Health: whose responsibility?

Health is wealth is a very old proverb. It can be interpreted in many ways. To give an example, it can be inferred that without health there is no meaning to wealth. In another way, it can be interpreted as health is a form of wealth, as money, land or any other asset is. Another phrase of Latin origin translated as “a healthy body in a healthy mind” emphasizes the importance of a healthy body to have good mental and psychological health. There are many such phrases in all languages of the world which essentially point towards the importance of health.

If health is of such importance, whose responsibility is it? To answer this question, we need to know various dimensions of health. Health is defined by WHO as a state of complete physical, mental and social well-being and not merely absence of disease or infirmity. There are physical and mental aspects of personal health as well as social health which needs to be considered when we assign responsibility for health. So health becomes a responsibility of various stakeholders who have different roles to play at various levels.

To a major extent, in this way, health is a personal responsibility. “Health can’t be given, it is earned and maintained,” puts this notion in a very effective way. People need to make efforts to maintain their health. Some of the aspects which make this evident that individuals are responsible for their health are as follows:-

1)     Maintaining a personal diet: one can’t expect someone else to dictate what kind of diet he/she has. One should properly appropriate nutritious foods to one’s diet and avoid having harmful food items in his/her diet. E.g. pizza, burgers and similar fast food items.

2)     Having proper sleep is a must. It is recommended that an adult should have around 7 hours of sleep every day. This again can be enforced by anyone else.

3)     Doing regular exercises can keep physical stress away and stimulate the blood flow essential for cells to get oxygen. This also is a personal choice and can be taken care of by an individual.

4)     Keeping a check on one’s weight: regularly checking weight and planning one’s diet & exercise accordingly is something very necessary to avoid many illnesses. This again is an individual’s responsibility.

5)     Avoiding consumption of alcohol, smoking and other such activities harmful to one’s health.

6)     Maintaining personal hygiene: at a personal level, one can do his/her bit by maintaining personal hygiene.

7)     Similarly having medical check-ups, seeking medical help when sick are all one’s responsibility towards ensuring his/her health. Family planning is another aspect where it is better to give the choice to the individuals. This means it is also an individual responsibility.

Certain aspects of health can’t be maintained by one’s acts. They need a broader responsibility. Some of them fall under the community’s responsibilities:-

1)     Cases of pandemic stress the importance of community responsibility. One can’t expect by maintaining personal hygiene, he/she wouldn’t get affected by viral diseases including the recent Corona virus. The example of malaria also stresses the responsibility of the community in maintaining public sanitation.

2)     The community is responsible for proper waste disposal. If any individual is disposing of his/her waste properly but his/her neighbours aren’t, it would still impact on the health of the person.

3)     Community plays an important role in maintaining health. They can provide healthy surroundings for an individual to grow to his/her fullest extent.

Community’s participation in planning, funding and executing thus becomes important and can be ensured in the following ways:-

a.      By providing human power to the planning and executing activities.

b.     By providing logistics support for the same.

c.      By using the services to the full extent for their benefits. E.g. using hospitals whenever needed and demanding medicines from government hospitals at proper prices as listed by the government.

d.     By evaluating the services provided through various mechanisms. E.g. the social audits of PHC’s working.

It is not always easy to engage the community in the process of planning, execution and evaluation because this faces resistance from the medical professionals. If community participation is ensured, most of the malpractices of the medical professionals can be checked.

Last but a big responsibility to maintain the health is of governments. In India, it is stated in the directive principles of state policies that state should make provisions for the health services for the society. The state has major responsibilities in the following ways:-

1)     Making policies for society’s better health and overall well-being.

2)     Making provisions for public access to health services.

3)     Making legislations to regulate the private sector’s involvement in health so that it does not become exploitative. Ayushman Bharat Yojna is one such step where the government has gone for a public-private partnership to provide private sector healthcare benefits to the poor.

In this way, it can be concluded that health is a holistic concept and is everyone’s responsibility. The responsibilities start from an individual and extend up to the communities and governments as well. Certain aspects of health, including diet, fitness and personal hygiene, have to be dealt with individually. Government and community can support them with the proper information and resources. Some other aspects including community sanitation and public hygiene have to be taken care of by communities and governments.