With COVID-19 cases in India crossing the 4 million mark , the focus is shifting to rural areas. In the initial months of the pandemic, when infections were growing at a relatively slower pace, most of India’s COVID-19 cases were confined to urban districts.
In subsequent stages, not only have the cases grown at a relatively quicker pace but the locus too has shifted to rural areas where the health infrastructure is fragile.
The lockdown in March left millions of migrant workers jobless and most of them returned to their villages when the lockdown was eased in April and May.
But India's health infrastructure is not equally spread between rural and urban areas. According to a World Bank estimate, more than 65% of India’s population resides in rural areas, but around 65% of all government hospital beds are in urban India.
85.9% of the rural population was not covered by insurance in Fiscal Year 2018, as compared to 80.9% among the urban population. 20% of all doctors in India are serving in the rural parts.
Data from the National Family Health Survey-4 showed that only about 25% of rural Indians have access to public outpatient healthcare.
The clear rural-urban divide is visible in many such indicators, including how as the number of COVID-19 positive cases in India increased to over 3 million, the number of positive cases spiked in rural areas.
The percentage of rural spread of COVID-19 was most intense in the following states during the various stages of increase in the number of cases.
Anecdotal evidence also suggests that stigma attached to the virus and fear of losing wages is a strong factor for not revealing COVID-19 symptoms to healthcare workers in these areas.
