Coinciding with the visit of the British prime minister, David Cameron, to India last week, a business seminar was held in Mumbai to identify opportunities for health sector partnerships.

Meeta Lochan, secretary of the public health department of Maharashtra, offered insights on the intricacies of healthcare provisioning in Maharashtra. For instance, over the years the government has invested substantially in building health facilities so that nearly 60% of beds at the tertiary care level are now in the public health sector. However, less than 25% of doctors and medical equipment are in the public sector. Lack of data on the health outcomes of these investments further prevents effective planning for the future. To set standards for the quality of care in the nation, the Clinical Establishments (Registration and Regulation) Act came into force in 2010. However, implementation of the act has been sparse and very few states have adopted it so far. more…

As a brutal rape attack in Delhi has outraged masses and spurred the demand for urgent action, my thoughts turn to to the thousands of cases every year that suffer in silence. I do hope this spirit of intolerance for violence sustains. While calls for the death penalty, chemical castration, faster court trials, and heightened vigilance demonstrate the disgust and anger we feel; they also affirm to a sense of helplessness—what could have been done to prevent such suffering and further, offer solace? more…

A child with rickets who has received varied, sporadic treatment over two years presents with the inability to walk and a short stature. A 55 year old widow diagnosed with hypertension meticulously preserves prescriptions from follow-up visits to the clinic, fully aware that she will purchase these medicines only when she has a good harvest. A middle–aged woman on anti-epileptics reports to the emergency department with a break-through seizure. These were in no way one-off encounters during my clinical rounds at a rural hospital; rather this was the norm. As doctors we could conveniently label these “cases” as those of “non-compliance” or due to “irregular treatment.” The problem lay with them, not us. more…