New Delhi: India has made rapid strides in improving healthcare in India in the last 75 years. Dr. Dileep Mavalankar, Director, Indian Institute of Public Health, Gandhinagar, joined the NDTV-Dettol Banega Swasth India’s 12-hour telethon – Lakshya – Sampoorn Swasthya Ka, on October 2, and spoke about the biggest game-changers in the healthcare sector. Remembering Mahatma Gandhi on his birth anniversary, Dileep Mavalankar said, “Not gold, not silver, it is health that is the wealth of any nation.”
Speaking about the history of healthcare in India, Dr. Mavalankar detailed how the British had created a healthcare system by establishing military and civil hospitals in various parts of India for their armed forces, as well as the British and Indian servants of the Raj.
It was after independence, the primary healthcare system was created in India, with more than 25,000 health centres (one for 30,000 people), and over 150 sub-centres with nurses (one for each five villages), Dr. Mavalankar said.
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Today, under the national rural health mission, India has Auxiliary Nurse Midwife (ANMs), Accredited Social Health Activist (ASHA) workers and community health officers as ‘foot soldiers’ of the health system.
The expansion of rural healthcare and taking healthcare to the grassroots of the country is revolutionary in the healthcare system.
This was unimaginable at the time we were becoming independent. As a public health expert, I would say this is one of the main game-changers in the healthcare system, Dr. Mavalankar said.
He said that an ASHA worker or a community health officer is a blessing for a villager, who would earlier cover more than 20 kilometres of distance to see a doctor or a medical specialist. Any kind of causality was difficult to answer, the expert said.
We saw how our ASHAs, ANMs, medical officers, and other laboratory technicians worked in the remote areas to prevent coronavirus and provided care to the infected. The expansion of our rural health services has been a boon, but there is no doubt that we need to do more, Dr. Mavalankar added.
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Speaking on the previous revolutionary changes in healthcare, Dr. Mavalankar quoted the examples of smallpox, polio, and many other diseases that were eradicated from India, with the help of various inventions and medical experts’ work.
Several immunisation programs, improvement in institutional deliveries, child health, etc., have also been game-changers in the healthcare system.
Earlier, maternal mortality was very high. The estimates of mothers dying during delivery were almost 1,000 to 2,000 per lakh of deliveries, he informed.
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Speaking on the importance of child immunisation, Dr. Mavalankar said that logistical issues have been an obstacle.
We are ready to fight emergencies. When a war is there against a pandemic, everything is galvanised. But we lack in following routine health programs, he said
Dr. Mavalankar emphasised the need to strengthen the public health system.
We have not been able to sell our public health, because our public health cadre is very weak. We don’t even have a cadre. The citizens do not understand what it is, as they think it is only a doctor’s job in the health sector. A public health cadre is a multidisciplinary platform comprising health educators, artists, lawyers, etc., who would educate people about the system, he said.
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About the concept of family planning, Dr. Mavalankar said that India was a ‘Vishwa Guru’, as it was the first to start any government family planning programme in 1952.
At the time, there were 6-7 children being born to a woman, now there are commonly two. This is an untold success story, he said.
Lastly, he spoke about the transformational liberalisation of abortion as a women’s right issue.
We liberalised abortion services in 1971, one year before Sweden did. In many public health areas, we have been the torch bearers, Dr. Mavalankar said.
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NDTV – Dettol have been working towards a clean and healthy India since 2014 via the Banega Swachh India initiative, which is helmed by Campaign Ambassador Amitabh Bachchan. The campaign aims to highlight the inter-dependency of humans and the environment, and of humans on one another with the focus on One Health, One Planet, One Future – Leaving No One Behind. It stresses on the need to take care of, and consider, everyone’s health in India – especially vulnerable communities – the LGBTQ population, indigenous people, India’s different tribes, ethnic and linguistic minorities, people with disabilities, migrants, geographically remote populations, gender and sexual minorities. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign will continue to raise awareness on the same along with focussing on the importance of nutrition and healthcare for women and children, fight malnutrition, mental wellbeing, self care, science and health, adolescent health & gender awareness. Along with the health of people, the campaign has realised the need to also take care of the health of the eco-system. Our environment is fragile due to human activity, which is not only over-exploiting available resources, but also generating immense pollution as a result of using and extracting those resources. The imbalance has also led to immense biodiversity loss that has caused one of the biggest threats to human survival – climate change. It has now been described as a “code red for humanity.” The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene. Banega Swasth India will also be taking forward the dream of Swasth Bharat, the campaign feels that only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and the country can become a Swasth or healthy India.