Rural Health Statistics: Unveiling the Healthcare Reality

The National Rural Health Statistics Report (RHS) 2019-20 published through the National Rural Health Mission portrays a predictable picture of shortfall of specialist doctors in Community Health Centers in rural India.  Year after year and report after report the shortfall remains predictably constant.

But does it represent the real picture of healthcare in India?

To start with, let’s agree on some given facts- healthcare in India is increasingly private driven.

 Ask any citizen on the road two questions-  

1. Would you prefer government or private healthcare if you had a choice- the answer will be ‘private’ in majority.
2. Why have you come to a government set up to avail healthcare?- ‘because I cannot afford private health care’ will be the answer

The reasons for such predictable answers merit a discussion of its own.

A Community Health Center (CHC) serves a population of around 1,65,000 (2019 RHS report) in rural areas and covers an average area of 13 km radius.

In most parts of India, there exists some form of private healthcare facility in the area served by a CHC.

For example- Chakaltore CHC in Purulia district of West Bengal- atleast 5 Nursing Homes/ Private hospitals exist in the same area covered by Chakaltore CHC along with many private clinics. These are served by doctors who work in the CHC as well as specialist doctors employed in private practice.

So, is there a short fall of specialist doctors serving an area covered by Chakaltore CHC? Probably not.

The MoHFW should probably rationalise it’s reports and integrate data of private and government health care facilities to give the true picture.

Of course, vast areas of the country would still be understaffed in terms of specialist doctors and facilities for them to practise as specialist.

But there will also be many districts which have sufficient health care facilities,- the aim should be to identify the districts with lacunae and provide focussed attention regarding staffing in such places.

With Clinical establishment acts being applied in many states, gathering data about private healthcare facilities should not be a difficult task.

As such the Rural health Statistics report is a self fulfilling,  repetitive pattern which though essential serves little to give the true healthcare scenario in rural areas.

Integrating private and government healthcare facility data will provide representative data of the availability of healthcare at the CHC level.