[Answered] “Instead of getting rational treatment in public health-care facilities, the women are pushed towards irrational treatments in the private sector.” Comment.

Despite of very rapid growth in India, women’s health outcomes are much worse than other countries. It is observed that mainly because of poor public health facilities women are pushed for treatments in the private sector, which often dodge them with unnecessary and irrational treatments endangering their lives.

Issues in public healthcare services that make it inaccessible for women:

1. Public spending: To deliver better health outcomes, public expenditure on health service delivery is absolutely essential, and this is especially important for women and girl children. Public spending on health is very low in relation to GDP, and around two-third of health expenditure is out-of-pocket payment by households.
2. Lack of doctors: Doctors in government hospitals are less wrt patient they cater. They are overburdened due to lack of staff, doctors and infrastructure. Many have to wait for long to get treated. This often push them to go for private services.
3. Less government hospitals: Still Many rural areas lack public healthcare facilities. Moreover facilities that are available have no doctors and infrastructure for diagnostics and treatment of patients. This push them to go for cities for treatment, which prove costly to poor women.
4. Low quality care: Low quality care is prevalent in government hospitals. It is mainly due to misdiagnosis by health professionals, and the prescription of incorrect medicines. A study discovered a doctor in a PHC in Delhi who prescribed the wrong treatment method 50% of the time. Indians in rural areas where this problem is rampant are prevented from improving their health situation.
5. Lack of accountability: There is also a lack of accountability across both private and public clinics in India. Public doctors feel less responsibility to treat their patients effectively than do doctors in private clinics. Impolite interactions from the clinic staff lead to less effective procedures.
6. Corruption:Healthcare professionals take more time off from work than the amount they are allotted with the majority of absences being for no official reason. This phenomenon is especially more in Sub Centres and PHCs and results in expenditure that isn’t correlated to better work performance. This make health facilities unavailable to many women.
7. Overcrowding of hospitals: Government hospitals are overcrowded and understaffed without enough beds to support their patients. Statistics show that the number of health professionals in India is less than the average number for other developing nations.
8. Nexus between public and private spheres: Public and private practitioners make deals behind the curtains to refer patients to private clinics. Commission are fixed for those working in government hospitals.

Irrational treatment in private hospitals:

1. Private doctor many times do false diagnosis to earn money from the poor.
2. They often recommend unnecessary tests and medicines to get more money. E.g private practitioners recommend ultrasound for women even if it is not needed.
3. Many a times private practitioners misguide their patients to go for costly surgeries and treatment.
4. In the past decade, many cases of unwarranted hysterectomies from many states in India are reported. This is a gross violation of sexual and reproductive health rights.

How to improve health facilities and ensure rational treatment?

1. Develop National standards and accountability mechanisms.
2. Conduct timely inspections and audits of private hospitals.
3. Improve and maintain infrastructure in public healthcare.
4. Develop health workforce.
5. Cancelling of license of doctors involved in corruption.
6. Increase awareness among people especially poor about their rights and consent.