91-404: A polyclinic (where poly means "many"; not to be confused with the homonym policlinic , where poli means "city" and which is sometimes used for a hospital's outpatient department) is a clinic or health care facility that provides both general and specialist examinations and treatments for a wide variety of diseases and injuries to outpatients and is usually independent of a hospital. When
182-523: A multi-payer universal health care model that is paid for by a combination of public and government regulated (through the Insurance Regulatory and Development Authority ) private health insurances along with the element of almost entirely tax-funded public hospitals. The public hospital system is essentially free for all Indian residents except for small, often symbolic co-payments in some services. Economic Survey 2022-23 highlighted that
273-493: A polyclinic , it can house outpatient departments of some medical specialties, such as gynecology , dermatology , ophthalmology , otolaryngology , neurology , pulmonology , cardiology , and endocrinology . In some university cities , polyclinics contain outpatient departments for the entire teaching hospital in one building. Large outpatient clinics are a common type of healthcare facility in many countries, including France, Germany (long tradition), Switzerland, and most of
364-644: A Twelfth Plan to expand the National Rural Health Mission to the entire country, known as the National Health Mission . Community based health insurance can assist in providing services to areas with disadvantaged populations. Additionally, it can help to emphasize the responsibility of the local government in making resources available. Furthermore, according to the Indian Journal of Community Medicine (IJOCM)
455-498: A cognate of the even rarer English term " policlinic " (spelled similarly to and pronounced the same as the English term "polyclinic") for outpatient departments (outpatient clinics) of (public) hospitals and for large independent (public) clinics for outpatients. Some languages, for example French, specifically use a cognate of "polyclinic" to refer to private outpatient clinics. Due to the different meanings of "poly" and "poli", it
546-451: A collapsed system with insufficient access to healthcare. Differential distributions of services, power, and resources have resulted in inequalities in healthcare access. Access and entry into hospitals depends on gender, socioeconomic status , education, wealth, and location of residence (urban versus rural). Furthermore, inequalities in financing healthcare and distance from healthcare facilities are barriers to access. Additionally, there
637-652: A concept note for the setting up of NeHa , inviting comments from stakeholders. Rural areas in India have a shortage of medical professionals. 74% of doctors are in urban areas that serve the other 28% of the population, leaving many with unmet medical needs. This is a major issue for rural access to healthcare. The lack of human resources causes citizens to resort to fraudulent or ignorant providers. Doctors tend not to work in rural areas due to insufficient housing, healthcare, education for children, drinking water, electricity, roads and transportation. Additionally, there exists
728-401: A concern to the country as a whole. Considering the goal of obtaining universal health care as part of Sustainable Development Goals , scholars request policy makers to acknowledge the form of healthcare that many are using. Scholars state that the government has a responsibility to provide health services that are affordable, adequate, new and acceptable for its citizens. Public healthcare
819-500: A doctor was told he would be sacked if he didn't have enough patients to operate on. The majority of India's private , for-profit hospitals charge exorbitant costs for medical services and supplies, which has put a strain on the country's public finances. India ranks among the lowest in the world in terms of public expenditure on healthcare due to significant limitations in its workforce, infrastructure, along with deficiencies in quality and availability of healthcare services. With
910-437: A first step in improving child morbidity and mortality in difficult-to-reach rural areas." Food supplementation in the context of routine mobile clinic visits also shows to have improved the nutritional status of children, and it needs further exploration as a way to reduce childhood malnutrition in resource-scarce areas. A cross-sectional study focussed on comparing acute and chronic undernutrition rates prior to and after
1001-780: A food-supplementation program as an adjunct to routine health care for children of migrant workers residing in rural communities in the Dominican Republic. Rates of chronic undernutrition decreased from 33% to 18% after the initiation of the food-supplementation program and shows that the community members attending the mobile clinics are not just passively receiving the information but are incorporating it and helping keep their children nourished. There are many different types of clinics providing outpatient services. Such clinics may be public (government-funded) or private medical practices. Healthcare in India India has
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#17327985522211092-502: A lack of awareness among parents, and other social factors. Inequalities in healthcare can result from factors such as socioeconomic status and caste , with caste serving as a social determinant of healthcare in India. One study showed more health disparities arise when comparing urban versus rural homes rather than between castes; using three rounds of the National Family Health Surveys, researchers calculated
1183-451: A local general practice run by a single general practitioner provides primary health care and is usually run as a for-profit business by the owner, whereas a government-run specialist clinic may provide subsidized or specialized health care. Some clinics serve as a place for people with injuries or illnesses to be seen by a triage nurse or other health worker . In these clinics, the injury or illness may not be serious enough to require
1274-453: A lower proportion of households with an underweight boy or girl than less developed states, which tend to contain more rural communities. Full immunization coverage also varies between rural and urban India, with 39% completely immunized in rural communities and 58% in urban areas across India. Vaccine illiteracy remains a significant obstacle in the path towards greater immunization coverage, often due to misinformation, unreliable healthcare,
1365-431: A lower standard of living. Additionally, women and the elderly are more likely to use public services. The public health care system was originally developed in order to provide a means to healthcare access regardless of socioeconomic status or caste. However, reliance on public and private healthcare sectors varies significantly between states. Several reasons are cited for relying on the private rather than public sector;
1456-476: A medical degree and 20% have not completed a secondary education . On 27 May 2012, the popular show Satyamev Jayate did an episode on "Does Healthcare Need Healing?" which highlighted the high costs and other malpractices adopted by private clinics and hospitals. According to Huffington Post , doctors spoke about the problems with "corporate hospitals" and senior surgeons being told to sell surgeries to their patients even if they weren't needed. In one instance,
1547-625: A nationwide universal health care system known as the National Health Assurance Mission , which would provide all citizens with free drugs, diagnostic treatments, and insurance for serious ailments. In 2015, implementation of a universal health care system was delayed due to budgetary concerns. In April 2018 the government announced the Aayushman Bharat scheme that aims to cover up to 100,000,000 vulnerable families (approximately 500,000,000 persons – 40% of
1638-475: A part of the visit compared to those working in public healthcare. However, the high out of pocket cost from the private healthcare sector has led many households to incur Catastrophic Health Expenditure, which can be defined as health expenditure that threatens a household's capacity to maintain a basic standard of living. Costs of the private sector are only increasing. One study found that over 35% of poor Indian households incur such expenditure and this reflects
1729-584: A polyclinic is so large that it is in fact a hospital, it is also called a general hospital . The term was rare in English until recently and is still very rare in North America, examples include the polyclinics in England (large health care centres able to provide a wider range of services than a standard doctor's (GP) office) and The Polyclinic in Seattle, Washington, US. Most other languages use
1820-406: A shortage of infrastructure for health services in rural areas. In fact, urban public hospitals have twice as many beds as rural hospitals, which are lacking in supplies. Studies have indicated that the mortality risks before the age of five are greater for children living in certain rural areas compared to urban communities. Due to these geographic barriers, limited healthcare infrastructure, and
1911-472: A shortage of doctors and healthcare providers, who are usually concentrated in urban environments, along with the already low government expenditure on health in India, a large percentage of the population is left underserved by the Indian health system, which relies on out-of-pocket payments from patients to fund care. These payments hinder a lot of patients from being able to receive healthcare services, leaving
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#17327985522212002-508: A shortage of healthcare professions, rural areas face unique challenges. Scholars believe that if healthcare providers are able to understand these cultural nuances, they may be able to provide culturally-sensitive services specifically tailored to the needs and preferences of these communities. Children face a myriad of health risks in relation to the healthcare challenges those in rural areas encounter. Across three different measuring points from 1992 through 2006, more developed states in India had
2093-416: A significant economic impact on the poor and an approximate 50-60 million people forced into poverty annually as a result of drastic medical expenses. Despite being one of the most populous countries, India has the most private healthcare in the world. Out-of-pocket private payments make up 48% of the total expenditure on healthcare in 2018 while government and health insurance funds accounted for 62%. This
2184-524: A specific field so they reside in urban areas where there is a higher market and financial ability for those services. Unemployed people without coverage are covered by the various state funding schemes for emergency hospitalization if they do not have the means to pay for it. Unemployed individuals often face significant barriers in accessing healthcare due to the high cost of medical treatment and lack of healthcare insurance coverage. As of 2020, 300 million Indians are covered by insurance bought from one of
2275-499: A steady increase in the usage of private healthcare facilities over the last 25 years for both Out-Patient and In-Patient services, across rural and urban areas. In terms of healthcare quality in the private sector, a 2012 study by Sanjay Basu et al., published in PLOS Medicine , indicated that health care providers in the private sector were more likely to spend a longer duration with their patients and conduct physical exams as
2366-475: A usually haphazard collection of more or less independent offices of private doctors. The polyclinics in England however use the term polyclinic more or less like the term policlinic and its cognates in other languages. Policlinic A clinic (or outpatient clinic or ambulatory care clinic ) is a health facility that is primarily focused on the care of outpatients . Clinics can be privately operated or publicly managed and funded. They typically cover
2457-456: A visit to an emergency room (ER), but the person can be transferred to one if needed. Treatment at these clinics is often less expensive than it would be at a casualty department. Also, unlike an ER these clinics are often not open on a 24/7/365 basis. They sometimes have access to diagnostic equipment such as X-ray machines, especially if the clinic is part of a larger facility. Doctors at such clinics can often refer patients to specialists if
2548-445: Is a lack of sufficient infrastructure in areas with high concentrations of poor individuals. Large numbers of tribes and ex- untouchables that live in isolated and dispersed areas often have low numbers of professionals. Finally, health services may have long wait times or consider ailments as not serious enough to treat. Those with the greatest need often do not have access to healthcare. The Government of India, while unveiling
2639-580: Is in stark contrast to most other countries of the world. According to the World Health Organization in 2007, India ranked 184 out of 191 countries in the amount of public expenditure spent on healthcare out of total GDP . In fact, public spending stagnated from 0.9% to 1.2% of total GDP in 1990 to 2010 and further increased to 3.2% of GDP in 2018. Medical and non-medical out-of-pocket private payments can affect access to healthcare. Poorer populations are more affected by this than
2730-610: Is often a lack of accountability and cooperation in healthcare departments in urban areas. It is difficult to pinpoint an establishment responsible for providing urban health services, compared to in rural areas where the responsibility lies with the district administration . Additionally, health inequalities arise in urban areas due to difficulties in residence, socioeconomic status, and discrimination against unlisted slums . To survive in this environment, urban people use non-governmental , private services which are plentiful. However, these are often understaffed, require three times
2821-407: Is provided to those regions' vast rural areas by mobile health clinics or roadside dispensaries , some of which integrate traditional medicine . In India these traditional clinics provide ayurvedic medicine and unani herbal medical practice. In each of these countries, traditional medicine tends to be a hereditary practice. The function of clinics differs from country to country. For instance,
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2912-421: Is the ability to receive services of a certain quality at a specific cost and convenience. The healthcare system of India is lacking in three factors related to access to healthcare: provision, utilization , and attainment. Provision, or the supply of healthcare facilities, can lead to utilization, and finally attainment of good health. However, there currently exists a huge gap between these factors, leading to
3003-432: Is very necessary, especially when considering the costs incurred with private services. Many citizens rely on subsidized healthcare . The national budget, scholars argue, must allocate money to the public healthcare system to ensure the poor are not left with the stress of meeting private sector payments. Following the 2014 election which brought Prime Minister Narendra Modi to office, the government unveiled plans for
3094-568: The Indian Journal of Ophthalmology analyzed barriers that prevent people from seeking eye care in rural Andhra Pradesh, India . The results displayed that in cases where people had awareness of eyesight issues over the past five years but did not seek treatment, 52% of the respondents had personal reasons (some due to own beliefs about the minimal extent of issues with their vision), 37% economic hardship, and 21% social factors (such as other familial commitments or lacking an accompaniment to
3185-439: The Insurance Regulatory and Development Authority ) private health insurances, achieving the goal of near-universal health coverage. Since 2020, it is mandatory for private sector employees who are not affiliated to the employees state insurance to receive a government regulated (through the Insurance Regulatory and Development Authority health insurance regulator) health insurance plan through their employer while employees of
3276-522: The National Health Accounts report, the total expenditure on health care as a proportion of GDP in 2018 was 3.2%. Out of 3.2%, the governmental health expenditure as a proportion of GDP is just 2%, and the out-of-pocket expenditure as a proportion of the current health expenditure was 42.06% in 2019 while expenditure of the government and health insurance funds increased to 57%. In 2019, the total net government spending on healthcare
3367-517: The National Health Protection Scheme health insurance. All employers in India are legally mandated to provide additional health insurance coverage to their employees and dependents as part of Social Security in India . People also receive additional complementary health insurance coverage by their employers through either one of the four main public health insurance funds which are the: The government of India has
3458-531: The World Bank , about 25% of India's population had some form of health insurance in 2010. A 2014 Indian government study found this to be an over-estimate, and claimed that only about 17% of India's population was insured. Private healthcare providers in India typically offer high quality treatment at unreasonable costs as there is no regulatory authority or statutory neutral body to check for medical malpractices. In Rajasthan , 40% of practitioners did not have
3549-417: The compulsory license , where any pharmaceutical company has the right to produce any patented product by paying a fee. This right was used in 2012, when Natco was allowed to produce Nexavar, a cancer drug. In 2005, new legislation stipulated that a medicine could not be patented if it did not result in "the enhancement of the known efficacy of that substance". Indians consumed the most antibiotics per head in
3640-446: The poverty line . Furthermore, over 23% of patients don't have enough money to afford treatment and 63% lack regular access to necessary medications. Healthcare and treatment costs have inflated 10–12% a year and with more advancements in medicine, costs of treatment will continue to rise. Finally, the price of medications rise as they are not controlled. However, out-of-pocket expenditure has declined substantially in recent years with
3731-400: The primary care needs of populations in local communities, in contrast to larger hospitals which offer more specialized treatments and admit inpatients for overnight stays. Most commonly, the English word clinic refers to a general practice , run by one or more general practitioners offering small therapeutic treatments, but it can also mean a specialist clinic. Some clinics retain
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3822-500: The 2007-2009 District Level Household Survey. Sanitation and hygiene are directly linked to disease and overall rural health outcomes. Similar with many other countries, often those in rural India rely on informal providers to deliver necessary medical care. Utilizing modern and traditional medical practices, such as allopathic medicines and herbal remedies, informal providers have varying degrees of skills and education, but usually no formal medical qualifications. Yet, they far outnumber
3913-757: The Central and State Governments’ budgeted expenditure on the health sector reached 2.1% of GDP in FY23 and 2.2% in FY22, against 1.6% in FY21. India ranks 78th and has one of the lowest healthcare spending as a percent of GDP . It ranks 77th on the list of countries by total health expenditure per capita . The National Health Policy was endorsed by the Parliament of India in 1983 and updated in 2002, and then again updated in 2017. The recent four main updates in 2017 mention
4004-719: The Multidimensional Poverty Index, which is aimed at further elucidating the indicators and social determinants of health. Between urban and rural households, the headcount ratio difference was found to be 20-30% in 2005–2006, while between scheduled castes/scheduled tribes and other households the difference was only 10-15%. Other critical social determinants of health in India include sanitation/hygiene, environmental pollution, nutrition, and more. Across all states, less than 50% (and in some less than 25%) of urban homes had unimproved sanitation, compared to over 50% (and in some over 75%) of rural homes, according to
4095-496: The NRHM is to provide effective healthcare to rural people with a focus on 18 states with poor public health indicators and/or weak infrastructure . NRHM has 18,000 ambulances and a workforce of 900,000 community health volunteers and 178,000 paid staff. The mission proposes creating a course for medical students that is centered around rural healthcare. Furthermore, NRHM wants to create a compulsory rural service for younger doctors in
4186-519: The National Health Portal, has come out with guidelines for Electronic health record standards in India. The document recommends a set of standards to be followed by different healthcare service providers in India, so that medical data becomes portable and easily transferable. India is considering to set up a National eHealth Authority (NeHA) for standardisation, storage and exchange of electronic health records of patients as part of
4277-678: The PM-JAY as a result of health technology assessment (HTA). Since 2005, most of the healthcare capacity added has been in the private sector, or in partnership with the private sector. The private sector consists of 58% of the hospitals in the country, 29% of beds in hospitals, and 81% of doctors. According to National Family Health Survey-3, the private medical sector remains the primary source of health care for 70% of households in urban areas and 63% of households in rural areas. The study conducted by IMS Institute for Healthcare Informatics in 2013, across 12 states in over 14,000 households indicated
4368-482: The art cardio-vascular procedures, organ transplants, and cancer treatments (including bone marrow transplants) are covered. Employers are responsible for paying for an extensive package of services for private sector expatriates (through one of the public or private funds) unless they are eligible for the Employees' State Insurance or the Employees' Provident Fund Organisation , which most foreign workers are. At
4459-424: The coast became "artificial" communities, and due to lack of traditional home healing practices here, alternative methods such as mobile clinics had to be implemented in these communities for the protection and prevention of diseases. A study done in rural Namibia revealed the health changes of orphans, vulnerable children and non-vulnerable children (OVC) visiting a mobile clinic where health facilities are far from
4550-451: The countries of Central and Eastern Europe (often using a mixed Soviet-German model), as well as in former Soviet republics such as Russia and Ukraine; and in many countries across Asia and Africa. In Europe, especially in the Central and Eastern Europe, bigger outpatient health centers, commonly in cities and towns, are called policlinics (derived from the word polis, not from poly-). Recent Russian governments have attempted to replace
4641-414: The country which will benefit about 33 lakh (3.3 million) ex-servicemen residing in remote and far-flung areas. Policlinics are also the backbone of Cuba's primary care system and have been credited with a role in improving that nation's health indicators. Providing health services through mobile clinics provides accessible healthcare services to these remote areas that have yet to make their way in
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#17327985522214732-655: The country's population). This will cost around $ 1.7 billion each year. Provision would be partly through private providers. In 2017, the Medical Technology Assessment Board and its secretariat Health Technology Assessment in India. The Health Financing and Technology Assessment (HeFTA) unit within the National Health Authority (NHA) in 2022 further enhanced evidence-based decision-making processes in prioritizing health benefits and demonstrating significant cost savings to
4823-409: The detrimental state in which Indian health care system is at the moment. With government expenditure on health as a percentage of GDP falling over the years and the rise of private health care sector, the poor are left with fewer options than before to access health care services. Private insurance is available in India, as are various through government-sponsored health insurance schemes. According to
4914-400: The distribution of different types of healthcare providers across urban and rural Madhya Pradesh in terms of the differences in access to healthcare through number of providers present. The results indicated that in rural Madhya Pradesh, there was one physician per 7870 people, while there was one physician per 834 people in the urban areas of the region. In terms of other healthcare providers,
5005-484: The federal level, a national publicly funded health insurance program was launched in 2018 by the Government of India, called the National Health Protection Scheme . This aimed to cover the bottom 50% (500 million people) of the country's population working in the unorganized sector (enterprises having less than 10 employees) and offers them free treatment at both public and private hospitals. For people working in
5096-470: The government and health insurance funds accounting for 62% of the total expenditure. There was a major gap between outreach, finance and access in India. However, with a growing economy, the state developed an enhanced fiscal capacity to cover most citizens and residents of the country with basic health insurance cover. In 1970, the Indian government banned medical patents. India signed the 1995 TRIPS Agreement which allows medical patents, but establishes
5187-482: The government should reform health insurance as well as its reach in India. The journal states that universal healthcare should slowly yet steadily be expanded to the entire population. Healthcare should be mandatory and no money should be exchanged at appointments. Finally, both private and public sectors should be involved to ensure all marginalized areas are reached. According to the IJOCM, this will increase access for
5278-495: The government's Digital India programme. The authority, to be set up by an Act of Parliament will work on the integration of multiple health IT systems in a way that ensures security, confidentiality and privacy of patient data. A centralised electronic health record repository of all citizens which is the ultimate goal of the authority will ensure that the health history and status of all patients would always be available to all health institutions. Union Health Ministry has circulated
5369-469: The healthcare facility). The role of technology, specifically mobile phones in health care has also been explored in recent research as India has the second largest wireless communication base in the world, thus providing a potential window for mobile phones to serve in delivering health care. Specifically, in one 2014 study conducted by Sherwin DeSouza et al. in a rural village near Karnataka , India, it
5460-688: The hopes that they will remain in rural areas. However, the NRHM has failings. For example, even with the mission, most construction of health related infrastructure occurs in urban cities. Many scholars call for a new approach that is local and specialized to each state's rural areas. Other regional programs such as the Rajiv Aarogyasri Community Health Insurance Scheme in Andhra Pradesh , India have also been implemented by state governments to assist rural populations in healthcare accessibility, but
5551-574: The lower classes do so because of health expenditures. This data shows that financial ability plays a role in determining healthcare access. In terms of non-medical costs, distance can also prevents access to healthcare. Costs of transportation prevent people from going to health centers. According to scholars, outreach programs are necessary to reach marginalized and isolated groups. In terms of medical costs, out-of-pocket hospitalization fees prevent access to healthcare. 40% of people that are hospitalized are pushed either into lifelong debt or below
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#17327985522215642-435: The main reason at the national level is poor quality of care in the public sector, with more than 57% of households pointing to this as the reason for a preference for private health care. Much of the public healthcare sector caters to the rural areas, and the poor quality arises from the reluctance of experienced healthcare providers to visit the rural areas. Consequently, the majority of the public healthcare system catering to
5733-573: The medical field: for example, legal clinics are run by lawyers .) Some clinics are operated in-house by employers, government organizations, or hospitals, and some clinical services are outsourced to private corporations which specialize in providing health services. In China , for example, owners of such clinics do not have formal medical education. There were 659,596 village clinics in China in 2011. Health care in India , China , Russia and Africa
5824-684: The mortality rates greater for girls compared to boys, even before the age of five. Other previous studies have also delved into the influence of gender in terms of access to healthcare in rural areas, finding gender inequalities in access to healthcare. A 2002 study with data taken from June 1998 to May 1999 was conducted by Aparna Pandey et al., published in the Journal of Health, Population, and Nutrition, analyzed care-seeking behaviors by families for girls versus boys, given similar sociodemographic characteristics in West Bengal , India. In general,
5915-422: The name "clinic" even while growing into institutions as large as major hospitals or becoming associated with a hospital or medical school . The word clinic derives from Ancient Greek κλίνειν klinein meaning to slope, lean or recline. Hence κλίνη klinē is a couch or bed and κλινικός klinikos is a physician who visits his patients in their beds. In Latin, this became clīnicus . An early use of
6006-459: The national government addresses broadly applicable healthcare issues such as overall family welfare and prevention of major diseases, while the state governments handle aspects such as local hospitals, public health, promotion and sanitation, which differ from state to state based on the particular communities involved. Interaction between the state and national governments does occur for healthcare issues that require larger scale resources or present
6097-400: The need arises. Large outpatient clinics vary in size, but can be as large as hospitals. Typical large outpatient clinics house general medical practitioners (GPs) such as doctors and nurses to provide ambulatory care and some acute care services but lack the major surgical and pre- and post-operative care facilities commonly associated with hospitals. Besides GPs, if a clinic is
6188-413: The need to focus on the growing burden of non-communicable diseases, the emergence of the robust healthcare industry, growing incidences of unsustainable expenditure due to healthcare costs, and rising economic growth enabling enhanced fiscal capacity. Furthermore, in the long-term, the policy aims to set up India's goal to reform its current system to achieve universal health care. In practice however,
6279-477: The organized sector (enterprises with more than 10 employees) and earning a monthly salary of up to ₹21,000 are covered by the social insurance scheme of Employees' State Insurance which entirely funds their healthcare (along with unemployment benefits), both in public and private hospitals. People earning above that threshold are mostly affiliated to the social security body Employees' Provident Fund Organisation and these people are also covered automatically by
6370-533: The payment as a public center, and commonly have bad practice methods. To counter this, there have been efforts to join the public and private sectors in urban areas. An example of this is the Public-Private Partnerships initiative. However, studies show that in contrast to rural areas, qualified physicians tend to reside in urban areas. This can be explained by both urbanization and specialization. Private doctors tend to be specialized in
6461-555: The policlinic model introduced during Soviet times with a more western model. However, this has failed. In the Czech Republic , many policlinics were privatized or leasehold and decentralized in the post-communist era: some of them are just lessors and coordinators of a healthcare provided by private doctor's offices in the policlinic building. India has also set up huge numbers of polyclinics for former defense personnel. The network envisages 426 polyclinics in 343 districts of
6552-528: The politicized space. For example, mobile clinics have proved helpful in dealing with new settlement patterns in Costa Rica. Before foreign aid organizations or the state government became involved in healthcare, Costa Rica's people managed their own health maintenance and protection. People relied on various socio-cultural adaptations and remedies to prevent illnesses, such as personal hygiene and settlement patterns. When new settlements that sprang up along
6643-468: The poor. See Twelfth Five Year Plan (India) . To counteract the issue of a lack of professionals in rural areas, the government of India wants to create a ' cadre ' of rural doctors through governmental organizations. The National Rural Health Mission (NRHM) was launched in April 2005 by the Government of India. The NRHM has outreach strategies for disadvantaged societies in isolated areas. The goal of
6734-603: The prescribing doctor and the patient's details. As of 2013, the number of trained medical practitioners in the country was as high as 1.4 million, including 0.7 million graduate allopaths. Yet, India has failed to reach its Millennium Development Goals related to health. Developed countries have been able to adapt to the changing needs of a growing elderly population faster than India and other countries with similar socioeconomic conditions and have developed models for over seventy years to address these needs, through more inclusive care and health insurance. The definition of 'access
6825-420: The private healthcare sector is responsible for the majority of healthcare in India, and a lot of healthcare expenses are paid directly out of pocket by patients and their families, rather than through health insurance due to incomplete coverage. Government health policy has thus far largely encouraged private-sector expansion in conjunction with well-designed but limited public health programmes. According to
6916-399: The public or private insurance companies by their employers as group or individual plans. Indian nationals and foreigners who work in the public sector are eligible for a comprehensive package of benefits including both public and private health, preventive, diagnostic, and curative services and pharmaceuticals, with very few exclusions, and no cost sharing. Most services including state of
7007-582: The public sector receive it through the Central Government Health Plan. The Human Rights Measurement Initiative finds that India is doing 84.9% of what should be possible at its level of income for the right to health. Public healthcare is free for every Indian resident. The Indian public health sector encompasses 18% of total outpatient care and 44% of total inpatient care . Middle and upper class individuals living in India tend to use public healthcare less than those with
7098-493: The quantity of medical providers in India; a study from Madhya Pradesh found there to be 24,807 qualified medical doctors, compared to 89,090 informal providers. They are also the most common first call for those in rural areas requiring medical services. Due to the lack of accessible healthcare in rural India, informal providers respond to much of the resulting unmet medical needs, proving them integral to rural health infrastructure. A 2007 study by Vilas Kovai et al., published in
7189-445: The remote villages. Over 6 months, information on immunization status, diagnosis of anemia, skin and intestinal disorders, nutrition, dental disorders was collected and showed that visits to mobile clinics improved the overall health of children that visited regularly. It concluded that specified "planning of these programs in areas with similarly identified barriers may help correct the health disparities among Namibian OVC and could be
7280-601: The results exhibited clear gender differences such that boys received treatment from a healthcare facility if needed in 33% of the cases, while girls received treatment in 22% of the instances requiring care. Furthermore, surveys indicated that the greatest gender inequality in access to healthcare in India occurred in the provinces of Haryana , and Punjab . The problem of healthcare access arises not only in huge cities but in rapidly growing small urban areas. Here, there are fewer available options for healthcare services and there are less organized governmental bodies. Thus, there
7371-460: The rural and remote areas relies on inexperienced and unmotivated interns who are mandated to spend time in public healthcare clinics as part of their curricular requirement. Other major reasons are long distances between public hospitals and residential areas, long wait times, and inconvenient hours of operation. Different factors related to public healthcare are divided between the state and national government systems in terms of making decisions, as
7462-417: The social aspect of gender as a determinant for health-seeking behavior , finding that male children and adult men were more likely to receive treatment for acute ailments compared to their female counterparts in the areas of rural Bihar and Uttar Pradesh represented in the study. These inequalities in healthcare based on gender access contribute towards the differing mortality rates for boys versus girls, with
7553-432: The study displayed some variation according to acute illnesses versus chronic illnesses. In general, it was found that as socioeconomic status increased, the probability of seeking healthcare increased. Educational level did not correlate to probability of healthcare-seeking behavior for acute illnesses, however, there was a positive correlation between educational level and chronic illnesses. This 2016 study also considered
7644-837: The study found that of the qualified paramedical staff present in Madhya Pradesh, 71% performed work in the rural areas of the region. In addition, 90% of traditional birth attendants and unqualified healthcare providers in Madhya Pradesh worked in the rural communities. Studies have also investigated determinants of healthcare-seeking behavior (including socioeconomic status, education level, and gender), and how these contribute to overall access to healthcare accordingly. A 2016 study by Wameq Raza et al., published in BMC Health Services Research, specifically surveyed healthcare-seeking behaviors among people in rural Bihar and Uttar Pradesh , India. The findings of
7735-448: The success of these programs (without other supplemental interventions at the health system level) has been limited. Furthermore, a key goal of the NRHM was to bolster maternal and child health via infrastructural support and incentives, a long-time obstacle in India. The program led to an increase in the number of institutional births, yet labor shortages meant patients received poorer care, trading one challenge for another. Statistically,
7826-422: The wealthy. The poor pay a disproportionately higher percent of their income towards out-of-pocket expenses than the rich. The Round National Sample Survey of 1955 through 1956 showed that 40% of all people sell or borrow assets to pay for hospitalization. Half of the bottom two quintiles go into debt or sell their assets , but only a third of the top quintiles do. In fact, about half the households that drop into
7917-449: The word clinic was "one who receives baptism on a sick bed". Clinics are often associated with a general medical practice run by one or several general practitioners . Other types of clinics are run by the type of specialist associated with that type: physical therapy clinics by physiotherapists and psychology clinics by clinical psychologists , and so on for each health profession. (This can even hold true for certain services outside
8008-460: The world in 2010. Many antibiotics were on sale in 2018 which had not been approved in India or in the country of origin, although this is prohibited. A survey in 2017 found 3.16% of the medicines sampled were substandard and 0.0245% were fake. Those more commonly prescribed are probably more often faked. Some medications are listed on Schedule H1, which means they should not be sold without a prescription. Pharmacists should keep records of sales with
8099-436: Was $ 36 billion or 1.23% of its GDP. India had allocated 1.8% of its GDP to health in 2020–21. Since 2022, the healthcare funding by the central and state governments increased substantially to $ 74 billion. Out of pocket expenditure significantly reduced as most healthcare expenditure is met by government health insurance schemes, social health insurances such as the Employees' State Insurance and government regulated (through
8190-850: Was found that participants in community who owned a mobile phone (87%) displayed a high interest rate (99%) in receiving healthcare information through this mode, with a greater preference for voice calls versus SMS (text) messages for the healthcare communication medium. Some specific examples of healthcare information that could be provided includes reminders about vaccinations and medications and general health awareness information. The distribution of healthcare providers varies for rural versus urban areas in North India. A 2007 study by Ayesha De Costa and Vinod Diwan, published in Health Policy , conducted in Madhya Pradesh , India examined
8281-439: Was traditionally considered incorrect to use the English term "polyclinic" for European policlinics. In addition, European policlinics (called "poliklinik", "policlinique", "поликлиника" [poliklinika], or similarly in other languages) are more like hospitals or are part of a hospital and are public and therefore free or inexpensive whereas polyclinics are traditionally much less structured and comprehensive organizations consisting of
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