Challenges in accessing Healthcare Services in Rural Areas of Manipur

H D Daziinai Mercy Poumai *

Over the past few years, healthcare in Manipur, a state in northeast India, has seen substantial improvements to meet the specific challenges it encounters. However, the rural communities face challenges in accessing adequate healthcare due to the lack of medical facilities in these areas.

The state has a population of over 3 million people and is divided into two regions: hilly areas and plains. The majority of the population, 69.79%, lives in rural areas where there is limited access to medical services. The remaining 30.21% of the population resides in urban areas.

The challenges encountered by rural people in Manipur

Manipur faces obstacles such as geographical constraints, diverse ethnicities, and scant resources in providing healthcare services. One of the biggest challenges in rural Manipur is the lack of healthcare infrastructure, such as hospitals, clinics, and medical professionals.

Many remote villages do not have access to proper medical facilities, forcing residents to travel long distances to reach the nearest hospitals or healthcare centres. This results in delayed treatment and a lack of preventive care for many individuals, which ultimately impacts their overall health and well-being.

The shortage of healthcare professionals in rural Manipur worsens the situation, as many medical workers prefer to work in urban areas with better infrastructure and career opportunities. This leaves rural communities underserved, with few healthcare providers available to meet their needs.

Furthermore, rural healthcare facilities lack essential medical equipment and resources, making it difficult for healthcare workers to effectively treat patients. As a result, residents in rural Manipur experience higher rates of sickness and death, as well as a lower quality of life. It is vital for the government and healthcare organizations to address these challenges and invest in improving healthcare services in rural areas.

The ethnic conflict that began on May 3, 2023 between the Meitei and Kuki communities has significantly hindered the functioning of the healthcare system in the state, especially affecting rural residents.

Numerous healthcare workers have been harmed during the attacks, causing disruptions in crucial healthcare services. The conflict has had devastating impacts on individuals requiring treatment for chronic diseases and general health concerns. The turmoil has made it extremely challenging for healthcare services to operate effectively, exacerbating the healthcare crisis faced by the local population.

Additionally, there is a lack of vaccines available, particularly during special immunization campaigns targeting diseases such as measles in the relief camps. Teams of medical professionals have been assembled in every district in Manipur to offer comprehensive healthcare services to those affected by the disaster at specific relief camps.

Routine medical examinations are carried out at all relief camps in the state, and individuals requiring urgent medical attention are swiftly transported to the nearest hospitals using ambulance services.

Schemes and Initiatives by the Central and State Government

Here are some of the various health schemes and initiatives that have been introduced by both the Central and state governments to promote the well-being of the people:

1. The National Rural Health Mission (NRHM) was initiated in India on April 12, 2005, with a particular emphasis on 18 High Focus States, including Manipur. Manipur has successfully implemented NRHM activities to achieve the objectives of the National Population Policy and Millennium Development Goals.

The program has significantly improved public health services in the state, with a focus on decentralization, meeting local needs, changing the management of the health system, and providing untied funds for improved facilities and public trust.

2. Ayushman Bharat Yojana, known as one of the largest healthcare programs in the world, has a goal of providing health coverage to more than 50 crore economically disadvantaged Indian citizens. Launched in September 2018, this National Health Protection Scheme offers coverage of up to 5 lakh rupees per family per year for hospitalization services. It have merged existing centrally sponsored schemes like Rashtriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme (SCHIS) to reach its target of helping 10 crore poor families.

3. The Chief Minister-gi Hakshelgi Tengbang (CMHT) is an innovative health insurance program introduced by the Manipur government on January 21, 2018. This scheme offers cashless medical treatment to underprivileged individuals at designated hospitals in Manipur and Guwahati, providing up to Rs.5 lakhs in healthcare coverage per eligible family annually.

Eligible Beneficiaries under the Scheme are; Widows, Disabled and AAY cards holder, Local Media Person & Newspaper hawkers, Newly added to State SECC (identified through DC verification process), ASHA Workers, Anganwadi Workers, Anganwadi Helpers, and Ima Market Woman Vendors.

4. Community outreach was a key strategy used to deliver public health services in the remote hill districts of Manipur. The medical team from Primary Health Centre (PHC) Phungyar in Kamjong district conducted weekly visits to provide healthcare and immunization services to isolated villages, with the help of community health volunteers (ASHAs).

Despite challenges in transportation, the team was able to reach 38 villages and provide essential services. The WHO National Public Health Support Network also played a role in supporting these efforts by providing technical assistance and helping with immunizations in underserved areas.

5. The Telemedicine initiative in Manipur is another innovative approach to improving healthcare access, especially in remote areas. By leveraging technology, patients can receive medical consultations and advice from specialists without having to travel long distances to urban healthcare facilities. This initiative has helped bridge the gap in healthcare services and improve the overall quality of care for residents in rural Manipur.

What steps should we take next?

Manipur faces significant challenges in providing healthcare services, various government initiatives and programs have to be implemented to improve access and quality of care for the local population. It is essential for stakeholders to continue investing in healthcare infrastructure, human resources, and innovative solutions to address the unique healthcare needs of rural communities in Manipur.

Health education and awareness programs should be organized to educate the local population about the importance of preventive healthcare measures and promote healthy living practices. This will help in reducing the incidence of preventable diseases and improve the overall health status of the rural population.

The expansion of health services in these areas is a priority and requires immediate attention. By working together, we can overcome these obstacles and ensure that all residents have access to essential healthcare services.