Community  Empowerment
Community Empowerment
March 2, 2016 by Dr.C. Srinivasa Raju


You all know, health care is different from public health. Preventive measures like health awareness, health education, ideal delivery of safe potable water and sanitation and vaccination are major initiatives comes under the heading of public health. Public or community health, otherwise called as wellness- physical, mental and social wellness-depending on per capita income, purchasing capacity and equality across the gender, caste & creed.


Unless and until community participation has been materialized, no government health program will get sustainable success. It needs that the people especially rural folk should have whole hearted faith over the importance of community health which could lead to good happy & healthy nation. Simple healthy & hygienic habits can be inculcated in the minds of citizens since childhood, which is possible only by health conscious parents especially mother and the teachers. Strengthening the hands and minds of women is the need of the hour. Here we have to empower the women- emotionally, economically and with right information @ right time.


These above measures shall be taken by government either on its own or in a PPP mode. The financial allocation towards public health should be raised to meet the needs. Mere allocation is not enough unless good monitoring and accountability is injected in to the system. VENEJULA and SRI LANKA are faring better in all health parameters even with lesser allocations.


More Indians are emptying their pockets to buy health. Most of our patients pay 70% of their hospital Bills with straight up cash from the pockets. The need of the hour is cashless health care facility to all with certain riders and ceiling. 


Along with life-style diseases like metabolic syndrome, CAD, malignancy & stroke, HIV & T.B., Malaria & other vector borne diseases are attacking  hand in hand to sap our health and crippling our economy.


We are producing 50,000 graduate doctors in modern medicine and another 30,000 AYUSH graduates and 25,000 dentists annually. We have 6 lakh villages and 600 districts, which ideally should have 6 lakh sub-centers and 40,000 PHCs and 20,000 CHCs and 600 district hospitals. Sub-centers should have one AYUSH and one Modern doctor. Every PHC should have one dentist, two modern doctors, one AYUSH doctor backed with paramedics & nursing staff. Every PHC should be equipped with mini operation theater, blood transfusion facility and X-ray & Uscan.


For everything we cannot compare with developed nations like USA & UK. For every problem no need to look towards WHO guide lines and norms. Luckily, our country has abundance of knowledge. We have to channel it in right direction for which we need better leaders in the front. We have to instill better practices in to our human resources. Our country has been galloping with technocrats and newer technologies since 2 decades, which has been facilitating tremendous achievements in all spheres of life.


Recent advances in genome study, proteomics, bio informatics paving the way to personal medicine. Stem cell and cloning gives us new breath of life. Robotics and minimally invasive surgeries turning our hospitals as day care centers and reducing the cost for patients and for hospital owners. Nowadays with newer technologies, we do not  need enormous number of hospital beds as per the stipulated norms of old school like bore committee and WHO.


We have to chisel our own formulas to suit the demography and mind set of our country. WE HAVE TO GIVE UTMOST IMPORTANCE TO CLEANLINESS. Swachh bharat is one good policy.  If we make it implemented whole heartedly throughout the country, India could become temple of health. Even though they have knowledge, our people still not consuming proper balanced food. Even though they know the bad repercussions of tobacco & alcohol consumption, still sizable population do not heed to the healthy advises. Superstitions, gender discrimination and social outreach still haunting our populace especially rural folk. Road connectivity, electricity and availability of doctors are sourly lacking at the rural and tribal fronts.


If Indian women are well informed and if they believe what they learn, the days are not faraway that our country blooms in pink of health in no time. We have sufficient food production. We have enough supply of medicines though some life savers are out of reach for aam admi… 
What we lack is confidence and sense of belongingness. 
What we lack is application. 
What we need is presence of mind.
What we need is action’, not reaction.


Complacency, ignorance and laziness in community is a major daunting challenge we have to overcome! Fraudulence and corruption in the system is another big challenge. Misinformed leaders and mis-prioritized policies are the result of insufficient data analysis and political compulsions. We can adapt information technology and make digitization of our care. Tele-medicine, propagating health care apps, seamless real time evaluation of electronic medical records are few of the newer methods we can utilize to address the vast demography and varied geography of our country. Health insurance is another measure that the government can initiate to cover all 25 crore households. IRDA should allow or empanel all clinics and small hospitals to participate in health insurance to provide out-patient care and day care. The insurance companies should stop categorization of hospitals on the basis of mere bed strength. 


In these technology driven days, what we should look for in a health care establishment is- "good number of doctors, nurses, paramedics and better equipment with needy supportive set-up". Once the government & insurance companies make universal health insurance a reality and empanel all clinics & hospitals then we can overcome the major daunting challenge i.e. urban-rural divide..


Today our total budget valued at just Rs.20 lakh crore, whereas USA's is Rs.150 lakh crore. Of this 20 lakh crores, the government allocating just 33,000 crores towards health care and public health. You all know, in any government department, the major over head of expenditure goes to employees of that respective department. So it is not a wonder that 50% of allocated budget i.e. Rs. 16,000 crores goes to salary bill. So, with remaining 16,000 crores what we could achieve? For your information, out of this 16,000 crores, only 40% is going for primary care!


So, it is imperative, that we have to depend on our communities. For this, we have to empower our communities, especially women & children.



DR.C. Srinivasa Raju, MBBS, DLO.
Chairman - Hospital Board of India - IMA AP STATE.
National Director- HBI- IMA H.Q.
Chairman- IT wing & Editor- IMA AP news.

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