[India] Poor health keeps UP farmer in debt

from The Times Of India

LUCKNOW: UP has the highest population of indebted farmer households in the country. And the main reason is that a large portion - around 60% - of their earnings is spent on health. As a result of which 25% of those falling ill end up in belw poverty line strata.

What is more disturbing is the fact that proportion of India's poor living in UP has risen from 17% in 1983 to over 20% in 1999. Studies show that UP has high concentration of people living around the poverty line and their nutritional status leaves them vulnerable to poor health.

Moreover, the worst hit are the indebted farmer households. They are estimated to be well around 40.3% (6.9 million) of the total 17.6 million farmer households in the state. Average outstanding loan per household is around Rs 6706.

Studies show that diseases are rampant among them and over 40% of those hospitalised are forced to borrow heavily or sell assets to cover medical expenses. As a result, over 25% of them fall below poverty line because of hospital expense.

These facts were pointed out in the UP development report, prepared by the Planning Commission; the Twelth Finance Commission's report, annual plan document of the planning department of UP and the World Bank's document entitled 'Poverty in India: The Challenge of UP'.

An assessment of utilisation patterns of public and private healthcare facilities shows that despite the provision of free or low-cost services at government healthcare facilities, demand for public sector outpatient services are low even amongst those of BPL category.

The poor are increasingly turning to private providers, even for treatment of infectious disease such as TB and Malaria, which are designated as primary responsibilities of the public health system.

The high percentage of outpatient curative services sought from the private sector, even by the lowest income group of the population suggests that the public health system is not adequately fulfilling the health needs of the poor, particularly in rural areas.

At present, the major problems at the primary level in healthcare can chiefly be attributed to shortage of around 3200 qualified doctors at primary health centres (PHC), non-availability of proper infrastructure - including equipment and consumables - besides poor motivation of the public to seek timely help mainly because of misbeliefs, superstitions and lack of health education.

The result of non-functioning PHCs has been that in many cases, diseases are neither diagnosed in their early stages, nor treated.

The rural population has to often travel to urban areas when they can no longer bear the suffering caused by the disease, thus increasing the load on hospitals in the urban areas and ending up with serious complications that, in many cases, could have easily been treated at their early stages.