. These systems, though it may have distinct disadvantages, serve to cater to the health needs of their people to a reasonable extent. It may be noted that even developed countries are shying away from supporting health care delivery by public sector. In many developing nations health care is provided jointly by the government and the private sector. Public health institutions are the only hope for the underprivileged people. Most of the developing nations are plagued by problems of under nutrition and a host of infections. Epidemics of diarrhoeal diseases provide a rough guide to the poor sanitation of the community. Safe drinking water is a dream for millions even now. We have a couple of national level institutions offering post graduate education and reasonable patient care. The services of these hospitals are however not within the reach of the massive majority of Indians living in rural areas. The private sector is obviously interested only in curative medicine and these hospitals and clinics are necessarily run with a profit motive except for a handful of institutions run by charitable institutions. We cannot blame them as it is not their responsibility to provide free health care to poor people. The government pumps in money to keep the system afloat, but the services rendered to people are generally abysmally poor especially in a rural setting. Many programmes aimed at the prevention of communicable disease are run in under developed countries with the help of the WHO. Even these programmes have not had the desired effect due to faulty implementation. It is revealing to note that the custodian of world health has started disbelieving cooked up reports of programme implementation by corrupt officials and has instead started on site status checking by their own independent teams. The reasons for the failure of these national health programmes are multifactorial. The most important among these are the lackadaisical approach by the government officials involved in implementing the programmes. Apart from the half hearted involvement of government in these programmes, the money gets diverted to construction of buildings, purchase of vehicles and equipments. Very often the beneficiaries receive less than 1% worth of what is envisaged in the programme. Who is to blame? Everyone involved in the programme implementation in this chain from the top to bottom is responsible for this sorry state of affairs. The rural people, who are the beneficiaries, should change their role from meek passive observer status beneficiaries into active decision makers in the planning and implementation of the programmes in their locality. Major strategies regarding fund
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V.Thomas
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