Health matters

Editor,
Its that time of the year when we greet friends, relatives  and loved ones with best wishes for a happy and prosperous  New Year. When we say “Prosperous” it would naturally   include among other things abounding good health because  in the end health is wealth. It is hard to think of anything more important than health for human well being and the quality of life. But often the most important thing in life is less talked about and I say this because the topic of health is virtually absent from public debates and democratic  politics  in  Meghalaya. For example, in a year there is hardly any lead article or editorial in our leading local newspapers on the state health issues and the state of health care  in our state. Again, if one is to also analyse the discussions in the State Legislative Assembly, a very negligible percentage is related to health issues such as poor delivery services,  inefficiencies, poor coverage, poor  health education, basic health issues such as high infant mortality rates, low immunization, child nutrition and health care, prevalence rate of communicable diseases, and many other issues which still need attention.
Since the practice of  democracy depends greatly on the  issues which are publicly discussed, the comparative silence on public  health care makes it that much more difficult to remedy the problems from which the state health care suffers. Hence the massive inadequacy particularly in the rural areas where the poor people too often have limited access to decent and affordable health care. The silence would have been tolerable if the state population enjoyed good health and adequate health services but nothing could be further from the truth. While the number of  Community Health Centres (CHCs) Primary Health Centres (PHCs) and Sub Centres in the state may reflect the quantitative aspect of achievements in the health sector, the quality of the delivery system leaves much to be desired. Quite a few of these Centres remain non-functional due to one reason or the other and those which function are quite often very poorly run and are usually inefficient and disorganized. In spite of all these, there is hardly any deliberation on the accountability issues and other challenges that affect the operation of these centres and  on the need for well delivered basic public service. There is instead a continued reliance on a commercialised health care system which is however virtually unregulated.
Lately the Government has introduced private insurance for health risks. Despite its attractive sound there are very serious reasons to be deeply concerned about this health care model. Private health insurance would ultimately end up promoting further privatisation of health care and affect the resource, time, energy and commitment to strengthen public health services. While this model cannot be completely debunked the issues of efficiency, distortion, equity and irreversibility in this model perhaps  need to be  discussed more. On the whole we should stop believing  that transition from poor health to good health could be easily achieved through private health care and insurance. Instead we need to emphasize more on the importance of commitment to universal coverage  for all in a comprehensive provision of health care. We also need to go back to basics  which is both of a preventive and curative kind with a renewed focus on primary health centres, village level health workers  and ensuring timely health care on a regular basis. Finally, the power of public reasoning and social action in elevating the visibility of health issues through lively public discussions will open up new horizons because  such democratic engagement will play a very important role in the transformation of health policies of the state. I do hope that such engagements would be more visible henceforth for an effective approach towards good health and well being of each and every citizen of our state in the years to come.
Yours etc.,
K.L.Tariang
Via email