Facts about UP healthcare

Uttar Pradesh has a large public as well as private healthcare infrastructure, but the performance of the state on various health parameters is not encouraging. Although an extensive infrastructural network of Medical and Health services in the government as well as private sectors has been created over the years, the available health infrastructure is inadequate to meet the demand for health services in the state. In 15 years to 2012–13, the population of Uttar Pradesh increased by more than 25 per cent. However, the public health centres, which are the frontline of the government’s health care system, decreased by 8 per cent. Smaller sub-centres, the first point of public contact, increased by no more than 2 per cent over the 25 years to 2015, a period when the population grew by more than 51 per cent.

A newborn in Uttar Pradesh is expected to live four years fewer than in the neighboring state of Bihar, five years fewer than in Haryana and seven years fewer than in Himachal Pradesh. Uttar Pradesh contributed to the largest share of almost all communicable and noncommunicable disease deaths, including 48 per cent of all typhoid deaths (2014); 17 per cent of cancer deaths and 18 per cent of tuberculosis deaths (2015). After Assam, Uttar Pradesh has India’s second-highest maternal mortality rate, 285 maternal deaths for every 100,000 live births (2013), with 62 percent of pregnant women unable to access minimum ante-natal care.

Around 42 per cent of pregnant women, more than 1.5 million, deliver babies at home. About two-thirds (61 per cent) of childbirths at home in Uttar Pradesh are unsafe.State has the highest child mortality indicators, from the neonatal mortality rate (NNMR) to the under-five mortality rate of 64 children who die per 1,000 live births before five years of age, 35 die within a month of birth, and 50 do not complete a year of life. A third of the rural population in the state has been deprived of primary healthcare infrastructure, according to the norms of the Indian Public Health Standards.

 What need to be done ?

While the conventional reforms like increasing expenditure, strengthening public health systems, strengthening health regulation etc. are indispensable, some areas of reforms which haven’t been given adequate attention but are important and can be game-changer:

• Shift to Preventive healthcare : India’s health system continue to be guided by curative healthcare. There is a need to shift to preventive healthcare which is more inclusive, cheaper and offers a better life experience.
• Change in conception of Health : There is a need to view health not as absence of illness but a state of well being. There is a need to shift from hospital-centred model of health.Thus, the value system needs to be re-oriented to inculcate importance of sports, right surroundings, right food, right sleep etc.
• Women as agency of health : One of the major ways of reforming healthcare has been through agency of Women. Amartya Sen in his capability approach has highlighted how Women empowerment has led to significant improvements in fertility rates, IMR and MMR. Use of technology :Information Technology can be a huge game changer in healthcare sector. New technologies like Big Data, Artificial Intelligence and Machine Learning can enable to strengthen and enhance the reach healthcare delivery. States like Odisha, Chhattisgarh etc. are now using telemedicine for strengthening healthcare delivery. India needs to put more emphasis in research and innovation especially in biotechnology which can enable the healthcare to be more affordable, available and accessible.
• Use of SHGs, PRI and Strengthening of ANMs, ASHAs: There is a need to develop decentralized institutions like SHGs, PRIs for delivering health.Apart from that The ASHA, the Dai with traditional skills and modern hygiene, the re-skilled ANM and the ICDS workers, should be trained together to form a multi-skilled team at the village level.
• Rejuvenating our indigenous systems :While there has been an increasing focus on Yoga and AYUSH, the supporting and regulatory systems for the policy initiatives continue to remain weak. There is also need for further research into these systems to make them in-line with needs of today.For e.g. Recent studies have shown the use of turmeric in fighting cancer and depression.
• Learning from other successful models/examples : Countries like Bangladesh, Thailand, Performance-based financing in Rwanda have developed successful healthcare model. Even within India, states like Kerala, Karnataka, Andhra Pradesh etc. have developed successful healthcare model.These models be replicated and moulded to the needs and requirements of the health sector in India

This can help improve the health condition in Uttar Pradesh.