Jean Drèze, Reetika Khera, Rishabh Malhotra, ‘The Changing State of Health Centres in North India’, Economic & Political Weekly (2024)
There is a well-documented infamy around public health centres. Some have likened it to a chasm, others to a systemic rot representing the “greatest failure of the Indian state”. There is proven dilapidation and disrepute — there are no doctors, no diagnostics, no drugs. There are no buildings either sometimes, and people walk for miles to get substandard treatment. These centres, as reflections of the vast network of public healthcare, stoke the fear that India’s health system has either collapsed or is disintegrating rapidly.
In this paper, the authors counter and complicate the prevailing narrative of ‘collapse’. They present a portrait of the healthcare centres in five north Indian States, documenting their strengths and struggles alike. Their survey shows a pattern of “improving quality and utilisation [of services] over time”, but the nature of progress is “largely cosmetic”, and “the pace of improvement” remains “far from adequate”. Still, there is scope and strength in redeeming health centres’ potential, they say. Against all odds, health centres “are mostly functional” and show “a demonstrated capacity to improve”.
