Reshaping inclusive healthcare in India involves leveraging technology for remote care, enhancing primary healthcare accessibility, and implementing policies to ensure equitable distribution of resources and services among all socio-economic strata.
Tags: GS – 2 -Health Government Policies & Interventions, GS – 3 -Government Budgeting- Planning.
For Prelims: Universal Health Coverage, Sustainable Development Goals (SDGs), NFHS-5, Pradhan Mantri Jan Arogya Yojana, Right to Health, WHO, Universal Declaration of Human Rights (1948), United Nations, Fundamental Rights, DPSPs, Supreme Court.
For Mains: Challenges in Achieving Universal Health Care/Coverage (UHC), Significance of Healthcare for Viksit Bharat by 2047.
Context:
- World Health Day, celebrated each year on April 7, acts as a poignant reminder of the significance of health equity, recognized as a basic human right by the World Health Organization (WHO).
- Therefore, it is crucial to delve into the theme of “My Health, My Right,” delving into the hurdles and remedies in attaining health equity in India, a country confronted with varied socioeconomic gaps in healthcare accessibility and outcomes.
What is Inclusive Healthcare?
- According to the WHO, health equity is the principle asserting that every person should have the chance to attain their utmost level of health, irrespective of their social, economic, or environmental conditions. Four hallmarks of inclusive care include:
- Culture of Inclusion: Integrate inclusive care into the organisational culture for all staff, fostering an understanding of common barriers faced by patients. Provide regular training to ensure staff do not pose additional challenges to patients, starting from the initial interaction. Recognize sustainable inclusion as fundamental to providing optimal care, beyond mere compliance.
- Welcoming Spaces: Ensure physical spaces cater to individuals of all abilities, including materials available in patients’ languages. Staff in inclusive spaces should mirror the diversity of patient groups seeking care.
- Accessible Materials: Extend inclusive care to available materials, offering large print, multiple languages, inclusive language, and cultural sensitivity.
- Valuing All Patients: Involve patients in decision-making, considering their concerns and adapting care to their educational and access levels. Staff should collaborate with patients while considering their means and access.
What is the Meaning of Health Equity?
- Equal Opportunity for All:
- Health equity ensures everyone has the same chance to reach optimal health regardless of their circumstances.
- It acknowledges the impact of social, economic, and environmental factors on health outcomes, surpassing genetic influences. WHO aims to eliminate unfair health disparities among various social and economic groups.
- Addressing Root Causes:
- True health equity tackles the underlying reasons for health inequalities such as poverty, discrimination, and limited access to education, healthy food, clean water, and housing.
- It doesn’t merely provide equal healthcare access but targets the factors contributing to health disparities.
- Challenges like pandemics, climate change, and sociopolitical unrest exacerbate existing differences, especially in diverse countries like India.
- Comprehensive Strategy:
- Achieving health equity requires a holistic approach that goes beyond legislative changes. It involves addressing socioeconomic determinants of health through collaborative efforts from governments, communities, and individuals.
- Ensuring everyone can lead a healthy life demands a collective endeavour to overcome barriers to health and well-being.
Health Equity Challenges in India:
- Global Challenges:
- Pandemic Risks: The battle for health equity faces global hurdles requiring unified international efforts. COVID-19 has starkly highlighted how infectious diseases disproportionately affect marginalised groups, widening health disparities.
- Climate Change Concerns: Climate change poses grave health risks, particularly affecting low-income and vulnerable populations. Conflicts further hinder healthcare access by damaging infrastructure and displacing communities, thus restricting vital medical services.
- India-Specific Challenges:
- Population Challenges: India’s diverse population poses ongoing health equity challenges, with significant disparities in healthcare outcomes. Rural areas particularly need improvement despite overall progress.
- Urban Slum Disparities: Urban slums, covering 17% of India’s cities, face severe health disparities due to overcrowding, poor sanitation, and limited access to clean water, leading to higher prevalence of diseases like tuberculosis.
- Caste and Gender Disparities: Deep-rooted disparities persist across caste and gender lines, reflected in higher child mortality and lower immunisation rates among Scheduled Castes and Scheduled Tribes. Economic status intersects with caste and gender, influencing health outcomes such as anaemia.
- Non-Communicable Disease Burden: Non-communicable diseases (NCDs) account for over 60% of deaths in India, necessitating equitable access to treatment and preventive healthcare to mitigate potential economic impacts projected to exceed USD 6 trillion by 2030.
- Doctor Shortage: India faces a critical shortage of doctors, especially in rural areas, with only 0.8 doctors per 1,000 people, below recommended levels. Rural areas suffer from acute shortages despite the majority of healthcare professionals being concentrated in urban regions.
- Financial Protection: Despite initiatives like Janani Shishu Suraksha Karyakram, out-of-pocket healthcare expenditure remains high, particularly in urban areas. Disparities persist among Indian states, with some witnessing an increase in expenditure between NFHS-4 and NFHS-5, highlighting significant urban-rural variation.
The Various Suggestions to be Incorporated in Providing Equitable Healthcare:
- Comprehensive Approach Beyond Healthcare Facilities: Elevating health literacy should be a shared goal, integrating health education into initiatives like the National Health Mission (NHM) to empower individuals in seeking equitable care and making informed health decisions.
- Necessitating Government’s Intervention: Initiatives like Ayushman Bharat demonstrate commitment to reducing disparities by offering free health coverage to the economically disadvantaged. National Rural Health Mission (NRHM) and National Urban Health Mission (NUHM), narrows the healthcare gap between rural and urban areas by expanding access and providing essential services to vulnerable populations.
- Public and Private Sector Collaboration: Non-governmental organisations (NGOs) and civil societies engage in community outreach, addressing regional health issues collaboratively with international and governmental organisations.
- Reliance on International Institutions: International institutions offer financial and technical support to bolster healthcare systems in developing countries. Collaborations with organisations like WHO and the Global Fund enhance healthcare infrastructure and access to essential resources.
- Promoting Innovation and Technical Growth: The commercial sector and charitable organisations drive accessibility and affordability through innovation, particularly in digital health. Technological advancements in healthcare, including Precision Medicine, Artificial Intelligence, Wearable Devices, and Robotics, improve diagnostics, treatments, and patient care.
- Following Organizations With Strong Local Presence: Organisations with strong local presence actively engage in health programmes, ensuring relevance and effectiveness through comprehensive planning and evaluation. They understand and address community needs effectively.
- Adopting Shared Approach and Open Communications: Successful collaborations rely on open communication, mutual respect, and common goals. Empowering communities, sharing knowledge, and building capacity are central to achieving health equity.
- Increasing Allocation as Percentage of GDP: Budgetary allocations for public health in India slightly increased to approximately 1.35% of GDP in fiscal year 2020. Recommendations aim to raise this to 2.5% by 2025, focusing on expanding coverage for the “missing middle” without health insurance
What are the Initiatives for the Health Care Sector?
- 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).
Conclusion:
Hence, Inclusive healthcare goes beyond medical treatment, prioritising the dignity and rights of all individuals. It involves addressing diverse needs, especially of marginalised groups, and providing accessible, affordable, and culturally competent services. It’s both a moral imperative and a practical necessity for improving health outcomes. Embracing inclusivity in healthcare fosters healthier, more equitable societies, ensuring everyone can lead a fulfilling life.
UPSC Civil Services Examination, Previous Year Questions (PYQs)
Prelims
Q:1 Which of the following are the objectives of the ‘National Nutrition Mission’? (2017)
- To create awareness relating to malnutrition among pregnant women and lactating mothers.
- To reduce the incidence of anaemia among young children, adolescent girls and women.
- To promote the consumption of millets, coarse cereals and unpolished rice.
- 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)
Mains
Q:1 “Besides being a moral imperative of a Welfare State, primary health structure is a necessary precondition for sustainable development.” Analyse. (2021)
Source: (TH)
FAQs on Reshaping Inclusive Health Care in India:
1. Why is there a need to reshape inclusive health care in India?
- Answer: India’s current health care system faces challenges such as accessibility, affordability, and quality of care, particularly for marginalized communities. Reshaping inclusive health care is essential to address these disparities and ensure equitable access to health services for all citizens.
2. How can technology play a role in reshaping inclusive health care in India?
- Answer: Technology can revolutionize inclusive health care by improving access to telemedicine services in remote areas, facilitating health data management for better patient care, and enabling mobile health applications for health education and awareness among underserved populations.
3. What policy changes are necessary to promote inclusive health care in India?
- Answer: Policy changes must focus on increasing public health spending, strengthening primary health care infrastructure, implementing health insurance schemes for vulnerable populations, and enforcing regulations to ensure quality standards across health care facilities.
4. How can community engagement contribute to reshaping inclusive health care in India?
- Answer: Community engagement fosters trust, understanding, and participation in health care initiatives. By involving communities in decision-making processes, designing culturally appropriate interventions, and leveraging local resources, inclusive health care becomes more responsive to the needs of diverse populations.
5. What role do healthcare professionals play in reshaping inclusive health care in India?
- Answer: Healthcare professionals are pivotal in advocating for equitable health policies, providing culturally sensitive care, and promoting health literacy among underserved communities. Training programs focusing on diversity, equity, and inclusion can empower professionals to address systemic barriers and deliver patient-centered care effectively.
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