Mains Practice Questions

Approach

• Introduce by writing a few lines about the status of public health in India.
• Discuss the factors affecting public health outcomes especially the level of expertise of health personnel and the civic sense of a population.
• Conclude by giving a way forward.

Introduction

• Public health services, which reduce a population’s exposure to disease through such measures as sanitation and vector control, are an essential part of a country’s development infrastructure, are not up to the mark in Indian context.
• Expenditure on public health funding has been consistently low in India (approximately 1.3% of GDP).
• With the advent of a global pandemic, the shortcomings of the public health care system in India have been highlighted.

Body

Problems faced by Public healthcare system in India

• Lack of Primary Healthcare Services: The existing public primary health care model in the country is limited in scope.
  
  • Even where there is a well-functioning public primary health centre, only services related to pregnancy care, limited childcare and certain services related to national health programmes are provided.
• Supply-Side Deficiencies: Poor health management skills and lack of appropriate training and supportive supervision for health workers prevent delivery of the desired quality of health services.
• Sub-optimal Public Health System: Due to this, it is challenging to tackle Non-communicable Diseases, which is all about prevention and early detection.

Factors affecting public health outcomes

• Hospital Infrastructure: Infrastructure is a key pillar supporting the fundamental aim of promoting improved standards of care and wellbeing for all patients, together with a good experience of the healthcare system.
  
  • Infrastructure must integrate the hospital, as the centre for acute and inpatient care, into the broader health care system, and should facilitate the seven domains of quality – patient experience, effectiveness, efficiency, timeliness, safety, equity and sustainability.
• Level of expertise of health personnel: There are several shortfalls that need to be addressed in the development of human resources for public health services.
  
  • There is a dire need to establish training facilities for public health specialists along with identifying the scope for their contribution in the field.
  • The Public Health Foundation of India is a positive step to redress the limited institutional capacity in India by strengthening training, research and policy development in public health.
  • Pre Service training is essential to train the medical workforce in public health leadership and to impart skills required for the practice of public health.
  • Changes in the undergraduate curriculum are vital for capacity building in emerging issues like geriatric care, adolescent health and mental health. Inservice training for medical officers is essential for imparting management skills and leadership qualities.
  • Equally important is the need to increase the number of paramedical workers and training institutes in India.
• Civic sense: Civic sense means social ethics and norms. Its examples include keeping roads, streets and public places clean, maintaining hygiene etc. It reflects the actual personality and shows the responsibility of any person.
  
  • By abiding by these social norms and ethics, the health care outcomes can be positively affected.
  • In order to catalyse people’s participation for healthy India, there is need for Swasth Bharat Jan Andolan on lines of Swach Bharat Abhiyan.
  • Indian citizens need to play their role in a manner which helps India prosper. There is a need to bring the positive and constructive discourse of civic sense in India so that citizens can play their due role in strengthening the country.

Conclusion

• Pandemics such as Covid-19 starkly remind us that public health systems are core social institutions in any society. The government has made several efforts to address the shortfall in the public health system through the schemes like the National Medical Commission (NMC) Act, 2019, Pradhan Mantri Bhartiya Janaushadhi Pariyojana, Pradhan Mantri - Jan Arogya Yojana etc.
• However, the need of the hour is an adequate investment, for creating a health system that can withstand any kind of public health emergencies and deliver universal health coverage.