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Rural health infrastructure in a state of disrepair

It is no secret that India’s rural healthcare infrastructure is in a state of disrepair. However, the extent to which this is the case is a major cause for concern.

Image credit: TeshTesh [CC BY-SA 4.0 (]
A recent article in India Today notes that many healthcare facilities in rural areas have simply been abandoned or repurposed, instead being used for other purposes such as cattle sheds and storage. According to the article

“When India Today visited [Vijaygarh] in the Pinahat tehsil area of Agra, local residents said that the primary health center (PHC) in the village has been shut down for several years and the premises are currently being used to tie cattle and store straw and cow dung cakes. Local officials claimed that all PHCs will soon be operational after cleaning the building premises and repairs.”

The vast majority of India’s population reside in rural villages. As of 2018, 66 percent of India’s population are defined as living in rural communities according to the World Bank. Despite this, the vast majority of India’s healthcare infrastructure is focused within the more densely populated urban centres.

Given the limited healthcare budget, this decision may be one of harsh pragmatism, servicing the most people with a limited number of healthcare facilities by focusing on densely populated areas. However, this approach leaves the majority of the population — those spread across rural areas in sparsely populated villages and towns — scrambling for limited resources. 

As previously reported by Health Issues India, “rural areas often have such poorly developed healthcare infrastructure in their area that access to such basic medicines as paracetamol or ibuprofen is sporadic at best.” This leaves these areas particularly vulnerable to diseases that would otherwise be entirely treatable. The COVID-19 pandemic has truly underlined the issues caused by such inequities in the health system.

COVID-19 ran amok in India’s rural villages during the first wave. This was, in part, caused by an influx of approximately forty million migrant workers into their native villages following a mass exodus from the cities. As lockdown measures were announced at a moments notice, millions of individuals found themselves without work, resulting in starvation and homelessness. Many of these individuals flocked back to their native villages in massed crowds, facilitating the spread of the virus.

Without addressing health issues in an equitable way infectious diseases cannot be eradicated. Areas that are all but left to fend for themselves by the health system become reservoirs for infectious diseases, allowing resurgences later down the line. If India is to prepare for a future pandemic, or even a third wave of COVID-19, it must ensure rural areas are also able to avail healthcare services.

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