QUESTION :  Enumerate the various initiatives taken by the government to augment rural health care in the country and analyse the loopholes in the rural healthcare system during the covid-19  pandemic by giving some steps that can be taken to make the process resilient. 

Status of Rural Health Care in India
Rural health infrastructure (SHCs, PHCs and CHCs) needs to be Modernised to cater to the health needs of the 65% of the population living in rural areas
• According to info, out of 139 crore population of India, at least 91 crore people are living in 649,481 villages.
• The second wave of Covid-19 had impacted the rural community the most.
• Further, there is a growing incidence of non-communicable diseases (NCDs) such as hypertension, diabetes, cancer and cardiovascular diseases in rural India. As per WHO, NCDs cause nearly about 5.87 million (60%) of all deaths in India.
• Accordingly, there is a need to focus on strengthening the existing rural health infrastructure.
• Prioritising the development of the rural health network (SHCs, PHCs and CHCs) will help in the effective delivery of Health services to rural people.
According to the fact shared by the Union Minister of State for Health and Family Welfare in the Rajya Sabha. India is having inadequate PHCs, CHCs, specialists, etc.
• Inadequate primary health centres (PHCs):  India has only 25,743 primary health centres (PHCs) though the estimated requirement of PHC’s in rural India is 29,337. (Shortfall of 3,594 units).
• Inadequate community health centres (CHCs): Against the requirement of 7,322 CHC’s, rural India has only 5,624 community health centres (CHCs).
• Inadequate specialists in CHC’s: Data on CHCs, show that, overall, there is a shortfall of 81.8% specialists as compared to the requirement for existing CHCs.
• Inadequate infrastructure: According to the Human Development Report 2020, India has eight hospital beds for a population of 10,000 people, while China has 40 beds for the same number of people. 
• Rural health networks will help to treat the diseases at the primary level. Further, it will also help us save a lot of money and the resources being spent at tertiary level health care.
o For instance, if our Sub-HCs work effectively, there will be less pressure on PHCs. If the PHCs function well, then there will be minimal pressure on CHCs and so on.
• It will enable people’s participation in ensuring better functioning of rural health services.
o For example, in case of Haryana, Swasthya Kalyan Samitis, or SKSs were constituted for all CHCs, PHCs.
o It helped health providers  to engage with all kinds of rural community organisations (panchayats, gram Sabha, notified area committees, municipal bodies and non-governmental organisations) in minimising the adverse impact of the pandemic on rural life. 
• Rural health networks should have access to the health data of people in their respective areas. 
• Need to conduct Regular health camps. It will help us to identify those on the verge of developing tuberculosis, hypertension, diabetes or any diseases owing to their socio and economic conditions.
• A CHC or referral centre should be modernized with effective and adequate health infrastructure. For example, A single CHC should have least 30 beds for indoor patients, operation theatre, labour room, X-ray machine, pathological laboratory, standby generators’ etc. 
• Affordable medical facilities are provided to people living in rural areas.
• Medical colleges need to encourage students to visit rural areas and understand the healthcare requirements of poor and downtrodden.
• Doctor in the government service must mandatorily serve in rural areas before getting his/her first promotion.
• Young doctors at grass roots level need to be sensitive to patients and their family.
• Private sector need to work with a spirit of altruism, commitment and missionary zeal in providing modern and affordable healthcare facilities in the rural areas and bridge the urban- rural divide.
• Medical associations should campaign to educate people on preventing lifestyle diseases which are slowly penetrating even the rural areas. 
• It seems  impossible to transform its primary health care in a day or a week or a month, the right steps in this direction will help in dealing with future pandemics and other health emergencies.
• The government should strive to provide regular and comprehensive healthcare needs in rural areas guided by the World Health Organization (WHO)’s principle of Universal Health Coverage (UHC).

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