What the people focussed on

With three themes being taken up during the collection of ‘ Voices from the field’, on the first ‘Health care access and concerns of human resources’, the people had focused on:

The distance to hospitals Difficulty in accessing specialized care

Difficulty in getting to hospitals at night/off-peak hours – particularly due to distance and problems such as wild elephants being on the road after dark

Inability to access the full spectrum of care Not having adequate staff – doctors, nurses and others Continuity of care as the doctor turnover was high Smaller hospitals not being managed well

On the second theme ‘Out-ofpocket payments for health’, they had said: Considerable Out-Of-Pocket Expenses (OOPEs) when seeking healthcare

Not having services led patients to seek out city/large hospitals and mostly the large channelling centres and private hospitals in the city. These provide specialized care and other services at a cost. Some medicines not being available at the smaller hospitals

The smallest hospitals (Primary Medical Care Units – PMCUs) not having laboratory services and Divisional Hospitals having limited capacity for investigations Specialized investigations, surgeries and cancer care among the high spenders People taking village loans at high interest to cover these costs Some of them not taking treatment due to the cost

On the third theme ‘Health education and promotion including behaviour change’, they had said:

People are not “health” literate Bad/adverse behaviours seen in society. These are making the people sick. It is obvious that lifestyle modifications are needed

There are so many economic determinants of health and many influences, including advertising and that of tobacco and alcohol