Times of India
1 April 2010
By Umesh Isalkar
Pune, India

‘Poor quality of care’ and ‘no facility nearby’ are primary reasons for most rural households not preferring government hospitals in Maharashtra.

The public health department’s report on ‘health status of Maharashtra for 2009’ says that approximately 70.3 per cent people living in villages do not use government health facilities largely owing to these two factors.

“The percentage is much higher as compared to the national average (65.6%), and also when likened to states like Tamil Nadu and Kerala,” said Prakash Doke, executive director of the State Health Resource Centre (SHSRC), on Monday.

The SHSRC is an initiative of the public health department, established to provide technical support to the government health sector. Besides its own data, the findings of the report by the SHSRC were mainly based on the National Family Health Survey’s study on utilisation of public health services carried out in 1,016 randomly selected villages, connected to primary health centres and rural hospitals across the state.

On why such a drift from government hospitals, Doke said, “In some settings, private practitioners are perceived to be better because they include injections as part of every treatment, and are willing to visit home. In contrast, government services are not popular because of long waiting periods, arrogance on part of staff and non–availability of medicines. To get good and timely treatment, villagers don’t mind incurring ‘out of pocket’ expenditure.”

In the absence of a robust statefunded health infrastructure providing free care, citizens have no option but to seek private help. As a result, we have a burgeoning private health care sector, unregulated and often exploitative, said Abhay Shukla, co–ordinator of SATHI and one of the editors of the report.

Director of Health Services D S Dakhure said, “The state health department has been trying to improve health facilities in rural parts of state with the help of National Rural Health Mission (NRHM). Under the scheme, every village will have a health and nutrition committee. The state government is also giving Rs 10,000 to each village under the patient welfare fund.”

Efforts are on to clear the blacklog of health institutions and create new facilities as per the needs of villages. Efforts are also underway to upgrade health institutions in a phased manner to the Indian Public Health Standards (IPHS) that guarantee services of a high quality, he added.