The government has made Healthy India a top priority, which reflects in flagship programmes such as Swachh Bharat. However, the government can't do everything on its own. India is a nation of 1.3 billion people and without their participation no programme can succeed. As citizens, we must participate actively not just in policy-making, but also programme implementation. Without that, even the best resources would not be enough to achieve the objective.
As citizens, we must participate actively not just in policy-making, but also programme implementation.
Community participation, apart from ensuring buy-in, has important benefits: collaboration, greater reach, positive change in the social environment, etc. Participation would ensure that the needs of each community are better understood and also that citizens have a say in how healthcare is delivered.
There is no other way to achieve a healthy India, which is critical not just for quality of life but also for the economy. Consider the facts. Traditionally, millions have not had access to healthcare, our hospitals are overburdened and they have inadequate facilities. An IndiaSpend analysis pointed out that India is short of 500,000 doctors, based on the World Health Organization (WHO) norm of 1:1,000 population. With 740,000 doctors at 2014-end, which works out to a doctor-patient population ratio of 1:1,674, India was worse off than Vietnam, Algeria and Pakistan. On 8 March this year, a parliamentary standing committee on health and family welfare report termed this shortage a health-management failure. Fortunately, the government had taken cognizance of this even before the report and began a process of change.
With participation from citizens, however, programmes would be better grounded in reality. In fact, globally, the extent of community participation is an important parameter of success for such initiatives. Governments everywhere, including ours, strive for societal participation right from the planning stage. They understand that it's a prerequisite for success.
It is this volunteer spirit that can make a difference and can help us achieve our health system goals. For instance, let's consider changing lifestyles, which have caused a shift in the healthcare burden from communicable to non-communicable diseases. Volunteers and community participation would spread awareness about healthy behaviour at the family level. A fresh, training-based approach would help to change behavior patterns, and promote the concept of healthy living and self-care. Clear health targets would ensure that the entire system—from government agencies to volunteers and local self-governments—strive as one.
We are facing unique challenges to national health, making it imperative for governments and us as responsible citizens to work together.
You could get involved in the design and implementation of initiatives at the local level or help build support for and awareness of government policy.
Our participation would have global precedence. Efforts to involve citizens in healthcare decision-making are well established and recognised. The WHO states in the 1978 Declaration of Alma-Ata: "People have a right and duty to participate individually and collectively in the planning and implementation of their healthcare."
The environment, of course, is a critical aspect of this. Recently, the World Bank said that 1.4 million Indians lost their lives to air pollution in 2013. Poor air quality increases the risk of contracting ailments such as lung cancer, stroke, heart disease and chronic bronchitis, all of which put a massive strain on public healthcare. Incidentally, air pollution is fourth on the list of fatal health risks worldwide after metabolic risks, dietary risks and tobacco smoke.
Public involvement, ideally, should be in the form of well-thought-out interventions based on credibility, legitimacy and influencing ability. You could get involved in the design and implementation of initiatives at the local level or help build support for and awareness of government policy.
Do not underestimate what you as an individual can achieve when you work in lockstep with the government to create a healthy India.