Utilisation of Public Health Facilities: A Situational Assessment

The preceding three chapters have lent considerable evidence to suggest that people in backward regions of UP and Rajasthan are severely pressured by OOP expenditure on health care. Almost a similar result was presented for the slum residents in Delhi as well. These results have also lent credence to the fact that a bulk of these households is marred by varying levels of catastrophe with possibilities of major curtailments in their living conditions. A probit regression analysis in Chap. 5 further indicates that the poor, economically less secured, lower caste, moderately educated, poor sanitation, lack of access to potable drinking water, low levels of living without proper lighting or cooking fuel and kutcha houses are among the factors making people susceptible to enhanced risks of health catastrophe. However, a question that needs to be examined in the context of these findings is: what happens to the public health facilities and despite high financial burden, why do people go to private practitioners? A related question may arise with regard to the utilisation of added services created in rural areas since the inception of the NRHM in April 2005. Do people even know about these facilities and their intended objectives to provide an added package of services including sanitation, potable drinking water, better childcare with timely vaccination and assistance to pregnant rural women with basic medicines and institutional deliveries? We will try to examine a few, if not all, of these issues in the rest of this chapter.