Report on ‘Health Care Equity in Urban India’

• 23 Nov 2021

Why in News

According to a recent report, life expectancy among the poorest is lower by 9.1 years and 6.2 years among men and women, respectively, compared to the richest in urban areas.

Key Points

• About the Report:
  
  • The report explores health vulnerabilities and inequalities in cities in India.
  • It also looks at the availability, accessibility and cost of healthcare facilities, and possibilities in future-proofing services in the next decade.
  • It was released recently by Azim Premji University in collaboration with 17 regional NGOs across India.
• Findings of the Report:
  
  • Number of Urban People:
    
    • A third of India’s people now live in urban areas, with this segment seeing a rapid growth from about 18% (1960) to 34% (in 2019).
    • Close to 30% of people living in urban areas are poor.
  • Chaotic Urban Health Governance:
    
    • The report, besides finding disproportionate disease burden on the poor, also pointed to a chaotic urban health governance, where the multiplicity of healthcare providers both within and outside the government without coordination are challenges to urban health governance.
  • Heavy Financial Burden on the Poor:
    
    • A heavy financial burden on the poor, and less investment in healthcare by urban local bodies is also a major challenge.
• Suggestions:
  
  • Strengthen community participation and governance.
  • Build a comprehensive and dynamic database on the health and nutrition status, including co-morbidities of the diverse, vulnerable populations; strengthening healthcare provisioning through the National Urban Health Mission, especially for primary healthcare services.
  • Put in place policy measures to reduce the financial burden of the poor.
  • A better mechanism for coordinated public healthcare services and better governed private healthcare institutions.
  • The Covid-19 pandemic has brought to attention the need for a robust and resourced healthcare system. Addressing this now will benefit the most vulnerable and offer critical services to city dwellers across income groups.

Status of India’s Healthcare

• India’s healthcare system has been battling various issues, including the low number of institutions and less-than-adequate human resources for quite a while now.
• Essentially, a three-tier structure defined the Indian healthcare system — primary, secondary and tertiary care services.
  
  • The Indian Public Health Standards (IPHS) states that the delivery of primary health care is provided to the rural population through sub-centre, primary health centre (PHC), and community health centre (CHC), while secondary care is delivered through district and sub-district hospitals.
  • On the other hand, tertiary care is extended at regional/central level institutions or super specialty hospitals.
• While there is an urgency to focus on all the three levels of primary, secondary and tertiary healthcare, it is imperative that the government look towards improving primary health care as a public good.

Initiatives for Public Health Sector

• Emergency Response and Health Systems Preparedness Package:
  
  • Under the National Health Mission (NHM), technical and financial support is provided to the States/UTs to strengthen the public healthcare system at public healthcare facilities.
• Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY):
  
  • Launched on 23^rd September 2018, Ayushman Bharat PM-JAY is the largest Government funded health assurance/insurance scheme in the world.
  • PM-JAY is a centrally sponsored scheme.
• Pradhan Mantri Swasthya Suraksha Yojana (PMSSY):
  
  • PMSSY was announced in 2003 with objectives of correcting regional imbalances in the availability of affordable/reliable tertiary healthcare services and also to augment facilities for quality medical education in the country.

Source: TH