Access to Healthcare

As of 2013, the number of trained medical practitioners in the country was as high as 1.4 million, including 0.7 million graduate allopaths. Yet, India has failed to reach its Millennium Development Goals related to health. The definition of 'access is the ability to receive services of a certain quality at a specific cost and convenience. The healthcare system of India is lacking in three factors related to access to healthcare: provision, utilization, and attainment. Provision, or the supply of healthcare facilities, can lead to utilization, and finally attainment of good health. However, there currently exists a huge gap between these factors, leading to a collapsed system with insufficient access to healthcare. Differential distributions of services, power, and resources have resulted in inequalities in healthcare access. Access and entry into hospitals depends on gender, socioeconomic status, education, wealth, and location of residence (urban versus rural). Furthermore, inequalities in financing healthcare and distance from healthcare facilities are barriers to access. Additionally, there is a lack of sufficient infrastructure in areas with high concentrations of poor individuals. Large numbers of tribes and ex-untouchables that live in isolated and dispersed areas often have low numbers of professionals. Finally, health services may have long wait times or consider ailments as not serious enough to treat. Those with the greatest need often do not have access to healthcare

Rural Areas - Rural areas in India have a shortage of medical professionals. 74% of doctors are in urban areas that serve the other 28% of the population. This is a major issue for rural access to healthcare. The lack of human resources causes citizens to resort to fraudulent or ignorant providers. Doctors tend not to work in rural areas due to insufficient housing, healthcare, education for children, drinking water, electricity, roads and transportation. Additionally, there exists a shortage of infrastructure for health services in rural areas. In fact, urban public hospitals have twice as many beds as rural hospitals, which are lacking in supplies. Studies have indicated that the mortality risks before the age of five are greater for children living in certain rural areas compared to urban communities. Full immunization coverage also varies between rural and urban India, with 39% completely immunized in rural communities and 58% in urban areas across India. Inequalities in healthcare can result from factors such as socioeconomic status and caste, with caste serving as a social determinant of healthcare in India.

Urban Areas - The problem of healthcare access arises not only in huge cities but in rapidly growing small urban areas. Here, there are fewer available options for healthcare services and there are less organized governmental bodies. Thus, there is often a lack of accountability and cooperation in healthcare departments in urban areas. It is difficult to pinpoint an establishment responsible for providing urban health services, compared to in rural areas where the responsibility lies with the district administration. Additionally, health inequalities arise in urban areas due to difficulties in residence, socioeconomic status, and discrimination against unlisted slums. To survive in this environment, urban people use non-governmental, private services which are plentiful. However, these are often understaffed, require three times the payment as a public center, and commonly have bad practice methods. To counter this, there have been efforts to join the public and private sectors in urban areas. An example of this is the Public-Private Partnerships initiative. However, studies show that in contrast to rural areas, qualified physicians tend to reside in urban areas. This can be explained by both urbanization and specialization. Private doctors tend to be specialized in a specific field so they reside in urban areas where there is a higher market and financial ability for those services.