Politics of Rural Health in India

Abstract

The setting up of the National Rural Health Mission is yet another political move by the present government of India to make yet another promise to the long-suffering rural populations to improve their health status. As has happened so often in the past, it is based on questionable premises. It adopts a simplistic approach to a highly complex problem. The Union Ministry of Health and Family Welfare and its advisors, because of ignorance or otherwise, have doggedly refused to learn from the many experiences of the past, either the earlier, somewhat sincere efforts to develop endogenous mechanisms to offer access to health services or the devastating impact on the painstakingly built rural health services of the imposition of prefabricated, ill-conceived, ill-formulated, technocentric vertical programs on the people of India. They also ignore some of the basic postulates of public health practice in a country such as India. That they did not substantiate the bases of some of their contentions with scientific data from health systems research reveals that they are not serious about their promise to rural populations. This is yet another instance of what Romesh Thaper called “Baba Log playing government government.”