What exists on paper is non-existent in government health institutions

If one looks at the policy decisions taken by the Central Government regarding the health of children in rural areas, then provisions of the National Health Mission (NHM) would paint a rosy picture and show that priority attention is granted to the kids. However, the ground realities show a dismal picture and a lot needs to be done in the public health sector.

If we take just one policy of the government in consideration — the Janani Shishu Suraksha Karyakaram (JSSK) — it would show the entitlement of all pregnant women delivering in public health institutions to absolutely free and no expense delivery, including Caesarean section.

The JSSK initiative stipulates that free drugs, diagnostic tests, diet, free transport from home to institution, between facilities in case of a referral and drop back home, and free blood, if required, must be provided. Similar entitlements have been put in place for all sick infants accessing public health institutions for treatment till one year of age.

The abovementioned facilities, if put into practice, would not only take care of all the health and related problems that are faced by residents of rural India, but also result in a healthier population giving maximum productivity, and thereby contributing to nation building to the fullest.

However, what exists on paper is rarely there in reality. One can always raise questions as to why such facilities do not exist even though the Central Government budgets for it. The answers will, perhaps, come in the form of the likes of Uttar Pradesh Rural Health Mission scam that robbed the public exchequer of US$ 1.6 billion (roughly Rs 10,000 crore).

A visit to any of the public health institutions in rural areas would show the dilapidated state they are in. While the infrastructure is non-existent, the doctors deployed there rarely land up on duty. They stay confined to the comfort of their government accommodations and offer their services in private hospitals and clinics charging a humongous fee from patients.

The free drugs supplied to government hospitals rarely find their way in the hands of poor patients, especially if they are for serious diseases requiring a specialist's care. The free pick up and drop facility is something that patients can only dream about as the ambulances can be seen rusting in the parking lots due to lack of maintenance. While some lucky patients are able to get the “rude” care of nurses at the public health facilities, others have to turn towards delivering babies at home with the help of midwives who do not have any certification and carry out their task due to experience.

The Central Government needs to streamline the flow of funds so that they actually reach the places and facilities they are meant for rather than landing up in the pockets of unscrupulous bureaucrats and middlemen. This is the only manner in which health service can improve. The other thing would be for doctors to practice their profession in the right manner and follow the Hippocratic Oath they took in earnest.