MODICARE FACES RURAL HURDLE

The acute shortage of qualified medical professionals in rural India may affect the relaunch of 150,000 health sub-centres and primary health centres (PHCs) as “health and wellness centres” under the Ayushman Bharat Yojana

A less known part of the health insurance programme, also called Modicare, comprise health and wellness centres that will have a critical role in controlling the growing burden of non-communicable diseases in India. They will also offer maternal and child health services.

The problem is that sub-centres are short of staff while PHCs do not have enough doctors. Of the 156,231 subcentres in India, 78,569 were without male health workers, 6,371 without auxiliary nurse midwives and 4,263 without either, stated the Rural Health Statistics, 2017.

PHCs require 25,650 doctors across India to tend to a minimum of 40 patients per doctor per day for outpatient care, as per the Indian Public Health Standards. If these standards are met, 1 million patients could be benefit everyday. But with a shortage of 3,027 doctors, 1,974 PHCs are without doctors. This means 12 per cent, or 121,080 patients, go without access to primary health care everyday.

Health care in villages is a threetiered structure under the National Rural Health Mission — sub-centres, PHCs and community health centres (CHCs).

Sub-centres are at the forefront, covering 5,000 people in the plains and 3,000 in hill or tribal areas. PHCs are equally important for the Ayushman Bharat Yojana to succeed because they are the first link to a consultation with a doctor and act as referral points for specialist consultations at CHCs.

This is not the only problem. Perception of the services provided at these centres tells its own story. Unless acted upon, Modicare cannot succeed.