Role Of The Government In Healthin Healthin Health
CHAPTER2Role of theGovernmentin HealthIn a democracy people expect thegovernment to work for their welfare. Thiscould be through the provision ofeducation, health, employment, housingor the development of roads, electricityetc. In this chapter we shall examine themeanings and problems related to health.Look at the sub-headings of this chapter.In what ways do you think this topic isrelated to the work of government?2015-16 (12-01-15)
What is health?We can think of health in many ways. Health meansour ability to remain free of illness and injuries. Buthealth isn’t only about disease. You may haveassociated only some of the situations in the abovecollage with health. What we often ignore is the factthat each of the above situations is related to health.Apart from disease, we need to think of other factorsthat affect our health. For example, if people get cleandrinking water or a pollution free environment theyare likely to be healthy. On the other hand, if peopledo not get adequate food to eat or have to live incramped conditions, they will be prone to illness.All of us would like to be active and in good spiritsin whatever we may be doing. It isn’t healthy to bedull, inactive, anxious or scared for long stretches oftime. We all need to be without mental strain. All ofthese various aspects of our lives are a part of health.Would you associate all or some ofthese pictures with ‘health’ ? Inwhat ways? Discuss in groups.Pick two situations from the abovecollage that are not related toillness and write two sentences onhow they are related to health.Chapter 2: Role of the Government in Health2015-16 (12-01-15)19
Healthcare in IndiaCan you provide a title to thesecolumns?Let us examine some of the aspects of healthcare inIndia. Compare and contrast the situation expressedin the first and second columns.India has the largest number of medicalcolleges in the world and is among thelargest producers of doctors.Approximately15,000 new doctors qualifyevery year.Most doctors settle in urban areas.People in rural areas have to travel longdistances to reach a doctor. The numberof doctors with respect to the population ismuch less in rural areas.Healthcare facilities have grownsubstantially over the years. In 1950,there were only 2,717 hospitals in India.In 1991, there were 11,174 hospitals. In2000, the number grew to 18,218.About five lakh people die from tuberculosisevery year. This number is almostunchanged since Independence!Almost two million cases of malaria arereported every year and this number isn’tdecreasing.India gets a large number of medicaltourists from many countries. They comefor treatment in some of the hospitals inIndia that compare with the best in the world.We are not able to provide clean drinkingwater to all. 21per cent of allcommunicable diseases are water borne.For example, diarrhoea, worms, hepatitis, etc.India is the fourth largest producer ofmedicines in the world and is also a largeexporter of medicines.Half of all children in India do notget adequate food to eat and areundernourished.In India, it is often said that weare unable to provide healthservices for all because thegovernment does not have enoughmoney and facilities. After readingthe above left hand column, doyou think this is true? Discuss.In order to prevent and treat illnesses we needappropriate healthcare facilities such as healthcentres, hospitals, laboratories for testing,ambulance services, blood banks, etc., that canprovide the required care and services that patientsneed. In order to run such facilities we need healthworkers, nurses, qualified doctors and other healthprofessionals who can advice, diagnose and treatillnesses. We also need the medicines and equipmentthat are necessary for treating patients. Thesefacilities are required to take care of us.20 Social and Political Life2015-16 (12-01-15)
India has a large number of doctors, clinics andhospitals. The country also has considerableexperience and knowledge in running a publichealthcare system. This is a system of hospitals andhealth centres run by the government. It has theability to look after the health of a large section of itspopulation scattered over hundreds of thousands ofvillages. We will go into more detail on this later.Moreover, there has been a phenomenaladvancement in medical sciences whereby many newtechnologies and treatment procedures are availablein the country.However, the second column points out how poorthe health situation in our country is. With all theabove positive developments we are not able toprovide proper healthcare facilities to people. This isthe paradox – something that is contrary to what wewould expect. Our country has the money, knowledgeand people with experience but cannot make thenecessary healthcare available to all. In this chapter,we will look at some of the reasons for this.Patients usually have to wait in longqueues in public hospitals, like this one.The story of Hakim SheikHakim Sheik was a member of the Paschim Banga Khet Mazdoor Samity (PBKMS), an organisationof agricultural labourers in West Bengal. One evening in 1992, he accidentally fell off a runningtrain and suffered head injuries. He was in a very serious condition and needed immediatetreatment.He was taken to a government hospital in Kolkata but they refused to admit him because theydid not have a spare bed. Another hospital did not have the facility or the specialised doctorsnecessary for his treatment. In this way he spent 14 hours in a critical state and was taken toeight different government hospitals, but none of them admitted him.Finally, he was admitted in a private hospital, where he received treatment. He spent a lot ofmoney on his treatment. Angry and upset over the indifferent attitude of all the hospitals thatrefused to admit him, Hakim Sheik and PBKMS filed a case in the court.Read the story given above. Thenimagine that you are a Judge inthe court. What would you say toHakim Sheik?Chapter 2: Role of the Government in Health2015-16 (12-01-15)21
THE COST OF A CUREAman and Ranjan are good friends.While Ranjancomes from a well-to-do family,Aman’s parents haveto struggle to make ends meet.Hi Aman! Good tosee you back! How haveyou been?The building looked so posh. I thought itwas a five star hotel! Daddy said that wasbecause it was a private hospital, with thebest of facilities.The doctor asked for many tests.buteveryone was so friendly! The lady who tookmy blood for testing told me so many jokesthat I forgot to feel the pain!.and have youheard the oneabout Batmanon Reality TV?I had viral fever andhad to go to thehospital.Oh! Me, too! I just got back toschool on Monday. My Daddytook me to see the doctorat the new hospital inKingsway. It was very exciting!Daddy had to pay Rs 500 at the reception counteritself – befor e we even met the doctor! There wasnice music playing and everything was really cleanand shiny.After the test results came, we went back to thedoctor. He looked through them and said everythingwas fine, and I only had viral fever. He prescribed lotsof medicines and rest.and so young man – this pink pill should betaken three times a day, and the white tabletonce before bed time – that’s for thebodyache! This one is a syrup – don’tworry, it’s tastyThank youDoctor.I feelbetteralready!2015-16 (12-01-15)
You see, I’ve been dying to tell you allabout it! But what aboutyou? Which hospital didyou go to?.and it really did! We went to a bigGovernment Hospital. We had to wait in a longqueue at the OPD counter. I was feeling so sickthat I had to lean on Abba all the time!Um.it wasn’t as nice as your’sat all! At first,Abba didn’t wantto take me because he said itwould take too much time.When our turn came, the doctor examined me, andasked for a blood test.Then we had to go and stand inanother long queue! People were crowding around inthe testing room too.He seems to be suffering froma bout of viral fever – nothingto worry about. All he needs isthis one fever-reducingmedicine.We got the test results after three days.and wentback to the hospital. There was a different doctorthat day.Show me his OPDcard.and the test results– quickly please!My hospital was nice, butthey gave me too manymedicines and the wholething cost more thanRs 3,500!That much! Mytreatment cost justRs 150!2015-16 (12-01-15)
Why did Ranjan have to spend somuch money? Give reasons.What problems did Aman face inthe public hospital? How do youthink the hospital can work in abetter manner? Discuss.Where do you go when you are ill?Are there any problems that youface? Write a paragraph based onyour experience.What problems do we face inprivate hospitals? Discuss.Why pay taxes to the government?Government uses tax money forproviding many public services forthe benefit of all citizens. Someservices such as defence, police,judicial system, highways etc.benefit all citizens. Otherwise, thecitizens cannot organise theseservices for themselves.Taxes fund developmentalprogrammes and services such aseducation, health care,employment, social welfare,vocational training etc. required forneedy citizens. Tax money isutilised for relief and rehabilitationin case of natural disasters such asfloods, earthquakes, tsunami etc.Space, nuclear, and missileprogrammes are also funded fromthe revenues collected as taxes.Government provides someservices especially for the poorwho cannot afford to purchasethem from the market. Oneexample is health care. Can yougive other examples?Public and private health care servicesFrom the above story, you must have understoodthat we can roughly divide up various health carefacilities in two categories –(a) Public health services and(b) Private health facilities.Public health servicesThe public health service is a chain of health centresand hospitals run by the government. They are linkedtogether so that they cover both rural and urbanareas and can also provide treatment to all kinds ofproblems – from common illnesses to special services.At the village level there are health centres wherethere is usually a nurse and a village health worker.They are trained in dealing with common illnessesand work under the supervision of doctors at thePrimary Health Centre (PHC). Such a centre coversmany villages in a rural area. At the district level isthe District Hospital that also supervises all thehealth centres. Large cities have many governmenthospitals such as the one where Aman was takenand also specialised government hospitals such asthe ones in Hakim Sheik’s story.The health service is called ‘public’ for manyreasons. In order to fulfil its commitment of providinghealth care to all citizens, the government hasestablished these hospitals and health centres. Also,the resources needed to run these services areobtained from the money that we, the public, pay tothe government as taxes. Hence, such facilities aremeant for everyone. One of the most importantaspects of the public health system is that it is meantto provide quality health care services either free orat a low cost, so that even the poor can seektreatment. Another important function of publichealth is to take action to prevent the spread ofdiseases such as TB, malaria, jaundice, cholera,24 Social and Political Life2015-16 (12-01-15)
diarrhoea, chikungunya, etc. This has to be organisedby the government with the participation of peopleotherwise it is not effective. For example, when takingup a campaign to see that mosquitoes do not breedin water coolers, rooftops, etc., this has to be donefor all houses in the area.Recall the case of Hakim Sheik. Would you like toknow what the court said in this case?According to our Constitution, it is the primaryduty of the government to ensure the welfare of thepeople and provide health care facilities to all.A doctor in a rural health care centre givingmedicines to a patient.The government must safeguard the Right to Lifeof every person. The Court said that the difficultythat Hakim Sheik had to face could have cost himhis life. If a hospital cannot provide timely medicaltreatment to a person, it means that this protectionof life is not being given.The Court also said that it was the duty of thegovernment to provide the necessary health services,including treatment in emergency situations.Hospitals and medical staff must fulfil their duty ofproviding the necessary treatment. Hakim Sheik wasdenied treatment at various government hospitals.Therefore, the Court asked the State Government togive him the money that he had spent on histreatment.Private health facilitiesThere is a wide range of private health facilities thatexist in our country. A large number of doctors runtheir own private clinics. In the rural areas, one findsRegistered Medical Practitioners (RMPs). Urban areashave a large number of doctors, many of themproviding specialised services. There are hospitalsand nursing homes that are privately owned. Thereare many laboratories that do tests and offer specialfacilities such as X-ray, ultrasound, etc. There arealso shops from where we buy medicines.A woman and her sick child at a governmenthospital. According to UNICEF, more thantwo million children die every year in India frompreventable infections.In what ways is the public healthsystem meant for everyone?List some Primary Health Centres(PHCs) or hospitals near yourplace. From your experience (or byvisiting any one of them), find outthe facilities provided and peoplewho run the centre.Chapter 2: Role of the Government in Health2015-16 (12-01-15)25
As the name suggests, private health facilitiesare not owned or controlled by the government.Unlike the public health services, in privatefacilities, patients have to pay a lot of money forevery service that they use.A post-operative room in a leadingprivate hospital in Delhi.Today the presence of private facilities can be seenall around. In fact now there are large companiesthat run hospitals and some are engaged inmanufacturing and selling medicines. Medical shopsare found in every corner of the country.Healthcare and equality:Is adequate healthcare available to all?Private health facilities can meanmany things. Explain with the helpof some examples from your area.In India, we face a situation where private servicesare increasing but public services are not. What isthen available to people are mainly private services.These are concentrated in urban areas. As theseservices are run for profit, the cost of these servicesis rather high. Medicines are expensive. Many peoplecannot afford them or have to borrow money whenthere is an illness in the family.In order to earn more money, these private servicesencourage practices that are incorrect. At timescheaper methods, though available, are not used.For example, it is common to find doctors prescribingunnecessary medicines, injections or saline bottleswhen tablets or simple medicines can suffice.In fact, barely 20 per cent of the population canafford all the medicines that they require during anIn rural areas, a jeep is often used to serveas a mobile clinic for patients.26 Social and Political Life2015-16 (12-01-15)
illness. Hence, even for those whom one might notthink as being poor, medical expenses causehardship. It was reported in a study that 40 per centof people who are admitted to a hospital for someillness or injury have to borrow money or sell someof their possessions to pay for the expenses.For those who are poor, every illness in the familyis a cause of great anxiety and distress. What is worseis that this situation tends to happen again andagain. Those who are poor are in the first placeundernourished. These families are not eating asmuch as they should. They are not provided basicnecessities like drinking water, adequate housing,clean surroundings, etc., and therefore, are morelikely to fall ill. The expenses on illness make theirsituation even worse.This pregnant lady has to travel manykilometres to see a qualified doctor.Sometimes it is not only the lack of money thatprevents people from getting proper medicaltreatment. Women, for example, are not taken to adoctor in a prompt manner. Women’s healthconcerns are considered to be less important thanthe health of men in the family. Many tribal areashave few health centres and they do not run properly.Even private health services are not available.What can be done?There is little doubt that the health situation of mostpeople in our country is not good. It is theresponsibility of the government to provide qualityhealthcare services to all its citizens, especially thepoor and the disadvantaged. However, health is asmuch dependent on basic amenities and socialconditions of the people, as it is on healthcareservices. Hence, it is important to work on both inorder to improve the health situation of our people.And this can be done. Look at the following example–Chapter 2: Role of the Government in Health2015-16 (12-01-15)27
The Kerala experienceIn 1996, the Kerala government made some majorchanges in the state. Forty per cent of the entire statebudget was given to panchayats. They could planand provide for their requirements. This made itpossible for a village to make sure that properplanning was done for water, food, women’sdevelopment and education. This meant that watersupply schemes were checked, the working of schoolsand anganwadis was ensured and specific problemsof the village were taken up. Health centres werealso improved. All of this helped to improve thesituation. Despite these efforts, however, someproblems – such as shortage of medicines,insufficient hospital beds, not enough doctors –remained, and these needed to be addressed.* Telangana became the 29th State of India onthe 2nd June 2014, after the reorganisation ofthe State of Andhra Pradesh.Let us look at an example of another country andits approach to issues of health.The Costa Rican approachThe above map of India shows the state ofKerala in pink.page 123 of this book has a map of India.Using your pencil outline the state of Kerala onthis map.Costa Rica is considered to be one of the healthiestcountries in South America. The main reason forthis can be found in the Costa Rican Constitution.Several years ago, Costa Rica took a very importantdecision and decided not to have an army. Thishelped the Costa Rican government to spend themoney that the army would have used, on health,education and other basic needs of the people. TheCosta Rican government believes that a country hasto be healthy for its development and pays a lot ofattention to the health of its people. The Costa Ricangovernment provides basic services and amenitiesto all Costa Ricans. For example, it provides safedrinking water, sanitation, nutrition and housing.Health education is also considered very importantand knowledge about health is an essential part ofeducation at all levels.28 Social and Political Life2015-16 (12-01-15)
EXERCISES1. In this chapter you have read that health is a wider conceptthan illness. Look at this quote from the Constitution andexplain the terms ‘living standard’ and ‘public health’ inyour own words.2.What are the different ways through which thegovernment can take steps to provide healthcare for all?Discuss.An important part of theConstitution says it is the “duty ofthe State to raise the level ofnutrition and the standard ofliving and to improve publichealth.”3. What differences do you find between private and publichealth services in your area? Use the following table tocompare and contrast these.FacilityCost of servicesAvailability of servicePrivatePublic4. ‘Improvement in water and sanitation can control manydiseases.’ Explain with the help of examples.GlossaryPublic: An activity or service that is meant for all people in the country and is mainly organised bythe government. This includes schools, hospitals, telephone services, etc. People can demandthese services and also raise questions about their non-functioning.Private: An activity or service that is organised by an individual or company for their own profit.Medical tourists: This refers to foreigners who come to this country specifically for medical treatmentat hospitals that offer world–class facilities at a lower cost than what they would have to pay intheir own countries.Communicable diseases: These are diseases that are spread from one person to another in manyways such as through water, food , air, etc.OPD: This is the short form for ‘Out Patient Department’. This is where people are first brought inand treated in a hospital without being admitted to any special ward.Chapter 2: Role of the Government in Health2015-16 (12-01-15)29
Public and private health care services From the above story, you must have understood that we can roughly divide up various health care facilities in two categories – (a) Public health services and (b) Private health facilities. Public health services The public health service is a cha
May 02, 2018 · D. Program Evaluation ͟The organization has provided a description of the framework for how each program will be evaluated. The framework should include all the elements below: ͟The evaluation methods are cost-effective for the organization ͟Quantitative and qualitative data is being collected (at Basics tier, data collection must have begun)
Silat is a combative art of self-defense and survival rooted from Matay archipelago. It was traced at thé early of Langkasuka Kingdom (2nd century CE) till thé reign of Melaka (Malaysia) Sultanate era (13th century). Silat has now evolved to become part of social culture and tradition with thé appearance of a fine physical and spiritual .
On an exceptional basis, Member States may request UNESCO to provide thé candidates with access to thé platform so they can complète thé form by themselves. Thèse requests must be addressed to esd rize unesco. or by 15 A ril 2021 UNESCO will provide thé nomineewith accessto thé platform via their émail address.
̶The leading indicator of employee engagement is based on the quality of the relationship between employee and supervisor Empower your managers! ̶Help them understand the impact on the organization ̶Share important changes, plan options, tasks, and deadlines ̶Provide key messages and talking points ̶Prepare them to answer employee questions
Dr. Sunita Bharatwal** Dr. Pawan Garga*** Abstract Customer satisfaction is derived from thè functionalities and values, a product or Service can provide. The current study aims to segregate thè dimensions of ordine Service quality and gather insights on its impact on web shopping. The trends of purchases have
Chính Văn.- Còn đức Thế tôn thì tuệ giác cực kỳ trong sạch 8: hiện hành bất nhị 9, đạt đến vô tướng 10, đứng vào chỗ đứng của các đức Thế tôn 11, thể hiện tính bình đẳng của các Ngài, đến chỗ không còn chướng ngại 12, giáo pháp không thể khuynh đảo, tâm thức không bị cản trở, cái được
Le genou de Lucy. Odile Jacob. 1999. Coppens Y. Pré-textes. L’homme préhistorique en morceaux. Eds Odile Jacob. 2011. Costentin J., Delaveau P. Café, thé, chocolat, les bons effets sur le cerveau et pour le corps. Editions Odile Jacob. 2010. Crawford M., Marsh D. The driving force : food in human evolution and the future.
Le genou de Lucy. Odile Jacob. 1999. Coppens Y. Pré-textes. L’homme préhistorique en morceaux. Eds Odile Jacob. 2011. Costentin J., Delaveau P. Café, thé, chocolat, les bons effets sur le cerveau et pour le corps. Editions Odile Jacob. 2010. 3 Crawford M., Marsh D. The driving force : food in human evolution and the future.
