In India approximately 70% of the population lives in rural areas. Rural healthcare in India faces numerous problems, including the lack of quality rural health care services, adequate infrastructure, basic medicine, and medical facilities. This results in high mortality rates.
India is among the countries with the highest number of maternal deaths. Most of them happen in rural areas. From 1997 to 2020, about 1.30 million maternal deaths occurred in India, according to ‘Trends in maternal mortality in India over two decades.’ Also, the majority of maternity deaths occurred among women between 20 and 29 in poorer regions of India.
In short, rural healthcare is dealing with a severe crisis. Despite the government’s efforts to reform rural healthcare in India, access to quality rural healthcare remains a major challenge.
Rural health care system in India
Sub Centre
Primary Health Centre
Community Health Centre
Main problems of rural healthcare in India
Chronic shortage of human resources
The chronic shortage of healthcare professionals negatively affects the rural health care system India.
Medical professionals are not willing to work in rural areas, as they have to face significant challenges, like improper sanitation facilities, shortage of electricity and water, etc. That’s the main reason that rural people face difficulties in accessing qualified physicians.
‘The Rural Healthcare Statistics for 2020-2021’ indicates that the number of the allopathic doctors at primary health centers has increased by 56.2% (2005-2021). However, there is still a shortfall of 4.3% of allopathic doctors in Primary Health Centres.
Additionally, there is a shortage of 79.9% of healthcare specialists at Community Health Centers (in comparison to the requirement for this infrastructure). This table provides more details:
| The shortfall of specialists at rural CHCs as compared to the total requirement for the Infrastructure | |
|
Surgeons |
83.2% |
|
Obstetricians & Gynecologists |
74.2% |
|
Physicians |
82.2% |
|
Pediatricians |
80.6% |
Source: Rural Health Statistics 2020-2021 (Government of India, Ministry of Health and Family Welfare)
Inadequate infrastructure
Inadequate healthcare infrastructure in rural India is a major concern. Healthcare centers in rural areas lack up-to-date medical equipment and healthcare personnel. Moreover, most of them aren’t equipped to support diagnosis and investigation processes.
In addition to that, the supply of medicine in rural areas isn’t provided regularly. Basic medicine can be unavailable for rural people quite frequently.
Low affordability
Unaffordability is a major issue for the rural healthcare in India. To access quality healthcare in rural India, most people have to rely on private medical centers.
However, the costs of private healthcare are too high for low-income rural people. Since most of them lack health insurance, they have to use their savings or just delay the treatment.
Rural patients can be directed to physicians who are far from their homes. Occasionally, transportation options are unavailable. For this reason, rural people may have trouble accessing top-quality healthcare because of distance and high costs.
Approximately 86% of all medical visits in India are made by rural people, according to the ‘Academic institutionalization of community health services: Way ahead in medical education reforms’ study. Most of them travel over one hundred kilometers to access health care facility. Furthermore, rural households bear about 80 percent of the expenses privately. Due to this, rural population is pushed further into poverty.
Limited health awareness
The level of health awareness is low in rural regions of India. The reasons are diverse. The list includes low educational status, inappropriate accent on education within the healthcare system, etc.
The rural population in India needs education on issues such as healthcare policies, healthcare-seeking behavior, etc.
Over half of the patients in the hospital had health literacy levels below adequate, according to the study ‘The Evaluation of Health Literacy Status Among Patients in a Tertiary Care Hospital in Coastal Karnataka, India’.
Government Initiatives
NRHM (The National Rural Health Mission)
The NRHM was lauched in 2005. The key objective of the NRHM is to provide accessible and equitable health care to rural people. With a particular focus on vulnerable groups, it has improved rural health care in India. However, India’s budgetary allocation to healthcare is still quite low.
PM (Pradhan Mantri) Ayushman Bharat Health Infrastructure Mission
Another successful initiative is PM Ayushman Bharat Health Infrastructure Mission (PM-ABHIM) . The goal is reforming the healthcare system to provide better access to health both in urban and rural areas. Among the key initiatives are:
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Enhancing Health and Wellness Centers in villages and cities to promote early detection of various diseases.
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Increasing the number of critical care beds at district hospitals.
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Upgrading the quality of public health laboratories across all districts of India.
National Ambulance Service under NHM (National Health Mission)
As part of the National Ambulance Service under NHM, the government provides free transport to health facilities. This service is available in rural areas of India as well. The states may set the population norm or use a time-to-care approach to make these ambulances easily accessible to everyone.
Incentives under NHM (National Health Mission)
India’s National Health Mission offers specialist doctors a hard area allowance to work in rural areas. The goal is motivating them to serve in remote public health facilities. Such initiatives include:
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States can offer attractive salaries to specialist doctors and use flexible payment strategies such as ‘You Quote We Pay’.
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Special incentives for ANM (Auxiliary Nurse Midwife) to provide timely antenatal checkup and recording, etc.
Healthcare startups to improve the rural healthcare in India
Healthcare sector is turning into one of the biggest sectors in India. From 2021 to 2026, the healthcare market will grow at a compound annual growth rate of 29.79%, according to the report “Healthcare Market in India 2021”.
This growth is giving rise to healthcare startups in India. Currently, healthcare startups are striving to use technological innovations to improve rural healthcare in India and bridge the rural urban divide.
Boosting the use of technology in health system can be efficient in addressing a major challenge: access to high-quality healthcare in rural India. Here are several healthcare startups that strive to achieve this goal.
CureBay
With its hybrid care model, CureBay seeks to bridge the healthcare gap existing between urban and rural areas. It offers last-mile access to primary healthcare services. CureBay has a technology platform and a network of e-clinics.
It provides a wide range of healthcare services, including:
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Appointment scheduling,
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Teleconsultations,
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Hospital admission booking,
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Medicine delivery, etc.
As of now, it operates fifteen e-clinics across Odisha, but plans to expand to other states as well.
Gramin Healthcare
The Gramin Healthcare has established health centers in villages throughout Haryana, West Bengal, Bihar, Madhya Pradesh, etc. With telemedicine service, doctors screen patients’ cases and carry out diagnosis. Moreover, patients have health cards and their medical history is digitized.
Gramin Healthcare runs 120 centres. The startup is currently setting up pharmacies to enable easier access to affordable medicines in the villages.
AI Health Highway
AI Health Highway is an IISC incubated startup that developed a web app for COVID-19 self-screening. This tool provides solutions based on risk-assessment scores of COVID-19 related to clinical symptoms, comorbidities, and contact history. The goal is empowering the rural population.
The web app is adapted with a nurse-led model. Therefore, rural people can connect with their nurses using an IVR Helpline to get medical aid. Telehealth interventions enable rural population to screen for non-communicable illnesses, such as diabetes, hypertension. Now the app is used in Karnataka, Tamil Nadu and Gujarat.
Meta16Labs
With a focus on semi-urban and rural areas in India, Meta16Labs aims to make healthcare services accessible to everyone. MyTeleOPD is the startup’s core product: a telemedicine platform and digital clinic.
Patients in rural and semi-urban areas of India can consult with doctors from different parts of the country remotely. Using voice and video calls allows rural patients to communicate with doctors. They can get all the prescriptions via SMS.
Docus
Docus is a healthtech startup connecting the best international doctors with Indian hospitals and patients. With Docus, Indian hospital doctors can conduct video and written consultations with medical experts from the USA and Europe. They cover a wide variety of specializations, such as oncology, endocrinology, neurology, etc.
As a result, rural patients can receive the most accurate diagnosis and treatment based on the world-class medical knowledge. Consequently, patients from rural India no longer have to travel long distances and pay a lot for quality healthcare services in urban areas. Docus can improve the access to quality health care services in rural India.
In closing, access to quality rural health care services remains a serious problem in rural India. The role of healthcare startups and government initiatives is crucial to improve rural healthcare in India.
