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THE ROLE OF PUBLIC AND PRIVATE SECTORS IN HEALTH CARE: EMERGING ETHICAL DILEMMAS IN INDIA

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Title: THE ROLE OF PUBLIC AND PRIVATE SECTORS IN HEALTH CARE: EMERGING ETHICAL DILEMMAS IN INDIA


1
THE ROLE OF PUBLIC AND PRIVATE SECTORS IN HEALTH
CARE
EMERGING ETHICAL DILEMMAS IN INDIA
By Dr.Aruna Sivakami
2
  • The two factors, which are very important in
    public health, is urbanization and the health
    hazards which is due to over crowding and other
    is due to environmental quality of the
    surroundings.

3
Definition of Health
  • Health is ascribed to be a dynamic equilibrium,
    out come of which is determined by a wide variety
    of biological,socio,cultural,economic, political,
    physical, psychological and environmental
    factors.

4
Significance of the Study
  • Government in developing and under developed
    Countries dont take sufficient measures of
    Public Health Ethics even though it is the major
    provider of health care for its citizens.
  • The people living in the developing world and
    especially 70 percent of them who live in rural
    areas have little or no access to modern medicine
    and health care.

5
The Health care utilization pattern by the people

R esourceful clients I nfluential C ommunity
affiliation H aves
Private Sector
Ethics in provision of Health Care ?
  • Below Poverty Line
  • Lower and Middle Income
  • Group
  • Orphans / People living in
  • Streets and Slums
  • People who needs medical
  • attention for chronic diseases
  • Rural People

Avail
Access
Public Sector
Ability
The Health care utilization pattern by the people
6
Public Health Programme for Communicable Diseases
  • National Malaria Eradication Programme
  • National Tuberculosis Control Programme
  • National AIDS Control Programme (Sexually
    Transmitted Diseases are 26 entities)
  • National Filaria Control Programme
  • National Cancer Control Programme

7
Public Health Programme for Non-Communicable
Diseases
  • National Programme for Control of Blindness
  • National Nutrition Programme
  • National Mental Health Programme
  • National Diabetes Control Programme
  • National Oral Health Programme
  • National Cancer Control Programme
  • National Leprosy Eradication Programme
  • National Goitre Control Programme
  • National Programme for Cardio Vascular
  • Diseases, Cerebral Palsies

8
Programmes and Services that affects the Quality
of Health
Programmes and Services that affects the quality
of health
Influence on Private Sector
Influence on Public Sector
Low Commitment Seldom Affect the Lack of
support from Sector personnel
National Health Programme
Non-communicable Disease Undertake research
Control Program activities to
understand Change in sedentary pathological
pattern life style has resulted in increase
of non-communicable diseases
Non-communicable Disease Control Program
Communicable Disease problem
DNA of bacteria and virus Communicable
diseases Have not been changed are treated well
9
Care of the Instrument and Linen
Lacks availability Maintained well to And
technical support keep the brand name
Bio Medical Diagnostic Equipment Non
availability of Constant updating or
infrastructure and replacement
done bureaucraticbottle necks
Bio Medical Diagnostic Equipment
Unequal ratio and not They are pressurized
much hospitable. Receives to work for long
and less training receives less
remuneration hence have no
compassion. Whereas in VHOs, they
are doing with compassion, passion,
integrity, tollerance and sympathy
Nursing Services
10
Computer Technology and MIS Unavailable at most
of the Seldom share with delivery points,
hence government complete details are not
to be captured
Computer Technology and MIS
Finds difficult to meet annual Competitive
with Budget large margin of profit
Fee Structure
Poor maintenance and does Maintained well but
Not share with researchers/ information are
not shared Patients. It should be handled By
experienced and continued Expert staff.
Medical Records
11
Health Partnership
  • With Voluntary sector and NGOs in Partnerships,
    with State and Central Governments, should be
    able to effectively respond to the health needs
    of vulnerable population groups, such as workers,
    women, children and elders in the society this
    needs to be more vigorously pursued.

12
Health Partnership
  • Healthy public policies need to be developed to
    ensure supportive environments for individual and
    community health action, and to protect people
    from lifestyle-related problems such as those
    addicted to tobacco drugs and alcohol.
    Documentation and dissemination of health
    promotion outcomes are also critical to the
    legitimization of the cause of health promotion
    in the region.

13
  • The challenges have been well taken by private
    sector but public sector hasnt, why?

14
Intervention and Inclusion of feasible strategy
  • Catalytic steps needed to be adhered to reduce
    the wide disparity in the quality of health care
    in India are
  • Setting up of standards for Public Health Care
    system in order for equitable fair distributions
    and having a fully equipped medical team with the
    required infrastructure.
  • Recruitment of well qualified nursing and
    administrative staff.
  • Training module to include the suitable
    behavioural approach to patients.

15
  • Review the pay and allowance for the physician
    and surgeon.
  • Need for building an awareness amongst public by
    the government at all levels on the availability
    of a suitable policy that supports the
    improvement in health care delivery at both
    preventive and curative state.
  • To device a system that would require private
    health sector to directly support, participate
    and improve the quality of health care provision
    by the public sector.

16
Thank you
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