State of Healthcare Sector in India

This article is based on “How India has emerged as a global leader in public health” which was published in Hindustan Times on 07/01/2023. It talks about Health Sector in India and related challenges.

For Prelims: Ayushman Bharat, Venture Capital Fund, National Health Profile, Non-communicable diseases (NCDs), Indian Journal of Public Health, National Health Mission, Ayushman Bharat, Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), National Medical Commission, PM National Dialysis Programme, Ransomware Attack on AIIMS Delhi, One Health Approach.

For Mains: Potential of India’s Healthcare Sector, Issues Associated with India’s Healthcare Sector, Recent Government Initiatives Related to Healthcare.

India's healthcare system is complex and multi-faceted, with both government-run and private facilities providing medical services to the country's population of over 1.3 billion people.

The government has launched a number of initiatives to improve access to healthcare for the country's rural population, such as the "Ayushman Bharat" scheme, which aims to provide health coverage to over 500 million people.

Despite significant progress in recent years, the healthcare system still faces a number of challenges, including inadequate funding, shortage of healthcare workers, and inadequate infrastructure.

It is important that India's healthcare system be a priority and that both the government and private sector focus on addressing these challenges so that India's citizens have access to good healthcare.

What is the Potential of India’s Healthcare Sector?

• India's competitive advantage lies in its large pool of well-trained medical professionals.
  • India is also cost competitive compared to its peers in Asia and western countries. The cost of surgery in India is about one-tenth of that in the US or Western Europe.
• India has all the essential ingredients for the exponential growth in this sector, including a large population, a robust pharma and medical supply chain, 750 million plus smartphone users, 3^rd largest start-up pool globally with easy access to VC (Venture Capital Fund) funding and innovative tech entrepreneurs looking to solve global healthcare problems.
• India will have about 50 clusters for faster clinical testing of medical devices to boost product development and innovation.
• As of 2021, the Indian healthcare sector is one of India’s largest employers as it employs a total of 4.7 million people. The sector has generated 2.7 million additional jobs in India between 2017-22 - over 500,000 new jobs per year.

What are the Issues Associated with India’s Healthcare Sector?

• Inadequate Medical Infrastructure: India has a shortage of hospitals, particularly in rural areas, and many existing healthcare facilities lack basic equipment and resources.
  • According to the National Health Profile, India has only 0.9 beds per 1000 population and out of which only 30% are in rural areas.
• Lack of Standardisation of Quality Care: Quality of healthcare provided in India varies significantly, with inadequate facilities and resources in rural areas and poor regulation leading to substandard care in some private healthcare facilities.
• Non-Communicable Diseases: Non-communicable diseases (NCDs) are responsible for over 60% of all deaths in India, with high rates of chronic illnesses such as diabetes, cancer, and heart disease.
  • As a result, affordability concerns are also raised, and poor people are more vulnerable as a result.
• Lack of Adequate Mental Healthcare: India has one of the lowest numbers of mental health care professionals per capita.
  • Government's spending on mental health is also very low. This has resulted in poor mental health outcomes and inadequate care for people suffering from mental illness.
• Gap in Doctor-Patient Ratio: One of the most critical concerns is the gap in the doctor-patient ratio. According to the Indian Journal of Public Health India needs 20 lakh doctors by 2030.
  • However, currently a doctor in the government hospital attends to ~11000 patients, which is more than the WHO recommendation of 1:1000.

What are the Recent Government Initiatives Related to Healthcare?

• National Health Mission
• Ayushman Bharat
• Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)
• National Medical Commission
• PM National Dialysis Programme
• Janani Shishu Suraksha Karyakram (JSSK)
• Rashtriya Bal Swasthya Karyakram (RBSK)

What Should be the Way Forward?

• Improving Infrastructure and Human Resource: There is a need for investing in the construction of new healthcare facilities and upgrading existing ones, as well as increasing funding for healthcare services (currently 2.1% of GDP) and medical research.
  • Also, there is a need for increasing the number of healthcare workers. It includes increasing the number of medical schools and training programs, as well as offering financial incentives to encourage healthcare professionals to work in underserved areas.
• Accessibility of Quality Healthcare: There is a need for time bound implementing targeted programs to increase access to healthcare services for people living in poverty, members of lower castes, and specially women, as well as providing education and information about healthcare to these communities.
  • There is also a need for enforcing regulations, implementing quality control measures, increasing transparency and conducting audits of health care programmes.
• Improving Mental Health Services: It includes increasing funding for mental health services, training healthcare workers to better address mental health issues, and reducing the social stigma associated with mental illness.
• Addressing the Root Causes of Health Inequities: The healthcare system should work in coordination with other sectors, such as education, housing and sanitation to address the social determinants of health and reduce overall health inequities.
• Sustainable Health Governance: This could include implementing better management systems, strengthening healthcare regulatory bodies and creating independent oversight mechanisms to ensure more effective and efficient healthcare services.
  • Also, suitable cybersecurity measures should also be taken to secure critical medical infrastructure and data from any cyber attack like recent Ransomware Attack on AIIMS Delhi.
• Tax Reductions: Incentivising R&D (Research and Development) by additional tax deductions to further support greater investments in new drug developments and reducing GST (Goods and Services Tax) on life-saving and essential drugs is necessary.
• Towards One Health Approach: There is a need to recognize that the health of people is closely connected to the health of animals and our shared environment, and collective health initiatives covering healthy atmosphere, healthy animals, and healthy humans are the need of the hour.

Drishti Mains Question

Critically analyse the challenges facing India's healthcare system and suggest measures that could be implemented to improve the quality and accessibility of healthcare services in the country.

UPSC Civil Services Examination, Previous Year Questions (PYQs)

Prelims

Q. Which of the following are the objectives of ‘National Nutrition Mission’? (2017)

1. To create awareness relating to malnutrition among pregnant women and lactating mothers.
2. To reduce the incidence of anaemia among young children, adolescent girls and women.
3. To promote the consumption of millets, coarse cereals and unpolished rice.
4. To promote the consumption of poultry eggs.

Select the correct answer using the code given below:

(a) 1 and 2 only
(b) 1, 2 and 3 only
(c) 1, 2 and 4 only 
(d) 3 and 4 only

Ans: (a)

Exp:

• National Nutrition Mission (POSHAN Abhiyaan) is a flagship programme of the Ministry of Women and Child Development, GoI, which ensures convergence with various programmes like Anganwadi services, National Health Mission, Pradhan Mantri Matru Vandana Yojana, Swachh-Bharat Mission, etc.
• The goals of National Nutrition Mission (NNM) are to achieve improvement in nutritional status of children from 0-6 years, adolescent girls, pregnant women and lactating mothers in a time bound manner during the next three years beginning 2017- 18. Hence, 1 is correct.
• NNM targets to reduce stunting, under-nutrition, anaemia (among young children, women and adolescent girls) and reduce low birth weight of babies. Hence, 2 is correct.
• There is no such provision relating to consumption of millets, unpolished rice, coarse cereals and eggs under NNM. Hence, 3 and 4 are not correct.
• Therefore, option (a) is the correct answer.

---

Mains

Q. “Besides being a moral imperative of a Welfare State, primary health structure is a necessary precondition for sustainable development.” Analyse. (2021)