India's Culture and Healthcare System

Research Paper: Indian Culture

Introduction

During the last forty years, India has made progress in improving the health and well-being of its inhabitants. Life expectancy has increased from 44 to 62 years and the infant mortality rate has decreased by more than two thirds, according to 2005 data from the Ministry of Health and Family Welfare of the Government of India. Andhra Pradesh is above the country average with a life expectancy of 63.1 years. However, the emergence of HIV/AIDS +has begun to affect the rankings of epidemics, both regionally and nationally. The limitations of the health system, the poor hygienic conditions of the country, poverty and climate cause numerous infections and diseases. One of the most relevant problems of public medical services is that they should provide subsidized or free treatment to the poorest people, but they are unable to fulfill their objective and offer care to the entire rural population. This demonstrates once again that social inequalities are also evident in access to health, especially in a country with high demographics such as India.

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However, the quality of medical care in India varies considerably and is limited or inaccessible to the population of rural areas. Therefore, it is important to analyze the structure of the health system at the local level. For example, at the base of the hierarchical pyramid of Anantapur are the health sub-centers. That is the first ones where the rural population can go. These centers have a team of people trained to provide medical care to the population. Above, there are local hospitals or “taluka,” which serve between 90 and 100 contiguous towns, and, peripherally, there are district hospitals (Rathi, A. 2017). The Public Health Department deals with medical care – it includes awareness campaigns, immunization, preventive medicine and public health.

In India there are many types of traditional medicines, according to the customs of each one of their cultures and towns, however, at present; two types of traditional medicine have been recovered, having been positioned as main. One of these traditional medicines is what is known as Unani medicine. The etymological meaning of this medicine makes direct reference to the Ionic term since the Arabs felt great debtors of this culture. The Unani tradition has its origins in the Hippocratic Greek medicine of the Canon of Avicenna. Especially during the rule of the Mongols was that the Unani medicine had its apogee in the peninsula of India. It was in this period that great chemical and drug-chemical discoveries were made, in addition to the complementation with modern Western medicine, which achieved its best results in this traditional medicine (Mukherjee, et al. 2017).

On the other hand, another type of medicine, which has quite a reputation in the Indian region and little known in the Western world, is the medicine that is known as Ayurveda. This type of medicine, unlike attacking only the diseases that burden the body also helps to relax the mind and body, thus being able to maintain a state of integral health. The Ayurvedic medicine has a number of alternative treatments which alleviate diseases and conditions such as insomnia, migraine, nervous system disorders, plus it can achieve a balance in stomach digestion. The main objective of Traditional Ayurvedic medicine is not simply to cure diseases but to find the origins that generate the discomforts of the body, as well as to find the ideal form, so that individuals reach a state of health of their body, through of the balance of the body with the mind. This type of traditional medicine has found that one of the most important disturbing elements of the body and health of people are bad habits, severe nervousness and stress, which affect the majority of the population today.

India’s Healthcare in comparison to the USA

It is well known that the country with the highest health cost over GDP is the United States. According to the latest OECD report, the health cost in 2013 in the US amounted to 17.7% of GDP, almost double that represented by the average health cost of India is 29% and other OECD countries, 9.3% and even well above second and third classified the Netherlands and France with 11.9% and 11.6% of health spending on GDP. When we speak of health expenditure, we refer to aggregate health expenditure (both public and private) on the GDP of a country. The huge health expenditure in the US could have a simple explanation. The level of medicine in the US is much higher than in other countries and this involves an extra cost that results in better health for its citizens. However, if we go to the WHO life expectancy data, we see that life expectancy in the US is not exactly the highest in the world.

In India, the health system is mixed, since the money invested in health goes to the two sectors, public and private. But in practice, it can be called primarily private. Reform is being achieved to finance the health system through taxes to improve its funds where 29% of total health expenditure goes to the public sector when the global average is 62%. Furthermore, the organizations are divided into national, state, district, community and sub-level centers. The national level consists of the ministry of health and family welfare; this ministry has three departments: health, family welfare and the Indian system of Medicine and Homeopathy. This level is governed by the health department directed by the Director General of health services. Furthermore, at the district level, it is a link between the state and the sub-centers that are located in the periphery (Patel et al. 2015). It receives information from the state level and transmits it to the regions and sub-centers adapting it to their needs. It has administrator functions. There are offices that also take care of family welfare programs in the districts. Based on the above data India has to face several challenges to improve its healthcare system are as follows:

• The infirmary is a synonym of staying poor in India. The poverty rate in India would be 3.7 points lower, with the absence of out-of-pocket payments to improve their health.
• In the government, clinics have been found a 40% absence of health workers. Many times practitioners are not qualified to work in these clinics. The quality of outpatient care in the private and public sector is very low. After having made a study to the practitioners about hypothetical patients, they all showed a huge lack of knowledge, and in addition, the doctors do much less than they know. The inhabitants of India, especially the poor, have to make several visits when they have an illness, either to the same or to a different provider, but many times, after so many visits, they do not improve.
• To improve the public health system in India, the government has to invest much more. But there is a risk of spending much more and still not getting more. The chairmen of the committees think that a change cannot be achieved overnight, so reform was established with several proposals, of which they expect results between 10 to 15 years (Mehta, P. 2018).

Quality Healthcare in India

The biggest elections that have been held on the planet have taken place in India for a month and until last Monday to elect a new government, but what the country is playing is much more than that: of the 1.2 billion Indian citizens One third are poor. Although the main themes of the campaign have revolved around corruption, religion and the economic takeoff of the country, the majority parties have promised to reform a convalescent health system. India is the global epicenter of tuberculosis; it is also the place where half of the children under five suffer from malnutrition; where the immunization rate of children is one of the lowest in the world, and where the Leprosy, although it is less and less visible, is not a thing of yesterday.

The promise to guarantee universal access to health care for people living below the poverty line has not been enough to keep a third consecutive term in power for the Congress Party, suffering from corruption scandals, slowing growth economic growth of the country from 8% to 5% per year and high inflation of food. The internal pressures make a large part of the population perceive a lack of direction in the politics of Manmohan Singh, who has been at the head of the Government for almost a decade. Faced with this, the hard hand of Narendra Modi, leader of the Hindu extremist party Bharatiya Janata, has earned him a wide victory in the elections; which it makes a sudden change to the right in Indian politics (Kondasani et al, 2015).

Despite the inclusive will of the policies of the Congress Government, it has not managed to tackle the causes that structurally leave a large part of Indian society outside of the macroeconomic indicators and the development of the country. The government efforts made to date to guarantee access to healthcare for all citizens, with programs such as the National Rural Health Mission approved in 2005, have proved insufficient, and for that reason, it had now promised to triple health spending. India is one of the countries in the world that invests less in this sector, only 1% of its Gross Domestic Product compared to 6% of the world average. This decision is not innocuous: patients lying on the floor in the absence of beds in public hospitals; hundreds of people who crowd to be attended by one of the few doctors available in health centers and many others who resign themselves to the designs of the gods in the impossibility of traveling tens or hundreds of kilometers to access certain specialties, are some of the daily prints in which that lack of investment is translated.

However, the public sector is too centralized and is very rigid in its planning and inefficiently managed, while the private sector, which caters to the needs of a large part of the population, is mostly deregulated and fragmented. Currently, a pilot of the universal health project is being implemented in the States of Kerala and Karnataka, and includes access to free medicines, the construction of toilets in schools and homes, increasing health personnel, strengthening primary care medical centers and have five mobile clinics in each district with the capacity to perform X-rays, mammograms and blood tests in the most remote areas of the cities.
Communication Issues in Healthcare System

 Communication becomes a prerequisite for the existence of man and one of the most important factors in his social progress. Researchers suggest that being one of the core aspects of any type of human activity, as well as a condition for the development of individuality, communication reflects the objective need for mutual association and cooperation between people. The role of communication in health care is extensively important because it is an inexhaustible source of “information” that reflects modulation of behavior, personalities, values, counseling, and preservation of rights. However, in general communication, there are numerous barriers that influence the judicial process of the people. For example, semantic barriers arise from the limitations of the symbols with which communication is generally established. These symbols have like a variety to choose among many, but sometimes the wrong meaning is chosen and bad communication occurs. Likewise, Personal barriers are inferences from communication that arise from human emotions, values ​​and bad listening habits. They commonly occur in work situations. All people have experienced how personal feelings can limit communication with others (Ruan & Labmert, 2008).

 Concerning the case of the Indian health care system, there is a great linguistic barrier among the clinicians and Indian communities. According to estimates, there are more than 150 languages that have been spoken by Indian people. On the other hand, the ratio of clinicians in the same dialect is very limited which develop the communication gap among the patient and the doctor resulting in misleading information.

 Accordingly, on the national level, India is still lacking to communicate with all its population regarding health care reforms, knowledge of health care system and educating people towards their health rights. Researchers have stated that despite having such a large media industry including films, television and other communication resources, the government is only reaching to its 43% of the population with the message of the effective healthcare system. Although, the recent initiatives related to health reforms are proposed in order to respect the dignity of the people, with the incorporation of the values ​​of the Indian peoples, their interpretations and evaluations of the phenomenon of health and disease. The program presents transcendental modifications, calls for the different biological, psychological, social, economic, and cultural aspects of the peoples to be taken into account, as well as their social organization modalities, all of which are important in maintaining or losing Of the health. However, beyond the will formulated as a national crusade, there are linguistic and intercultural communication barriers that in many cases play a negative role in the relationship of people with public health institutions. On the part of the users, there is a resistance to the use of services and distrust of Western medicine persists. Very often the notions of the indigenous health-disease process collide, but they are also complemented with the scientific concepts that constitute modern allopathy, which permanently generates contradictory, complementary and conflicting relationships (Reddy et al., 2011)  

 The language used by doctors, one of the crucial aspects of intercultural communication, hinders the relationship as well as empathy and trust with the patient. The lack of management of a basic local vocabulary by institutional staff, in addition to the limited information given to the person about the purpose and necessity of some interventions, such as vaccination, injections, blood collection, Cabinet examinations, etc., end up distancing the actors from the therapeutic process. Furthermore, Physicians and patients not only speak different languages ​​but they also manage visions of the world that are often opposed. Most of the time there are no intercultural contact points driven by health personnel. This disqualifies many of the traditional and popular practices of attention to health and illness (Balarajan et al., 2011). 

Pain Management

 The lack of government actions and restrictive regulations condemn hundreds of thousands to unbearable suffering. Restrictive drug regulations, lack of training of health workers, and poorly integrated health care all result in unnecessary suffering for patients because they cannot get cheap and effective pain medications. In addition, many major cancer hospitals in India do not provide patients with morphine, despite the fact that more than 70 percent of their patients are incurable and most likely require treatment for pain and palliative care. Similarly, health centers that offer services to people living with HIV do not provide morphine or trained doctors to prescribe it. India’s health system leaves the patient to severe pain and is left to suffer. Severe pain is a common symptom among cancer patients, particularly during the later stages of the disease. It is estimated that more than one million patients with advanced cancer in India suffer from severe pain in any given year. In addition, many other patients, including those with HIV, tuberculosis or other infections or diseases, may have severe acute or chronic pain. There are three main obstacles to improving the availability of pain treatment and palliative care:

• Restrictive drug regulations. Many states in India have excessively strict drug regulations that make it very difficult for hospitals and pharmacies to obtain morphine. In 1998, the central government recommended that states adopt modified regulations, but more than half of the states in India have not done so.

• Lack of training for doctors. Most medical students and young doctors do not receive any training in pain management and palliative care, because the Government does not include instruction in the relevant curricula. As a result, most doctors in India simply do not know how to assess or treat severe pain.

• Poor integration of palliative care in health services. National cancer and AIDS control programs do not contain significant components of palliative care, depriving such care of public funds and relegating it to a second level (Mossey, 2011).

The Government of India deserves credit for investing in regional centers for cancer treatment and increased funding for cancer control, but without particular effort to ensure that all cancer hospitals can treat pain and providing palliative care, these funds will do little to alleviate the suffering of patients with advanced and incurable cancer. The researchers believe that governments have an obligation to ensure that essential medicines, such as morphine, are available to patients and that health workers receive adequate training on their use. The report states that the failure of the Indian government to comply with this obligation violates the right to health (Yip & Mahal, 2008).

Religion and Spirituality in India

 In all cultures and throughout the ages religion has played a prominent role, from which it follows that it performs an adaptive function, invoked in all societies to satisfy one or several human universal needs. Belief is the state of mind when we consider that something is true, even if we are not 100% sure or able to prove it. Everyone has beliefs about life and the world. Those that support each other can form belief systems, which can be religious, philosophical or ideological. In the simplest sense, religion is described as “the relationship of human beings with what they consider to be holy, sacred, spiritual or divine” is usually accompanied by a set of practices that foster a community of people who share the same faith. The religions and other belief systems of our environment have an influence on our identity, regardless of whether we consider ourselves religious or spiritual or not. At the same time, other parts of our identity, our history, our approach to other religions and groups considered “different” influence the interpretation we make of religion or a belief system (Kishore et al., 2011).

 Generally, in every society, many older people say that religion is the most important factor that allows them to cope with physical health problems and life stresses (such as decreased financial resources or the loss of a spouse or partner). For example, having a hopeful and positive attitude about the future helps people with physical problems maintain the motivation to recover. Some studies have shown that older people who use religious mechanisms to deal with problems are less likely to develop depression and anxiety than those who do not. Even the perception of disability seems to be altered according to the degree of religiosity. A study of older women with a hip fracture showed that the more religious women had lower rates of depression and were able to walk much farther when they were discharged from the hospital than those who were less religious.

 In India, it has been observed that religious values play a vital role in health-seeking behavior. Specifically, in rural areas, people at first glance seeking treatment through religious people and reach spiritual places due to the perception that has been developed by their ancestors. The ideology of seeking medical treatment through spiritual beliefs may not have an advantageous role. However, it has been noticed that patients find peace and security during the suffering sustained in their spiritual beliefs, especially with the issue of life after death, however, religious concern may also be a source of pain and spiritual tension patients who, for example, feel that God is punishing them or has abandoned them. In families where the presence of the religion is strong, they are more involved in the care and search of the patient’s well-being, that is, commitment and responsibility are more present. It may be because the religion refers to the origin, the collective memory, the family group, the history of life, and from there it is loaded with meanings that are expressed in the commitment to the other (Huang et al., 2011).

 Besides the patients and their family, clinicians also believe that religion and spiritual values play a vital role in the treatment of a patient, because they religion provides the sense of security and also enables the positive mood sign which helps the person to recover from even chronic diseases. However, there is controversy among the researchers and clinicians that religious have any significant role in the treatment process of the patients. But most of the researchers specifically related to mental health care system state that Religion is a system of practical beliefs, rituals and symbols that allow the active coping of the health-disease-care process, using religious beliefs and behaviors that prevent and / or alleviate the negative consequences, facilitating the resolution of problems. Religion gives the person hope, strength and courage to be optimistic and hope for the best, having a positive effect on their physiology, helping them to live, providing them with peace and security during their suffering although it can also be a source of pain when thinking that God has punished or abandoned them. Respect for spiritual needs is part of the basic care of a patient. Health professionals must respect the spirituality as it is part of their values, beliefs and cultural practices, and respecting patient’s beliefs can become an effective strategy to deal with the disease.

Conclusion

The human being, wherever he is, is always immersed and in a dynamic relationship with the culture that surrounds him. This is a powerful legacy that man himself has been building through his history and which, in a dynamic relationship with him, influences and molds him. For health care professionals culture could not go unnoticed, as a variable that affects not only the recipients of care but also themselves. Culture influences our development as human beings from the biological, the psychological, and the social and, of course, the cultural itself. Frequently, the term culture is associated with the way in which a certain group is expected to talk, feed, dress, organize their family and conduct themselves, in general.

Considering the context, healthcare in India is moving into the home progressively and involving a blend of individuals, an assortment of tasks, and an expansive decent variety of gadgets and innovations; it is likewise happening in scope of private situations. The elements driving this movement incorporates increasing cost of giving healthcare services; the developing quantities of more seasoned grown-ups; the expanding commonness of perpetual malady; enhanced survival rates of different infections, wounds, and different conditions (counting those of delicate babies); huge quantities of veterans coming back from war with genuine wounds; and an extensive variety of mechanical advancements (Noir, C., & Walsham, G. 2007). The healthcare or human services outcomes fluctuate extensively in its wellbeing, adequacy, and productivity, and in its quality and cost.

The advisory group was accused of analyzing this real pattern in medicinal services conveyance and coming about difficulties from just a single of numerous viewpoints: the investigation of human elements. From the beginning obviously the sensational and advancing change in human services practice and strategies displays a wide exhibit of chances and issues. Therefore the board of trustees tried to keep up spotlight explicitly on how utilizing the human variables approach can give arrangements that help to augment the security and nature of medicinal services conveyed in the home while enabling both consideration beneficiaries and guardians in the exertion.

The trend of healthcare is still in its earliest stages in India. However, it has a gigantic potential for development and improvement. Cost-adequacy, therapeutic ability and low lead times are the upper hands India can use on. The entire exposition examined how India can position itself to withstand rivalry from different nations. The Validated Positioning Model has been proposed by a specialist is theoretical in nature and is certain to work in every one of the cases regardless of whether certain components are missing. In this way, it stands near the genuine circumstance which would be the feature of this paper. As medicinal treatment costs are consistently expanding, travel for quality and financially savvy prescription will turn into an ordinary daily practice among nationals of developed countries.

Finally, it is obvious that there are varieties of problems and health needs, as well as the capabilities within the sector, demand the application of various methods. Consequently, the government must continue supporting decentralization and experimentation to meet the needs of each state. Furthermore, the government should invest in producing young professionals in the field of medical healthcare and other medical related sectors.

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