India's health worse than neighbours

India may boast of an economy zooming beyond 8 per cent, but when it comes to primary facilities like health, it lags behind smaller neighbours like Sri Lanka and Bangladesh.

A report, "Serve the Essentials," by Oxfam International on essential services in South Asia is revealing for its conclusions. In India, 80 per cent of health care expenses are from citizens' own pocket, with 40 per cent of the hospitalised taking loans or selling assets to pay for their treatment.

"This is in complete contrast with Sri Lanka where health care is free and there is a resistance to private intrusion in the health sector. In India, the public sector is losing its capacity to deliver and the private sector is without proper regulations," B Muralidharan, South Asia advisor, Millennium Development Goals, Oxfam, said.

While corporate hospitals attract 150,000 foreign patients every year, making India a preferred health tourism destination, one in four of those hospitalised fall below the poverty line as a result of their hospitalisation, the report says.

In Sri Lanka, 90 per cent of babies are delivered at public health facilities, attended by a qualified attendant, whereas in India every hour 12 women die during child birth, pointing at the absence of health services for the poor.

Even Bangladesh has shown a drop in infant mortality rate to 46 in 2003 from 145 per 1,000 live births in 1970, Oxfam says.

"In the South Asian region, India is like the big brother; but when it comes to health, while Sri Lanka has indicators comparable with highly developed countries, India scores worse than some sub-Saharan countries," Muralidharan said.

Also, while 170 million Indians do not have access to safe drinking water, 90 per cent of Pakistan's and 78 per cent of the Sri Lankan population had such access in 2002. While 70 per cent of Indians lack adequate sanitary facilities, in Pakistan only 46 per cent face that fate, the report adds.

Within India, the rich-poor, rural-urban and gender disparities in health are also very conspicuous.

According to the report, the poorest 20 per cent people have more than double the mortality and malnutrition rates as compared with the richest fifth. A girl born in a poor family is twice as likely to die before her first birthday than if her family were rich.

Suggesting a change in the government's attitude to the sector, Muralidharan said, "The government should provide health care as a basic fundamental right. User charges in hospitals should be abolished and resources raised through cess and community taxes, which will not affect the poor. Civil society has a major role to play and the government should be held accountable for its programmes."

In rural India, almost half the posts of doctors in primary health centres are vacant and the country needs an additional 325,000 nurses in order to meet the Millennium Development Goals on health by 2015, the Oxfam report adds.