Madhya Pradesh Status in Health - An Overview

Madhya Pradesh Status in Health - An Overview :

Madhya Pradesh is continuously releasing news related to mother and child mortality. Health surveys conducted by various organizations are also proving poor health status of the State. Now disaster of malaria, dengue is also being faced. Government Hospitals of the State are failed in improving health of children, women and people of all category. Why is it that the image that leaps to the mind when the words ‘government hospital’ are mentioned is of a filthy and foul smelling centre where ill-mannered behaviour of staff and corruption are the norm.

Around 80% of births now take place in hospitals or health centres in Madhya Pradesh. But 54% of the posts for women’s health specialists currently lie vacant and around 5,000 women continue to die every year of birth-related complications. Death is the final episode. But even if women do not die they are dogged by birth-related problems throughout their lives.

Madhya Pradesh today tops the country with its dismal infant mortality record. For every 1,000 live births, as many as 67 infants die before they reach the age of 12 months. The problem is obvious and evident. Everyone understands it and even at the political level there is wide acceptance that the state faces serious challenges in maternal and infant healthcare. If the situation is to be improved it is crucially important to revitalize and strengthen the healthcare system. The high maternal and infant mortality rates have called into question our development policies and high-sounding claims.

There is an intimate link between health indicators, the government’s intent and the distribution of the required resources. If quality health services are not free to the people the health indicators of the state would be dismal. It would certainly seem so because the system can never be changed without active state intervention. According to the guidelines set by a high-level expert group, Madhya Pradesh should spent Rs1,500 per capita per year at 2008-09 prices on health under the National Rural Health Mission, but the actual expenditure was a meagre Rs352. That left Rs1,148 unspent.

Currently, the per capita health spend is the lowest in Madhya Pradesh. Kerala spends Rs1,061, Tamil Nadu Rs1,104, Maharashtra Rs1,355 and Haryana Rs1,226. Against the standard annual per capita health expenditure of Rs2,000 for special category states, Arunachal Pradesh spends Rs3,563, Goa Rs3,148, Mizoram Rs4,500 and Sikkim Rs3,049.  The state health infrastructure and human resources do not measure up against the standard guidelines (National Health Mission, 2015).

Access to and affordability of care are challenges for Madhya Pradesh. The seventy first round of the National Sample Survey found that the average out of pocket hospital expenditure in Madhya Pradesh of 24,085 Indian rupees (approximately 360 US dollars) is higher than the national average of eighteen thousand Indian rupees (approximately 268 dollars). These expenditures in Madhya Pradesh are also higher than they are in states where care is dominated by the private sector, such as Andhra Pradesh, Tamil Nadu, and Karnataka, and most of the country. Out of pocket expenditures are higher in Madhya Pradesh despite a nearly equal balance between public and private facilities (NSSO, 2014).

The Planning Commission itself admits that the privatisation of health services is one of the main reasons for the indebtedness of the poor. But it is the agency that is stopping health from being declared a basic right. This is the biggest challenge – that the government becomes accountable.