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Illnesses bring enormous suffering to the poor, not just physically but also as a huge financial burden. What we should ideally aim at is a Maharashtra that is not dependent on doctors, hospitals and drug companies. The principle of Aarogya Swaraj will lead us to this.

Identifying potential risk factors of rampant death and diseases, and engaging healthcare and social resources to locate the hidden causes are the keys. The state should focus on targeting these risk factors. Otherwise, Maharashtra will remain merely as an employment guarantee scheme for doctors.

Let me list out the most glaring ones – water scarcity, air pollution, malnutrition, tobacco and liquor consumption. They cannot be eliminated completely but we need to have strong Universal Health Policy to keep them under control. Tobacco and liquor are two of the top seven risk factors causing diseases and deaths, globally. They are the plague and cholera of the modern world. Their sale, manufacturing and consumption should be strictly monitored and controlled through awareness programmes.

You have these items freely available, and at the same time, you have corporate hospitals running the business of treatment. Lifestyle and policy decisions will play a crucial role in reducing these risk factors and the disease burden.

If prevention, health awareness, primary health care and Aarogya Swaraj (आरोग्य स्वराज) are made the four pillars of healthcare of our state, we will not be far from becoming Healthy Maharashtra.

Prevention should be the thrust of primary healthcare system and can reduce the burden of diseases drastically in rural areas. Therefore, targeting universal healthcare for the poor should be the prime objective on which the policymakers should concentrate.

We need to train locals to serve their own communities. Appointing ‘Aarogya Doot’ or health messengers will improve the situation of tribal villages. Every village should have an ‘Asha Sevika’ and a male health worker, let us call him ‘Ashok’, to make rural areas more independent. We have implemented this healthcare model in Gadchiroli and have had a successful experience.

Over the years, we have developed public and private health infrastructure, but medical facilities have not reached rural and tribal areas yet. Tribal villages, slums, rural areas of Vidarbha and Marathwada still have basic health needs. As a state, we have to reach out to these healthcare deficient areas first.

Today, people in cities, towns as well as villages suffer from non-communicable diseases (NCDs) such as heart attack, stroke, diabetes, cancer and mental illnesses. The government should work on a blueprint for their prevention and treatment. It should be patient-centric and aim at providing affordable treatment and should never toe the line of the corporate hospital industry or drug manufactures.

Importance should also be given to manage NCDs at primary health centres as lifestyle diseases are not solely an urban phenomenon anymore. Ayushman Bharat, where the government is creating health and wellness centres, is an excellent project targeting the rural population.

Also, India, with annual per capita health spending of Rs7,000, should never follow the American model of healthcare where private health care is financed through insurance. This would be disastrous as the situation in America, where the per capita health spending is Rs7 lakh, is different from ours.

If prevention, health awareness, primary health care and Aarogya Swaraj (आरोग्य स्वराज) are made the four pillars of healthcare of our state, we will not be far from becoming Healthy Maharashtra.

The author is a Padma Shri and Maharashtra Bhushan awardee

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