Only about half of rural households in the country have government health insurance, while 34% lack any health insurance coverage at all, and 61% of those surveyed lack life insurance. This is coupled with limited access to diagnostic facilities and affordable medicines further posing challenges to this cohort, notes the ‘State of Healthcare in Rural India, 2024’ report, released recently. The survey was jointly undertaken by the non-government organisation (NGO) Transform Rural India and Development Intelligence Unit, which works in the healthcare sector.
Additionally, only 12.2% households of the survey have access to subsidised medicines from Pradhan Mantri Jan Aushadhi Kendras, while 21% lack a commutable medical store.
The survey encompassed 5,389 rural households with an average size of 5.7 members and spanned 21 States including — Andhra Pradesh, Bihar, Maharashtra, Mizoram, Punjab, Tamil Nādu, and Uttar Pradesh.
Significant demographic segments included children under 10 years (15%), elderly above 60 years (11.4%), pregnant women (6%), and infants (15.4%). Predominantly, the households belong to Other Backward Classes (40%), followed by Scheduled Castes (22%) and the general category (21%).
Of the surveyed households, major income sources for them are farming (43%) and daily wage labour (21%).
Shortage of trained personnel
The study also revealed that there is a lack of diagnostic facilities in the rural areas mostly because of shortage of trained personnel. Only 39% of the respondents confirmed that there was a diagnostic facility within a commutable distance from their village where they could visit only for blood tests or medical imaging. However, 90% of respondents do not get a routine health checkup done on their own wish, unless and until the doctor suggests them to do so. Accessibility to affordable medicine at government medical stores is a challenge for the rural population.
As per the report, only 12.2% respondents have access (within commutable distance from their villages) to subsidised medicines at Pradhan Mantri Jan Aushadhi Kendras. A total of 61% respondents had access (within commutable distance from their village) to a private medical store, whereas only 26% respondents had access to a government medical store located within the premises of a health facility that provides free medicines. Around 21% do not have a medical store within commutable distance.
Lack of drainage systems
Also on the marker for sanitation and environmental hygiene, which are important interventions for disease control in a community — one in five reported no drainage system in their villages and only 23% had a covered drainage network system in their villages, 43% of households did not have any scientific system of waste disposal and they ended up with dumping their waste everywhere. Only 11% burn the dry waste and convert their wet waste into compost, while 28% reported that the local panchayat has made plans to collect household waste.
Meanwhile, the report further notes that 73% of the households with elderly members need constant care and the majority (95.7%) prefer family caregivers, predominantly female (72.1%), highlighting the need for caregiver training on home-based care. Engaging an external caregiver as a paid service does not seem to have a great deal of traction in rural India, with only 3% of such households ever having opted for the same.
Only 10% of the households rely on neighbourhood support in the absence of family caregivers. Key caregivers for pregnant women include husbands (62.7%), mothers-in-law (50%), and mothers (36.4%). “In both cases, there is a need for strong social networks and supportive environments, and a need for capacity building for family members,” said the report, recommending focus on a people-centred system that integrates systems and schemes locally to address well being and healthy lifestyle.
