Rural Health System in India: A Review

Abstract

Rural Health is one of vital elements of rural life. India being a nation of villages requires an intensive approach towards rural health. Nearly 75 per cent of health infrastructure and other health resources are concentrated in urban areas. Even if several government programmes for growth of rural healthcare have been initiated, the procedural delay in implementation leads to its ineffectiveness. Rural areas have been infected with various contagious diseases like diarrhea, amoebiasis, typhoid, infectious hepatitis, worm infestations, measles, malaria, tuberculosis, whooping cough, respiratory infections, pneumonia and reproductive tract infections. The insanitary conditions of households aggravate expansion of these diseases which is further promoted by apathy of people and government. Although unit level institution under rural healthcare takes care of sanitation through its outreach services yet, there is a long milestone to upgrade our health scenario. Rural Health Care services in India are mainly based on Primary health care, which envisages attainment of healthy status for all. The Primary Health Centre (PHC) has been stated to be prime location for diagnosis and first referral of these patients. The coordination between primary and tertiary level institutions needs to be strengthened for overcoming present challenges. Methodology: This article is a review paper based on analysis of data collected through secondary sources like books, journal articles, government records, NGO reports. The current paper seeks to pinpoint key challenges of rural health system and possible strategies taken by the state for overcoming them.

National Institute of Rural Health for India: Need of the Hour

“…This imbalance is even more (three times) when we consider allopathic doctors (13.3 in urban areas versus 3.9 in rural areas), nurses and midwifes (15.9 in urban areas versus 4.1 in rural areas) and AYUSH practitioners (3.6 in urban areas versus 1.0 in rural areas) per 10,000 population. 8 The ratio of urban density to rural density for doctors, nurses & midwives and dentists was 3.8, 4.0 and 9.9, 10 which is highly skewed towards urban areas. In addition, rural primary level health institutions like Community Health Centres (CHC), Primary Health Centres (PHC) and Sub-Centre (SC) having HRH face a problem of absenteeism by them.…”

“…These factors promote several communicable, parasitic and respiratory diseases in rural areas. 8 Further, the emergence & re-emergence of communicable and non-communicable diseases combined with the uninhibited mobility has made the situation worrisome and expanded the realm of diseases/ health conditions to be addressed in rural areas.…”

“…Belief/ Superstition: In a comparative study to assess the difference of superstition in rural and urban area it was found that the same was more prevalent in people of rural areas than in urban areas. 8 In the rural area especially in tribal population of India beliefs that magic can cure the diseases are still persisting. This belief led to various superstitions and hinder the progression of modern medicine in rural areas.…”

“…Dehydration, heat exhaustion, heat cramps, heat stroke, skin cancer caused by weather/ climate • Respiratory hazards such as excessive cough, congestion, exaggeration in the symptoms of chronic bronchitis, COPD, Organic Dust Toxic Syndrome (ODTS), occupational asthma etc • Fatalities or injuries due to bites and stings caused by animal, snakes and insects • Injuries including cuts to deaths, hearing impairment caused by sharp tools and loud farm machinery • Several types of musculoskeletal disorders caused by excessive physical labour and loads lifting • Acute poisonings and chronic effects in the form of , health workers especially the doctors refrain from services in the rural areas 8. …”

Mobile for Mothers mHealth Intervention to Augment Maternal Health Awareness and Behavior of Pregnant Women in Tribal Societies: Randomized Quasi-Controlled Study

“…Maternal mortality remains a serious health issue for India, and the problem for deprived parts of the population is worse. Government bodies have taken several initiatives [ 1 ], but disparities in maternal health services, provision of maternal care, and health outcomes have been noticeable across India’s socioeconomic gradient [ 2 - 4 ]. For example, in Kerala, the maternal mortality rate was as low as 61 per 100,000 live births in 2013, whereas in the northern states of Bihar and Jharkhand, it was 208 per 100,000 live births [ 5 ].…”