Health Sector Challenges
HEALTH SECTOR CHALLENGES
Spread of Dengue and Negligence of Authorities
- More than 15 years ago, when dengue first showed up in a virulent form in Delhi and claimed many lives, a slew of prevention and control measures were discussed, debated and even implemented.
- But we have short memories and it takes very little to push people back into old behaviour patterns that time and again cause the same epidemics.This is really a behaviour issue, whether of the beneficiary of the health and civic system, or the providers of the same.
Apathy of Health care Providers
- The refusal by medical facilities to admit critically ill patients is also a behavioural issue, not supported by guidelines and protocol.
- More than a quarter of a century ago, in 1989, through the case of Parmanand Katara Vs the Union of India , the Supreme Court passed a landmark judgment that
“No medical facility can refuse or turn away any critically ill or emergency patient, on any grounds.”
It unambiguously stated that such refusal would be viewed as a violation of the right to health, enshrined within Article 21 of the Constitution that guarantees the right to life and liberty.
It is the state’s obligation to preserve life and provide timely medical treatment, overriding the professional freedom to refuse a patient.
“Every doctor, whether at a government hospital or otherwise, has the professional obligation to extend his services with due expertise for protecting life”.
But still many a times, people die due to lack of medical infrastructure.
- The Indian health care system needs simple, managerial reform that can no longer be denied to the people.
For example, how a first-point-of-contact institution, whether private or public, a small clinic or a large hospital, responds when a person is brought in clinical distress is critical.
Equally crucial is monitoring the quality and robustness of that response.
Neighbouring Sri Lanka, always known for its progressive and highly successful public health services and initiatives, has seen enormous success with its anti-malaria campaign despite nearly three decades of separatist unrest and war and is considered malaria-free because of enormous efforts focussed on the health system, communities, human resources and various other aspects of a public infrastructure.
- Meanwhile, is it difficult for ordinary people to challenge and question the kind of medical attention they receive at the best of times.
- The regulation of medical practice is a fraught issue and has been so for years.
- Although the Consumer Protection Act is applicable to health services, and there is now the Clinical Establishments (Registration and Regulation) Act of 2010– — the need to access emergency health care is always of such urgency, and characterised by extreme emotional upheaval, that human vulnerability takes over.
- Also, medical care is highly technical and skilled, making greater the vulnerability of those in distress.
Behavioural Change in People
Health behavior change refers to the motivational, volitional, and actional processes of abandoning such health-compromising behaviors in favor of adopting and maintaining health-enhancing behaviors.
Behavior change programs, which have evolved over time, encompass a broad range of activities and approaches, which focus on the individual, community, and environmental influences on behavior.
- Behavior change is a central objective in public health interventions,with an increased focus on prevention prior to onset of disease.
- This is particularly important in low and middle income countries, where efficiency of health spending and costs and benefits of health interventions has come under increased scrutiny in recent decades.
- Many health conditions are caused by risk behaviors, such as problem drinking, substance use, smoking, reckless driving, overeating, or unprotected sexual intercourse.
- The key question in health behavior research is how to predict and modify the adoption and maintenance of health behaviors.
- Fortunately, human beings have, in principle, control over their conduct. Health-compromising behaviors can be eliminated by self-regulatory efforts, and health-enhancing behaviors can be adopted instead, such as
Preventing Reproduction of Disease Vector and pathogen
Cooperative efforts among managed care organizations, health-care facilities, state and local health departments, and Health Ministry will improve treatment and prevention of infectious diseases.
Community-based demonstration programs will help identify cost-effective approaches to addressing emerging infectious disease problems.