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Sub-par healthcare kills more than a million

Access to healthcare (ambulance pictured).
An ambulance parked in downtown New Delhi.

India loses around 1.6 million deaths each year to sub-par healthcare according to a new study published in The Lancet. The vast majority of these deaths are entirely preventable.

This figure is twice the established number of people who died due to lack of access to healthcare, which is estimated to be around 838,000 people. This is a stark contrast that indicates that, in a considerable number of cases, the healthcare that is provided is of such low quality that it becomes ineffective, or even dangerous.

The study establishes that globally around five million people die due to low quality health care. India accounts for a third of these deaths. The paper highlights that access to healthcare — while a critical factor in improving global health — does not necessitate an improvement to the healthcare system.

“India loses around 1.6 million deaths each year to sub-par healthcare…the vast majority of these deaths are entirely preventable”

Large-scale rollouts of low-quality and under-regulated healthcare facilities are endangering public health. It is therefore of the utmost importance that standards are maintained throughout the healthcare system.

“For too long, the global health discourse has been focused on improving access to care, without sufficient emphasis on high-quality care,” said Muhammad Pate, co-chair of the commission that produced the report. “Providing health services without guaranteeing a minimum level of quality is ineffective, wasteful and unethical.”

Poor healthcare is reaching epidemic proportions. Substandard care was found to be a factor in 84 percent of cardiovascular deaths, 81 percent of vaccine-preventable diseases, and 61 percent of post-birth complications.

“India learned this with Janani Suraksha Yojana, a cash incentive programme for facility births, which massively increased facility delivery but did not measurably reduce maternal or newborn mortality,” claimed the Public Health Foundation of India, one of the participating groups of the study. Currently, approximately 130 women die per 100,000 childbirths in India.

“Poor healthcare is reaching epidemic proportions”

In India the issue of low-quality healthcare is often brought to public attention in the abundance of open healthcare positions. Understaffing is a considerable issue across many specialist positions. India needs 88,000 cardiologists to adequately provide cardiac care for its population. It has just 4,000. This is despite the fact that heart disease is the leading cause of death in India.

Rural areas suffer the brunt of the staff shortages. Many doctors outright refuse to work in rural locations. This is not entirely due to often lower wages. Infrastructure is hugely lacking in rural areas, even where clinics are present, doctors often state they lack even the most basic of medical resources, resulting in them not being able to provide simple services. This often draws the ire of the community they are serving.

These clinics however will count on healthcare records as providing healthcare coverage to the local area. This will appear to be fine in terms of the levels of access to healthcare, though if the facility cannot even provide basic services, the level of quality is dismal. A standardised level of quality, even in rural locations, could go a long way to addressing the high death toll of sub-standard healthcare.

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