A poor kid died just now. Do you know why?

This article was exclusively written for The European Sting by Mr. Abdul Basith K M, a final year MBBS student, currently studying at JIPMER, Puducherry, India. He is affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

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To quote John. F. Kennedy, “If a free society cannot help the many who are poor, it cannot save the few who are rich.” We can think of the current healthcare crisis as a bowl of hot soup wherein the privileged few are given spoons to relish and make the most out of it, while the poor manage to take small sips from the periphery and the rest die thirsty. Every day, 16,000 children die before they turn even five and the likelihood of a child from poorest 20% dying is twice as likely, as a child from the richest 20% (Cite reference). This data from WHO fact list is just one among the myriad statistical data revealing the dark truth of health inequity that merely serves as an eye-opener. The difference in distribution of health services among varied population groups are a result of the culmination of various factors like socioeconomic status, geography, political will etc., thus forming the very grounds of health inequity. This imparts a major hit to the public health system, helping us realise – that this is the society we live in, where the privileged few have access to the best medical facilities while the underprivileged many are still deprived of primary and preventive health care. This calls for an urgent need for action. Delving deeper into the subject it’s intricacies are not simply limited to mortality & morbidity rates, rather the high price of basic, quality healthcare which should ideally be made available at reasonable rates. This renders several citizens pushed to the brink of poverty as they struggle to cope with the exorbitant out of pocket expenditure. (Cite reference). This distribution takes an even more catastrophic turn in developing countries, wherein a large chunk of the population is staying in areas where the health resources are scarce and/or unaffordable. In case of rural population the main hindering factor is inaccessibility to good quality healthcare, whereas in urban slums the accessibility to best of the private healthcare facilities is limited by unaffordable rates. When all is said and done, managing health of 1.4 billion people is something that’s very complex and challenging. So what are the viable solutions for better health care delivery?

• The foremost step in attenuating this discrepancy would be to rearrange the operational structure of the healthcare system with the right mix of government policies. As per WHO Financing profile for India, total GDP (Gross Domestic Product) spent on healthcare, encompassing both private and public domains, is around 3.9%; the public sector alone contributing to a mere 1%. Privatization of healthcare is one of the major culprits for the discrepancies in the current system and measures to keep them under check should be enforced.
• Another major step in this regard would be a fortified primary healthcare system sustained with a strong referral strategy. Such a government controlled system will help in regulating the price of medications and medical services. This will also compel hospitals and doctors to provide uniform standards of care at an affordable cost.
• Channelling non-governmental agencies and enabling private-public partnerships can be worked out for better outcomes.
• Community participation is an integral component of maintaining a healthy society. Actions without proper community involvement are usually ineffective which in turn demands active efforts at solving teething healthcare problems in the community.
• Bringing about a behavioural change is a tedious task to do. But, ingraining a change in the lifestyles and spreading awareness and initiating preventive measures lay the foundation for a healthy self-sustaining society.
• Improving health infrastructure and work environment at underserved regions where healthcare delivery is deficient, will motivate more qualified health professionals to go and serve in such regions.

In the ever-evolving world of modern healthcare, ensuring that each and every person gets access to quality healthcare may seem like a Herculean task. But with proper planning, resource allocation and community participation, this dream of universal health coverage might just be within our reach. Change is difficult to bring, until the community realizes the dire need of it. About the author Abdul Basith K M is a final year MBBS student, currently studying at JIPMER, Puducherry, India. For the current tenure, he is holding the post of Local Officer on Public Health in Medical Students’ Association of India (MSAI). He is a public health enthusiast and has been involved in many activities at the community level for which he was awarded “Student Activist of the Year” award CURIS REMUNEROR ’18 (National Healthcare Award Series) by CIMCON foundation in association with WONCA Rural South Asia and Swasthya Gram. He has also been fortunate enough to share his experiences and motivate others during various occasions which include the Student Keynote Speech delivered by him during CONNAISSANCE (International Undergraduate Medical Students’ Conference).