The extent of variability and lacunae that several of these studies have

The extent of variability and lacunae that several of

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14. The extent of variability and lacunae that several of these studies have observed in infrastructure,basic facilites, human resources and medical equipment point to poor quality in the private sectoras well. 15. Problems in the formal private sector include the following: a.Physicians tend to over-prescribe care (medicines, diagnostc testng and surgeries)b.A lack of registraton procedures; c.Badly kept records; d.Inadequate infrastructure with poorly trained physicians and nurses according to patents’ ability to pay; 16. Studies on informal practtoners in rural and urban areas show that they ofen lack qualifcatons and adopt irratonal practces in prescribing medicines for the treatment of common illnesses. LACK OF ACCOUNTABILITY IN PUBLIC AND PRIVATE SECTORS: 1. The regulatory and insttutonal mechanisms for promotng accountability to consumers of health services are extremely weak in both the public and private sectors. 2. Some key areas in the public sector that lack accountability are - a. Absenteeism of providers (doctors and para-medical), b. Indiferent behaviour of service providers, and c. Corrupton. 3. The absence rates are much higher in poorer areas, more among doctors than health workers and at the primary level as compared to the secondary or tertary levels (Chaudhury et al 2006). 4. Apart from absenteeism it is well known that there is corrupton in the public health services. a. Patents’ report of corrupton in terms of bribes demanded for admission and treatment in public insttutons. 22 Downloaded by Vicky Gupta ([email protected]) lOMoARcPSD|3929542
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b. Corrupton is also rife in recruitment, promoton and transfer of personnel; admission to medical and paramedical educaton; procurement of drugs and technology. c. Since dual public and private practces are permited, the public sector acts, at tmes, only as a referral portal for the legalised private practces. 5.Also corrupton is not restricted to the public sector alone. The private sector also has its share ofcorrupton in the form of un-ethical practces. diagnostc testng in the private sector. incentves to doctors for prescribing specifc brands of medicines. under PPP liberalisaton are sometmes recipients of public subsidies especially in the tertary sectors. 6. While the lack of accountability of the public sector is well known, the private sector is not any diferent. If anything, there are fewer checks on their accountability due to weak regulaton . a. The role of consumer groups in ensuring accountability has been limited. b. An example of an efectve campaign by consumer groups was when they drew atenton to the rise in reported cases of medical negligence in the private sector. A few cases were registered with the consumer courts and compensaton was given for medical negligence in the private sector.
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