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Why I Think India’s Healthcare System Is In Absolute Shambles

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By Ankur Chhabra:

Healthcare is not only a service but a fundamental right of every citizen of the country.

The Constitution of India guarantees the ‘Right to Life’ but the citizens and authorities are responsible for upholding these rights. In the present day and age, India’s poor health outcomes are posing as one of the most pressing developmental challenges. India remains a laggard in health outcomes not only by World Health Organisation (WHO) standards but also by the standards of the developing world.

Deaths plague the Indian healthcare ecosystem. Deaths from preventable communicable and non-communicable diseases, poor infant and maternal mortality rates due to malnutrition, anaemia etc. Even though strides have been made as far as economic growth and development is concerned which has improved the poverty situation in India, progress in improving health outcomes have been dismal.

Recent incidents such as that of a man carrying his wife’s body home on his shoulders from a mortuary or that of a Kanpur boy dying on his father’s shoulder as the latter ran from pillar to post to get medical assistance, is very painful and disappointing.

As unfortunate as they are, these are some of the few cases that have got media attention. This is actually the order of the day in not only some of India’s poorest rural areas and urban slums, but also some of the richest states where there is discrimination on the basis of caste, creed and colour when it comes to getting access to basic public services.

In modern India, there is a dire need to reverse this trend in every aspect of life, particularly the healthcare sector. Medical negligence and apathy, poor quality of healthcare services, lack of hospitals and the shortage of doctors and nurses, low hospital bed density, doctor-to-patient ratios are greater issues that need to be addressed.

We could try to change the above-mentioned factors than conveniently putting the blame on low government expenditure on healthcare, which undoubtedly and inarguably is quite low even in relation to some of the Sub-Saharan African countries.

Even after seven decades of independence, it is unfortunate that health has remained an issue that isn’t paid much attention to in India. The primary reason behind poor health profile of an average Indian is the abysmal public health scenario. Low and regressive public health investments in preventive, promotive and curative health care facilities have been plaguing India’s public health sector for ages now.

There are two sides to every coin. Low Government expenditure is only one side of the problem. A greater problem that most certainly has a negative impact on the health scenario in India is the prevalent poor quality of public health facilities, especially primary health care (primary health centres and community health centres).

Health inequalities is another critical factor here, stultifying the growth and progress made in the healthcare domain, if at all. Due to high relative income inequality and poverty, the poor have to depend on the inadequate public health facilities vis-à-vis expensive private healthcare facilities in the country.

This is not so straightforward, since, the poorest of the poor receive fewer benefits from the public health system than their better-off counterparts.

So, in essence, the Indian healthcare sector grapples with twin issues – healthcare unaffordability and healthcare inequality. Thus, the lack of reliable public healthcare services and the absence of health insurance further compel the poor to depend and spend heavily on the only alternative available i.e. private healthcare. This translates to the high proportion of out-of-pocket expenditure (OPE) on health. High healthcare costs often lead people to delay treatment, aggravating health problems.

Lastly, medical negligence, corruption and laxity on the part of a few medical professionals, staff workers and other personnel in the public health ecosystem must be brought to justice. The Government must also be accountable. Politicians and ministers cannot just get away by launching inquiries, setting committees and condemning such careless acts in the medical field. There must be greater democratisation of health issues via increased participation of medical doctors, citizens, media and the judiciary alike.

Our political leaders, media, citizens, you and me need to question the regrettable state of affairs plaguing the Indian healthcare system. The Kanpur boy, named, Ansh, who died on his father’s shoulder was just 12 years old. He was in the sixth standard and a very bright child. He lost his life because a hospital denied him a stretcher.

I appeal to the health fraternity of our country and all those who care about social and public health problems that our country faces today, to make cautious and conscious decisions. We must be more conscientious. There is a general erosion of empathy in our society today.

More than saving human lives, humanity needs to be saved in India. If every citizen of the country is considerate of this simple rule, all other perils of the healthcare ecosystem in India shall, slowly but surely, be solved. I hope such careless acts don’t cost anyone’s life in the future. Health is serious business. Healthcare delayed is healthcare denied, and India needs to ensure affordable and accessible healthcare to all, at all times!


Image source: Uriel Sinai/Getty Images

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An ambassador and trained facilitator under Eco Femme (a social enterprise working towards menstrual health in south India), Sanjina is also an active member of the MHM Collective- India and Menstrual Health Alliance- India. She has conducted Menstrual Health sessions in multiple government schools adopted by Rotary District 3240 as part of their WinS project in rural Bengal. She has also delivered training of trainers on SRHR, gender, sexuality and Menstruation for Tomorrow’s Foundation, Vikramshila Education Resource Society, Nirdhan trust and Micro Finance, Tollygunj Women In Need, Paint It Red in Kolkata.

Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

Read more about his campaign.

Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

Read more about her campaign.

MH Fellow Sabna comes with significant experience working with a range of development issues. A co-founder of Project Sakhi Saheli, which aims to combat period poverty and break menstrual taboos, Sabna has, in the past, worked on the issue of menstruation in urban slums of Delhi with women and adolescent girls. She and her team also released MenstraBook, with menstrastories and organised Menstra Tlk in the Delhi School of Social Work to create more conversations on menstruation.

With YKA MHM Fellow Vineet, Sabna launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society. As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Read more about her campaign. 

A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Find out more about the campaign here.

A native of Bhagalpur district – Bihar, Shalini Jha believes in equal rights for all genders and wants to work for a gender-equal and just society. In the past she’s had a year-long association as a community leader with Haiyya: Organise for Action’s Health Over Stigma campaign. She’s pursuing a Master’s in Literature with Ambedkar University, Delhi and as an MHM Fellow with YKA, recently launched ‘Project अल्हड़ (Alharh)’.

She says, “Bihar is ranked the lowest in India’s SDG Index 2019 for India. Hygienic and comfortable menstruation is a basic human right and sustainable development cannot be ensured if menstruators are deprived of their basic rights.” Project अल्हड़ (Alharh) aims to create a robust sensitised community in Bhagalpur to collectively spread awareness, break the taboo, debunk myths and initiate fearless conversations around menstruation. The campaign aims to reach at least 6000 adolescent girls from government and private schools in Baghalpur district in 2020.

Read more about the campaign here.

A psychologist and co-founder of a mental health NGO called Customize Cognition, Ritika forayed into the space of menstrual health and hygiene, sexual and reproductive healthcare and rights and gender equality as an MHM Fellow with YKA. She says, “The experience of working on MHM/SRHR and gender equality has been an enriching and eye-opening experience. I have learned what’s beneath the surface of the issue, be it awareness, lack of resources or disregard for trans men, who also menstruate.”

The Transmen-ses campaign aims to tackle the issue of silence and disregard for trans men’s menstruation needs, by mobilising gender sensitive health professionals and gender neutral restrooms in Lucknow.

Read more about the campaign here.

A Computer Science engineer by education, Nitisha started her career in the corporate sector, before realising she wanted to work in the development and social justice space. Since then, she has worked with Teach For India and Care India and is from the founding batch of Indian School of Development Management (ISDM), a one of its kind organisation creating leaders for the development sector through its experiential learning post graduate program.

As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

Let’s Talk Period aims to change this by

Find out more about her campaign here.

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A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

A Gender Rights Activist working with the tribal and marginalized communities in india, Srilekha is a PhD scholar working on understanding body and sexuality among tribal girls, to fill the gaps in research around indigenous women and their stories. Srilekha has worked extensively at the grassroots level with community based organisations, through several advocacy initiatives around Gender, Mental Health, Menstrual Hygiene and Sexual and Reproductive Health Rights (SRHR) for the indigenous in Jharkhand, over the last 6 years.

Srilekha has also contributed to sustainable livelihood projects and legal aid programs for survivors of sex trafficking. She has been conducting research based programs on maternal health, mental health, gender based violence, sex and sexuality. Her interest lies in conducting workshops for young people on life skills, feminism, gender and sexuality, trauma, resilience and interpersonal relationships.

A Guwahati-based college student pursuing her Masters in Tata Institute of Social Sciences, Bidisha started the #BleedwithDignity campaign on the technology platform, demanding that the Government of Assam install
biodegradable sanitary pad vending machines in all government schools across the state. Her petition on has already gathered support from over 90000 people and continues to grow.

Bidisha was selected in’s flagship program ‘She Creates Change’ having run successful online advocacy
campaigns, which were widely recognised. Through the #BleedwithDignity campaign; she organised and celebrated World Menstrual Hygiene Day, 2019 in Guwahati, Assam by hosting a wall mural by collaborating with local organisations. The initiative was widely covered by national and local media, and the mural was later inaugurated by the event’s chief guest Commissioner of Guwahati Municipal Corporation (GMC) Debeswar Malakar, IAS.

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