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Survey stresses private role in health

New Delhi, Feb. 27: The Centre wants to levy “user” charges on people above the poverty line to meet spiralling health care costs.

“Strategies should be evolved for levying and collection of user charges from people above the poverty line,” says the latest report of the Economic Survey.

The Survey has stressed on the inevitability of privatisation in health care. “Health sector reforms are a part of economic reforms,” it says, but adds a rider. “Due care, however, will have to be taken to ensure that poorer segments of the population are able to access services they need.”

Listing innumerable lapses in the implementation of health policies and lack of finances, the Survey has called for an immediate increase in investments in this sector, especially to cope with escalating costs.

The report lists several drawback areas, such as the failure to bring under control diseases like polio and Kala Azar.

“This disease (Kala Azar) is endemic in West Bengal, Jharkhand and Bihar with high morbidity and mortality. There has not been a significant decline in the number of reported cases and deaths,” the Survey says.

Although the number of reported polio cases declined from 28,257 in 1987 to 268 in 2001, the survey says claims of success ran into trouble when the disease returned at a brisk pace in Uttar Pradesh, West Bengal and Gujarat. “During last year, 1,211 polio cases were reported,” it points out.

Population stabilisation, another high-priority area for the government, also does not seem to have happened. The Survey attributes the continued high fertility rate to the “large size of the population in the reproductive age group” and lack of contraception coupled with a high rate of infant mortality.

“The goal of population stabilisation is achieved only when issues of child survival, maternal health and contraception are simultaneously and effectively addressed,” it says.

The picture is less bleak in the education sector. The Survey says the government has accorded the highest priority to primary education. It quotes the 2001 census to show literacy rates have gone up to 75.85 per cent for males and 54.16 per cent for females.

The government takes credit for launching Sarva Siksha Abhiyan, a programme for universalisation of education, and passing the 93rd Constitutional Amendment Bill to make education a fundamental right for children in the 6-14 age group.

On the flip side is a catalogue of obstacles dogging further progress in the sector. “The elementary system is besieged by numerous systemic problems such as inadequate school infrastructure, single-school teachers, high incidence of absenteeism (and) large-scale teacher vacancies,” the Survey points out.

Ironically, the Survey does not highlight the problem of female foeticide, which forced the Centre to amend the Pre-Natal Diagnostic Techniques Act. Instead, the Survey trots out a list of programmes the Centre has undertaken for girls and women.

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