Essays: Neglect of Primary Health Care and Education in India are Reasons for its Back (August 2024) | Current Affairs & Hindu Analysis: Daily, Weekly & Monthly - UPSC PDF Download

"To keep the body in good health is a duty; otherwise, we shall not be able to keep our mind strong and clear." — Gautama Buddha

India, renowned for its rich cultural heritage and rapid economic development, faces ongoing challenges in achieving holistic progress. A major issue is the neglect of primary health care and education, which hinders comprehensive development.

The neglect of these critical sectors stems from historical, socio-economic, and political factors. Colonial rule and subsequent post-independence issues have left lasting impacts on India's development trajectory. During the colonial period, health care and education were often marginalized, catering mainly to the ruling elite. This legacy of insufficient investment continued after independence, compounded by challenges like poverty, population growth, and bureaucratic inefficiencies.

Primary health care is fundamental to an effective health system, providing essential services close to communities. However, in India, the primary health care infrastructure remains grossly inadequate, particularly in rural areas. Problems such as limited access to quality care, shortages of trained medical personnel, and inadequate funding have hindered efforts to improve health outcomes for millions. The consequences include high maternal and infant mortality rates, persistent communicable diseases, and limited healthcare-seeking behavior among marginalized populations.

A 2019 study by the National Health Authority (NHA) found that in rural Madhya Pradesh, nearly 18% of the population lives more than 5 km from the nearest Primary Health Centre (PHC). This distance is a significant barrier for pregnant women or those with critical illnesses, limiting access to essential care.

According to the World Health Organization (WHO), the ideal Allopathic general doctor-patient ratio is 1:1000, but in India, it stands at a poor 1:1445 (2018 data). This shortage is more severe in rural areas, where many PHCs have only one doctor, if any. Specialists such as pediatricians and gynecologists are even rarer in these centers, forcing patients to travel long distances for basic consultations, further straining the healthcare system.

Inadequate government funding means many PHCs rely on user fees, which make essential healthcare unaffordable for poor families, leading them to delay seeking care or use traditional medicine with potentially harmful effects.

India's Maternal Mortality Rate (MMR) is 97 (2018-20). Although there has been improvement compared to previous years, issues such as limited access to quality antenatal care and skilled birth attendants in rural PHCs persist.

India continues to struggle with diseases like tuberculosis and malaria. The lack of proper diagnosis, treatment, and public health education at PHCs due to resource constraints allows these diseases to persist.

Education is recognized as a fundamental right and a driver of socio-economic development. However, India faces significant challenges, including inadequate infrastructure, teacher shortages, outdated curricula, and high dropout rates. Particularly in rural and remote areas, children often lack access to schools or receive substandard education, perpetuating cycles of poverty and inequality. The neglect of education not only denies individuals opportunities for personal growth but also undermines the nation's potential for human capital and innovation.

For instance, the literacy rate in Kerala, a state with a strong focus on education, exceeds 94%, while in Bihar, a less affluent state, it is around 61.8%. Children from wealthier families are more likely to attend private schools with better facilities, while government schools in rural areas often offer inferior education. A UNESCO report highlighted that India has a shortage of over 1 million teachers, disproportionately affecting rural schools. Some school curricula may not focus on developing critical thinking and digital skills required in today’s job market.

The Annual Status of Education Report (ASER) 2023 reveals that nearly one-third of grade eight students in rural India cannot read at the expected level. Many rural schools lack adequate buildings, sanitation, and educational resources.

Indian higher education institutions are struggling to adapt to contemporary needs with curricula that have not been updated for almost four decades. A curriculum should evolve with socio-economic changes, but many colleges and institutes lag in providing students with future-ready skills. According to the "India's Graduate Skill Index: 2023" report, about 44% of graduates are employable for top technical jobs, while 53% are employable for top non-technical jobs.

The neglect of primary health care and education has extensive implications for India's development. Socially, it exacerbates inequalities and reinforces caste, gender, and regional disparities. Economically, it hampers productivity, reduces labor market efficiency, and limits opportunities for inclusive growth. Human development indicators, such as literacy rates and life expectancy, are closely tied to investments in health and education. By neglecting these sectors, India risks failing to achieve its sustainable development goals and realizing its potential as a global economic leader.

Without quality education, individuals, especially those from disadvantaged backgrounds, struggle to compete for jobs and escape poverty. A skilled workforce is vital for national development. Educational disparities limit India's potential for innovation and economic competitiveness.

The interconnectedness between health and education highlights the need for integrated policies and interventions. Improved health outcomes can enhance educational attainment, as healthy children are more likely to attend school regularly and perform well academically. Conversely, educated individuals are better equipped to make informed health decisions and access services. Initiatives such as school health programs and community-based education interventions can provide combined benefits for both sectors, fostering holistic development.

Addressing the neglect of primary health care and education in India requires a comprehensive approach, including policy reforms, increased investment, and community engagement.

Expand and upgrade primary health care infrastructure, especially in rural areas. Invest in training and deploying community health workers to bridge service delivery gaps and promote preventive care.

Revise curricula to be more relevant, inclusive, and responsive to diverse learner needs. Improve teacher training and support to enhance teaching effectiveness. Invest in technology-enabled learning platforms to reach remote populations and offer personalized learning experiences.

Implement targeted interventions to address disparities in access to health care and education, focusing on marginalized groups like women, children, and tribal communities. Provide services in culturally sensitive and linguistically appropriate ways to improve acceptability and utilization.

Increase public spending on health and education to meet international standards and address resource gaps. Explore innovative financing mechanisms, such as public-private partnerships and social impact investments, to enhance funding and optimize resource use.

Empower communities to participate actively in decision-making related to health and education. Strengthen grassroots organizations and community-based initiatives to promote ownership, accountability, and sustainability of interventions.

The neglect of primary health care and education in India represents a significant barrier to the nation's development goals. By addressing these systemic challenges and investing in human capital, India can unlock its potential and embark on a path of inclusive and sustainable growth. Through collective efforts across sectors and stakeholders, India can overcome these challenges and emerge as a symbol of progress and prosperity for the world.

"An education which does not teach us to discriminate between good and bad, to assimilate the one and eschew the other, is a misnomer." — Mahatma Gandhi