Education/Health
Healthcare and education are the basic essentials of a flourishing democracy and a nation whose citizens are gifted with active governance that focuses on both of these elements; sets forward with much pace and zest. On the other hand, a lack of good governance and political will in a country leads to deterioration in its citizens' health and education facilities, and it lags behind in all aspects of development.
Healthcare in India
India has been foremost, since ancient times, in guaranteeing its citizens national health care as a uniform right, but as of today, primary health care in India embodies a crisis unmatched by any other social sector.
The primary level of health care includes medical services by doctors and nurses without the need for hospitalization. This is generally dispensed at community health centres (CHCs), primary health centres (PHCs), and sub-centers (SCs) or private clinics. Secondary healthcare is specialists’ care provided at subdistrict hospitals or private clinics, and there’s no shortage of specialists like cardiologists, gynecologists, ophthalmologists, endocrinologists and so on, either in public or private practice. The tertiary level of healthcare is specialized care on hospitalization, and quaternary, an extension of tertiary, involving highly specialized and individualized intensive care. India has some of the best and cost-effective tertiary and quaternary care globally, which, thanks to the cost of medical treatment in the developed Western world remaining high, has given it a thriving medical tourism sector. Ayushman Bharat, the National Health Protection Scheme, covers over 10 crore poor and vulnerable families (approximately 50 crore beneficiaries), providing coverage up to 5 lakh rupees per family per year for secondary and tertiary care hospitalization. However, primary care for the large numbers of the rural and urban poor in the country is still a huge challenge.
Challenges Faced in Primary healthcare.
Primary healthcare gets hurdled by capital and financial viability amid the large disease burden in the face of extreme poverty and the inclination of people to directly approach medical facilities even for routine consultation. As the problem of aggregate supply of qualified physicians remains pressing, there is an urgent need of roping in sufficient numbers of physicians trained in alternate systems of medicine to fill the gap; they may be trained and given legal licenses to practice allopathic medicine.
A significant amount of effort is required to meet two structural challenges; making the related domains of primary care robust and integrating primary care with higher levels of care. All the countries seen as good models of healthcare delivery, such as Spain and the UK in the developed world and Thailand, Brazil, and Mexico in the developing world, have their primary care as the anchor around which the entire system is built. There is a high level of integration between various levels of care with strong gate-keeping and patient management functions performed by the primary healthcare providers.
In 2005, The Lancet journal reported that for every 10,000 people, India had 10 doctors in urban areas but only one in rural areas. Surprisingly, not much changed over the years. The Lancet report of 2018 stated that though there was an increase in the number of health facilities in rural areas in the previous decade, yet getting enough doctors to work in villages remained an alarming challenge for India.
Healthcare needs to be re-evaluated, and immediate reforms and concrete steps of improvement need to be taken. Community development, skill up-gradation, capacity development, capacity reinvigoration, and eliminating the scope of practice for unqualified practitioners or ‘quacks’ are some of the focus areas for boosting the healthcare sector. There is also a need for a medical curriculum that is adequately oriented to primary care and community health; and a healthcare system and policy environment that gives the poorest of the citizens their due.
The building blocks of a nation are the citizens of its tomorrow, and an investment in knowledge pays the best dividends, in the words of Benjamin Franklin. In an increasingly knowledge-based global economy, quality education is more important than ever. India’s education sector has expanded rapidly in the last decade, but the quality of learning remains pathetic on account of unimaginative and misguided policies.
The United Nation’s Sustainable Development Goals include a commitment to ensure inclusive and equitable quality education and promote lifelong learning opportunities for all. India’s Right to Education Act has successfully achieved three broad objectives: higher enrollment, lower dropout, and completion of mandatory basic education. However, the cause for concern is that even as enrolment has improved sharply for both boys and girls, not only at the primary but also in the 11-14 age group, literacy and numeracy skills remain dismally below par.
The latest Annual Status of Education Report (ASER 2018) survey — the most authentic barometer of India’s educational health — shows that its findings are not inspiring, and in some cases, quite dismal. The fragile foundation of basic education augurs a dim horizon for India’s future human capital. The students cannot learn the basics of reading, writing, and arithmetic and do not even meet elementary mathematics standards.
The ASER survey covered 5.46 lakh children in the age group 3-16 across 596 districts. What is alarming is the decline in reading and arithmetical abilities at the Class VIII level since 2012, with government schools faring worse than private ones: More than a quarter of all children at this level cannot read a Class II text, while over half of all children cannot divide (three digits by a single-digit number). Seen along ASER’s previous year survey on dismal learning abilities of the 14-18 age group, those about to enter the workforce, India’s “demographic dividend” riding on its largely young population seems a sour joke.
It is time the country moved beyond a singular focus on enrolment numbers and grappled with the problem of poor quality. Inefficient teaching methodologies, such as rote learning, which focuses on memorization as opposed to critical reasoning, are still widespread at the primary and secondary school levels. Real education is more about wide reading, deep thinking and asking hard questions rather than simply reproducing crammed answers faithfully. Formal teaching needs to be supplemented by in-school pull-out programmes, after-school tutoring, and summer camps supervised by NGOs, emphasizing non-conventional innovative pedagogies.
Education needs more champions than health and environmental advocates because it is one rising tide that can lift all the boats. Since education has more room for innovation than any other development sector, it holds a unique opportunity for social entrepreneurs.
The curriculum and teaching practices need to be transformed to focus less on rote learning or straightforward calculation and more on relevant skills, like communication, reasoning ability, problem-solving ability, and critical and independent thinking.
Adequate resources, higher standards for teachers and the flushing out of corruption must all be parts of a comprehensive reform package seeking to make education the nation’s top priority.
