Sometimes, when people think of how to address poor health in India, they think of expanding access to health care. But, as this new study published in Health Affairs recently by Jishnu Das, Alaka Holla, Veena Das, Manoj Mohanan, Diana Taka and Brian Chan, points out, providers are not lacking. On the other hand, there is a HUGE lack of quality and quality control.
The study, entitled “In Urban And Rural India, A Standardized Patient Study Showed Low Levels Of Provider Training And Huge Quality Gaps,” had trained surveyors pose as patients for a sample of 305 health providers in Madhya Pradesh. The authors found that almost 70% of the providers had no formal medical training, and that they only provided diagnoses in one third of cases. The correct treatment was given in 30% of cases, but more often than that, in more than 40% of cases, incorrect or harmful treatment was given!
As the authors suggest, further research is needed to better understand the quality constraints facing health care in India. But to me, this research also suggests that investments in public health to prevent disease (such as sanitation, helping people convert to clean cooking fuel or improving vaccination coverage) are all the more important in a setting where the project of securing appropriate treatment for the poor seems daunting.
This post on the World Bank website gives a lot more details about the new study, and links to the paper. (There is a link on the right side of the page that says, “Full Text.”) It is a must read for anyone interested in health in India!