This year’s Indian National Conference on Primary Care and Family Medicine, held in New Delhi in April 2013 was replete with challenges and encouraging innovations. In Madhya Pradesh, for example, 67% of healthcare providers reported having no medical qualifications, whereas in Chittoor only 21% of health clinics had a stethoscope and blood pressure measuring apparatus. Infant mortality (range 12–59 per 1000) and maternal mortality (162–347 per 100 000) are high and vary across states. The government’s 12th 5-Year Plan acknowledges deficiencies and has established the National Health Mission, to reform family medicine and tackle infrastructure inadequacies. Several novel and promising schemes, needing minimal investment, with demonstrable short-term gains, were described, including the Kangaroo Mother Care programme (caring for low birthweight babies, and reducing mortality), and assessing the basic life support knowledge of medical staff (identifying inadequacies, initiating remedial training, and improving outcomes). Yet government investment in health remains inadequate (1.2% of GDP, increasing to 2.5% by 2017, compared with 10% in the UK), indirectly promoting private sector growth. India raises only 15.5% of its GDP as tax revenues (one of the lowest among the G20 countries), demonstrating little commitment to redistribute wealth and reduce inequality.
Mahatma Gandhi’s Salt March Memorial, New Delhi. The Salt March campaigned against the British salt monopoly in colonial India, triggering the wider Civil Disobedience Movement.
- © British Journal of General Practice 2013
