Health being a State subject, it is the primary responsibility of the State Government to bring the desired improvement in the health sector of the State. It has been observed from a number of indicators that the health status of Odisha is quite disappointing. It seems that health has not been a top priority concern for the State Government. Health and education are vital to develop human resources but the State Government has been only taking piecemeal measures without improving the health sector of the State with the required seriousness and investment.
Poor health condition of a majority of masses has serious ramification over the economy and economic growth. One of the major reasons of the persistent backwardness of Odisha is negligence of its public health and education system which produces poor human resources. Majority of them remain unskilled and semi-productive manpower. Health indicators by the Sample Registration System report 2018 shows the infant (less than one year) mortality rate (IMR) in case of Odisha was 40, while infant deaths per thousand live births are higher than national average of 32.
It is highest 48 in MP but in case of Kerala it was seven and lowest four only in case of Nagaland. The States having higher IMR are also the ones having more percentage of people below poverty line such as Odisha, Bihar, Chhatisgarh and Jharkhand. These States have also poor health infrastructure in comparison to other southern States.
The primary healthcare centers in these States lack basic amenities and minimum healthcare professions. This data clearly establishes the link between poverty and poor healthcare system of a State and related issues.
The case IMR among STs and SCs and in rural backward regions in Odisha is much higher in comparison to other social groups. The impact of programmes such as ICDS linked to IMR and MMR for last three decades is very negligible so far as condition of the poorer section of the State is concerned.
The Juang tribe in Nagada of Jajpur, death of children due to Japanese Encephalitis in Malakangiri district, wretched conditions of the Paudi Bhuinya of Sundargarh, Dana Majhi of Kalahandi and Kabir Bhoi of Puri district are all symbol of our poor health service system which has not been improved much. Basic amenities are linked to qualitative and developed human living and the modern State has to ensure this out of public investment through dedicated institutional arrangement. But as experienced the process has not produced the desired result, especially for the deserving majority who are the poor and marginalized.
The negligence in public investment for developing basic amenities for last 60 years has widened rural and urban gap as a result of which mostly the rural poor are migrating to urban areas for a better living.
Studies have found that lack of basic amenities has wider impact on working condition and the trend shows that the work culture in rural areas has been deteriorating with increasing health problems along with lack of improvement in education and skill.
The social life and living condition in rural areas and its change process are linked to availability of basic amenities. The living condition of common people reflects the socio-economic, political and environmental development of a country. Mercer’s annual worldwide quality of living survey ranked Singapore as highest ranking city in the Asia pacific region.
The quality of living in Indian cities has been rated poor in comparison to global standard. Among the Indian States, the quality of living and availability of basic amenities are widely unequal. States such as Kerala, TN and AP are comparatively better than Odisha which ranked near the bottom of the list of the India Today survey 2016.
There is lack of disaggregated data over malnutrition issues of different social groups in various regions of the State which is required for different purposes. The malnutrition problem is linked to the overall economic –social, environmental issues. It is a fact that in spite of our planned interventions the access of vulnerable sections to healthcare facilities has not improved.
The physical and social environment of the living space of the marginalised sections in rural areas has suffered with lack of basic amenities such as safe drinking water and toilet for healthy living. Still the health delivery system discriminate against the poor and marginalized sections by preventing their access to available healthcare facilities.
The political parties play second fiddle with health issue and seldom discuss them. The prime time debates in media never focus health issues.
The health issues are thus less discussed in proper forums including the Assembly. Whether private or Government run health institutions, everywhere people silently suffer in many ways but the sufferings of the people hardly hit the conscience of the authorities.
(manasbbsr15@gmail.com)