Oxfam Report: Second wave hit rural India harder, states with higher health expenditure reported fewer cases and higher recovery

NEW DELHI: A new report by Oxfam India highlights the disproportionate effect of the second wave of Covid-19 on rural India. By May 2021, one in every two cases was in the rural areas, while states like Uttar Pradesh and Rajasthan had 75% of their cases in rural areas, the report states.
The “Inequality Report 2021- India’s Unequal Healthcare Story” goes on to state that “India’s particularly disastrous COVID-19 second wave-exposed the weakness of the public healthcare system.” Making a strong case for investment in health infrastructure, the report highlights that “state governments with higher expenditure on health had lower confirmed cases of Covid-19. States such as Odisha and Goa, with higher expenditure on health also had higher recovery rate from Covid.”
Besides drawing upon various available national data sources and reports, Oxfam shares find of a survey their teams carried out towards the end of 2020. They covered 768 respondents from Andhra Pradesh, Maharashtra, Uttar Pradesh, Delhi, Kerala, Bihar and Odisha who were either suffering from COVID-19 or had recovered from it. The survey found that the percentage of respondents in low-income brackets facing discrimination in the community for being COVID positive was five times more than those in the high-income bracket.
Also over 50% of SCs and STs among those surveyed faced difficulties in accessing non-Covid medical facilities compared to 18.2% in the general category. The percentage of SCs using an unsafe source of water was three times that of the general category for open wells, and four times for open springs or streams.
Among female respondents, 33.9% experienced anxiety, irritation and anger, and sleep deprivation during the lockdown as compared to 18.2% males.
The report also highlights that “the second wave is characterised by infrastructure lapse, overcharging at hospitals, black marketing of medicines, and a vaccination drive that is not inclusive. In cities, the virus is affecting the middle and upper-middle class more. On the other hand, the second wave has been harder for the rural populace as compared to the first.”
“In the midst of it all, while India’s vaccination drive attempted to tackle the second wave by inoculating its population, its execution was marred due to shortage of vaccine and the operations moving on to mobile applications making it accessible only to those who had internet or a smartphone,” it is stated.
The authors of the report point that it was only in June 2021 that the Centre revisited its vaccine policy. “While government-run centres are only now opening walk-in registrations, the vaccine strategy needs to be critically viewed from a gender lens to ensure that the digital divide and lack of information do not hinder the access of vaccines for women and other marginalised groups,” it is reiterated.
The report goes on to point that in the 2021-22 union budget, a year following a pandemic, the health ministry was allocated a total of INR 76,901 crore, a decline of 9.8% from Rs 85,250 crore from the revised estimates of 2020-21.
Amitabh Behar, CEO, Oxfam India said, “Persistent underfunding of the public health system especially primary health care and inadequate health infrastructure in India remain to be addressed by the government even after the devastating second wave. Otherwise, health emergencies will only aggravate existing inequalities and work as a detriment for the poor and the marginalised. Declaring health as a constitutional right can help to bridge these
gaps.”
Anjela Taneja, Inequality, Health and Education lead, Oxfam India added that “the current health status of the country is a testament to the unfulfilled dream of ‘Health for All’. The right to the highest attainable health is far from being realised. Even after one year into the pandemic and facing two COVID-19 waves, the government of India has repeated its failure to allocate 2.5% of Gross Domestic Product (GDP) for health.”