Abstract
At the time of independence 340 million lived in urban areas in India and currently 200 million of an estimated population of 800 million live in 3000 cities and towns with inhabitants over 10.000. There are 90.000 government-employed doctors in urban areas: 1 doctor per 2200 residents. Another 180.000 are practicing in such areas providing a ratio of 1 doctor for every 800 urban people. In Delhi in 1986 there were 63 allopathic hospitals with 15.000 beds and 561 dispensaries. Government employees receive preferential treatment while the public waits long hours. In frustration the poor often turn to private practitioners even if their qualifications are dubious. Despite 35 years of socialistic planning only 10-15% of children living in a Delhi colony received adequate vaccination. To rectify this inequality a system is recommended guaranteeing public access to dispensaries on the same fee-basis as that accorded to government employees. A health card could prevent misuse and it would ensure optimal utilization of existing health facilities. Future development of 50-100 bed hospitals within 2-3 km of clients homes and the attachment of 5-10 of them to a large hospital or medical school is proposed. A central health board could oversee and coordinate area-based health services.
Published Version
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