Health is a matter of socio-economic concern. India is a developing nation, which started off health programmes at the national level, but failed to eradicate mass health issues and reduce maternal and infant moartality rates. Series of initiatives taken by the state and central government has failed to make a significant impact on the existing health care system and improve the status of the rural population.

Government of India set up the Bhore committee in 1946 to investigate and recommend improvements to the Indian Public Health system. In 1952, it was suggested that the government should set up Primary health centers in order to expand the reach of basic health care facilities to general public. India was the first country to launch a national programme emphasizing family planning to stabilize the population at a level consistent with the requirement of the economy.  Following the Bhore committee, there were numerous such committees and programs, like the National Health policy(1982), Universal Immunization Programme (1985), etc, that were set up to address the rising need for adequate health care facilities.

Finally, the National Rural Health Mission (NRHM) was launched by the GOI in 2005.

The 12^th five year plan(2012-2017) proposes to expand the NRHM into National Health Mission (NHM) to include the vulnerable urban poor who are mainly migrants from the rural areas; health being the foremost priority of the 12^th year plan.

At present, public financing of health is only 1.05% of GDP. Although the government has chosen to further increase it to 2.5% of GDP.

In totality, the public and private investment in health in India has not been able to reduce the spread of health issues faced by the rural and urban poor. Public and private investments in health have still not been able to bridge the gap between demand and supply of health care facilities. India’s public spending on health is still among the lowest in the world. Currently, the opportunity cost of seeking medical care from the government sector is high, even for the poor, with 60-70% of the poor seeking care from the private sector and spending disproportionately on health care.

As mentioned earlier, the NRHM’s aim has been to improve the health care facilities provided for the rural population. The health care infrastructure has been developed as a three tier system to support the cause of NRHM

While panchayats are required to administer, manage and finance PHCs, it is the latter who are expected to offer an efficient need-based service to the rural community.

Besides the government, the panchayats have an equally important role to play towards the success of PHCs. However, the objective of NRHM has still not been served.

NRHM was launched with the aim to provide accessible and affordable health services to the poor households in remote areas, but the government has had very little success in achieving its goal to establish a fully functional health care system that could serve every individual in India.

Rural areas lack socio-economic development and have poor infrastructure and communication facilities. Despite the fact that a large proportion of resources have been deployed for the health and medical care in urban areas, the population living in urban slums and rural regions are still largely neglected.

Malnutrition, infant mortality rate and maternal mortality rate, diseases and epidemics,  poor sanitation and inadequate safe drinking water are some of the  problems that ails modern India. India tops in rate of maternal deaths worldwide. Infant mortality rate has come down by 3 points in the last 4 years (to 44 deaths per 1000), but still records one of the highest rates worldwide.

It is imperative that these issues be tackled with immediate effect, as the rise in these cases can affect the Indian economy and can hinder India’s growth.

Obstacles –

While the government has adopted various strategies and policies to eradicate diseases and create mass awareness;

• High absenteeism
• low quality of health care facilities
• poor infrastructure and communication (transportation) facilities
• unhygienic environment
• lack of awareness and affordability
• rampant corruption eating away at the funds available and playing power games are some of the basic obstacles faced by the public health system in India.

It is essential for the government to take up a wholesome view to resolve hurdles faced in implementing policies to support better health care facilities.

Necessary measures –

• District hospitals should be linked to medical and nursing colleges, in addition to increasing the reach of primary health centers
• Essential drugs and control to communicable diseases should be provided free of cost at all public health facilities
• Immediate attention needs to be given to the sanitation facilities; with majority of the rural population not having access to proper sanitation
• Improve infrastructure facilities: be it transportation or communication: that can assist the poor and make medical facilities more accessible
• Create awareness on basic sanitary measures

Every Indian citizen has the right to adequate health care facilities. Investing in public health today, is investing in India’s prosperity tomorrow.