Health Inequity in India Published in Blogs.BMJ.com

Title --: Health Inequity in India 
Authors are 
Professor Pranab Kumar Bhattacharya [1] ; Rupak Bhattacharya[2] , Upasana Bhattacharya [1], Ritwick Bhattacharya [2], Rupsa Bhattacharya[2], Ayishee Mukherjee[2], Dalia Mukherjee[2] Hindole Banerjee[2] Debasis Mukherjee[2] Runa Mitra[3]

[1] Professor of Pathology Murshidabad Medical College, Berhampore court, Murshidabad, West Bengal, India [ 2] of residence 7/51 Purbapalli, Sodepur, Dist 24 parganas[ north ], West Bengal kolkata-110, India [ 3] Social worker BK Mitra palliative care center Barrackpore 24 parganas [North] India

In India, 63 million people sink into poverty yearly due to unaffordable health cost in paradoxical health care system, since independence 1947. In 1950, central government designed national health programme. Severe variations amongst states economic development, social & religious conditions, familial income inequities, political governance and willing led wide disparities in access to health services and population health. India initially accepted public sector led model, where services were free to all, emphasizing rural health care, when private sectors were limited to general practitioners and charity run hospitals . It was pyramidal structure connected PHCs to S-D to district to government run tertiary medical colleges. Since 1947 economic planning regarded health expenditure was non-productive, poorly recorded. Public health needs to meet health of expanding population particularly in areas of stroke, CVD, cancer, diabetes, respiratory diseases, mental illness, suicide, HIV, tropical and infectious diseases and other chronic diseases and stressed health system beyond their capacity and private sectors proliferated, large corporate hospitals opened in urban aggregation and non engagement with primary health care providers, do not provide basic essential health care to largest sections of rural, suburban population & these are centres of all kinds of malpractices. Un affordable for most Indians, with weak regulatory system, failing to set and enforce quality, cost standard inadequate, inappropriate, unethical care & cure. Health insurance available to small proportions of workers and when poverty level is very high i.e. 10% of health care expenditure is out of pocket spending.All these are because economist & policy makers do not recognize health as essential for economic development and health is not a legislated right in India. NRHM focuses on maternal & child health. No attention is even paid to communicable, non-communicable, tropical & mental diseases which lead to largest death & disability in India. In 2012-2017 planning Government of India focussed & recommended increased public finances from 1% of GDP to 2.5% of GDP through toy funding supplemented by ESI & EPJ & free provision of essential drugs & diagnostics and referral system. India must address the enactment of right to health through parliamentary legislation and allow the state what services that the right should translate into welfare scheme. India & West Bengal must engage community care instead of mushrooming growth of private care. Improvement of public care & cure, improvement of quality health care personnel, Generalists, Specialists, nurses, GDAs, shortfalls & more training institutions.HEALTH EXPENDITURE VALUE Per Capita (US $) 61 Percentage of GDP 3 Amount of pocket private health expenditure 86 Public services(% of total) 33 Percentage of population insured in 2015 17 (Government 12%+ employee 3%+ individual 2%) No of Physician per 1000 population in 2015 7 Life expentancy at birth 66 Annual no. of death per 1000 population 17 No. of infant death per 1000 live birth 8 No. of death per 1000 live birth in 2014 41 No.of maternal death per 100000 live birth in 2014 190

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