One of the major challenges that we are facing today is providing quality healthcare to all people, irrespective of birth, caste, status and wealth. We are one of the most poorly served countries in terms of health care with a very high proportion of private expenditure on health care. Despite impressive infrastructure of medical institutions the travails of ordinary Indians who fall sick are unbelievably harsh. Most of the poor and middle classes have no health insurance. Modern medicine has seen spectacular advances, but medical care has become expensive. More than finances, it should be recognized that 80% of disease burden is a consequence of failure of preventive and public health care. To get millions of Indians out of the trap of poverty and disease we need greater clarity on the challenges and opportunities that are present in the realm of health care.
FDR’s initiatives focused on the state of healthcare in India and particularly in Andhra Pradesh. Committees of domain experts were constituted at various levels, to comprehensively study and recommend measures on:
- Universal access to free Primary, Secondary and Tertiary healthcare
- Effective utilization of resources and cost control
- Integration of Primary and Secondary care
- Integration of indigenous systems on a scientific basis
- Effective risk pooling which guarantees quality care to every person with no financial burden on the family
- Measurable improvements in health status, quality of delivery and productivity and economic status of the community
Dr. Jayaprakash Narayan was instrumental in formulating “National Rural Health Mission”. The following were the major recommendations for the health sector that he made when he was a member of National Advisory Council
- Raising an army of Community Health Volunteers
- Strengthening the Primary Health Care Delivery System
- National Mission for Sanitation
- Taluk / Block-level Referral Hospitals for Curative Care
- Risk-pooling and Hospital Care Financing
Dr. Jayaprakash Narayan had also recommended the constitution of following task forces to improve the delivery of health care services.
- Reproductive and Child Health (RCH) and birth control in High Fertility States
- Convergence and Integration of Services
- Medical Education and Medical Grants Commission
- Training of Voluntary Health Workers
- Regulation of Medical Care and Medical Ethics
- Regulation of Medical Profession
- Accreditation and integration of Rural Medical Practitioners (RMPs) into Health System
- Health Financing Mechanisms
FDR also contemplated designing a health project modeled on the basis of Comprehensive Rural Health Care Project (CRHP) of Jamkhed, Maharashtra, pioneered by Dr.Arole.