While representation of women seems to be a very real goal of the Congress party’s agenda, one cannot help but wonder where women’s health takes up position? Those, who listened closely to the UPA Government’s Common Minimum Programme (CMP) for improving health of India’s population through the National Rural Health Mission (NRHM), may have realised it doesn’t put forth or promise much. Of its three or four promises (raise the public expenditure on health, increase investment in the control of communicable diseases, improve the availability of life-saving drugs at a reasonable cost), the one that is least likely to deliver any results is the ensuring of health care for the poor through a national health insurance scheme.

First off, rural areas in India do have hospitals, they do have Community and Primary Health Centers (CHS and PHC respectively), they do have Accredited Social Health Activists (ASHAs), they do have Anganwadi workers (villagers themselves who are trained to be of medical assistance), they do have an Auxillary Nurse Midwife (ANM), and the likes. But the problem is all of these are hardly ever in the same place, they are hardly ever all there at the same time and they are hardly ever functioning at optimum capacity.

So, where can this disconnect possibly be? It’s mainly in the effective distribution of health care services at the collective, rural and community level. Like a lot of India’s programmes that lay emphasis on the rural health worker/officer, the good ideas don’t always percolate till the bottom as the planning, monitoring and service delivery tend to get garbled along the way.

Setting up health centers is only one small part of the whole health care aim. It’s very important for supplies (medicine, vaccination, medical apparatus etc) to reach their destination and for doctors to be around at their station.

A lack of doctors is a direct pointer at the abysmal salaries paid to them – and it’s only fair to demand a healthy sum of money from the government, given that their city counterparts are raking in the monies.
 
The most important aspect of a functioning health care system is accessibility. Most health care-related deaths occur due to the long proximity of the health care center or hospital from the village. Lack of transportation makes covering these distances troublesome, or impossible, especially during an emergency. And services must be available at the sub-center or village, as this would cause less death, mainly infant and mother deaths, or deaths related to pregnancy and childbirth.

Perhaps local ownership is the answer. But how about giving community ownership a chance? If well-to-do, responsible citizens from the cities got together, collected money in way of donations, got sponsorships from corporates, tied up with pharmaceutical companies, and set-up health care centers with equipment and doctors, the chances of corruption would be lowered, transparency would stand a better and accountability would be priority.

But for an idea like this one to take shape, or make it to fruition, people need to care enough and want to proactively help India progress towards a better future. With a country the size of ours, the government can use a little citizen help.