Health care in India is a vital yet complex system that plays a crucial role in the well-being of over a billion people. It includes a mix of public and private hospitals, clinics, and traditional practices. While India has made significant advancements in medical technology and healthcare services, challenges like unequal access, affordability, and infrastructure gaps persist. Many people in rural areas still struggle to receive basic healthcare, while urban centers offer world-class facilities. The government and private sector are continually working to improve the system, aiming to provide better healthcare for all Indians.
Tags:GS-2,Health-GovernmentPolicies & Interventions, GS – 3 Science & Tech. Government Budgeting– Planning
For Prelims: National Health Profile, National Health Mission, Ayushman Bharat, Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), National Medical Commission, One Health Approach.
For Mains: Potential of India’s Healthcare Sector, Issues Associated with India’s Healthcare Sector, Recent Government Initiatives Related to Healthcare.
Context:
- India’s healthcare sector is globally recognized for its excellence, demonstrating both medical prowess and economic resilience.
- This global reputation reflects substantial advancements and positions India as a key player in the international health-care arena.
About India’s Health Sector: Recent Trends and Initiatives
Government Health Expenditure and Primary Healthcare
- Increase in Government Health Expenditure:
- According to the National Health Accounts (NHA) estimates, there has been a notable rise in the share of government health expenditure (GHE) in the total GDP and total health expenditure.
- Specifically, primary healthcare expenditure as a percentage of GHE increased from 51.3% in FY15 to 55.9% in FY20.
- The combined share of primary and secondary care in GHE also grew from 73.2% in FY15 to 85.5% in FY20.
- Shift in Private Health Expenditure:
- There has been a decrease in the share of primary and secondary care in private health expenditure, falling from 83% to 73.7% between FY15 and FY20.
- This shift indicates a greater reliance on government facilities for primary healthcare due to increased tertiary care needs.
- Social Security Expenditure on Health:
- Social security expenditure on health has risen significantly, from 5.7% in FY15 to 9.3% in FY20, highlighting improved healthcare access and financial protection.
Medical Tourism and Cost Advantage
- Cost Advantage:
- India has emerged as a prominent destination for medical tourism due to its cost-effective healthcare services.
- Surgical costs in India are approximately one-tenth of those in the US or Western Europe, attracting patients globally.
Health Indicators:
- Infant Mortality Rate (IMR)
- IMR Decline: The IMR has decreased from 39 per 1,000 live births in 2013 to 28 per 1,000 live births in 2020, reflecting progress in maternal and child health.
- Maternal Mortality Rate (MMR)
- MMR Improvement: The MMR reduced from 167 per lakh live births in 2014 to 97 per lakh live births in 2020, demonstrating enhancements in maternal care and delivery practices.
India: From Medical Tourism to Preferred Destination:
Economic Implications
- Shift in Medical Tourism:
- Previously, Indians sought medical treatments abroad, but now India retains substantial foreign exchange by treating its citizens domestically.
- The lower cost of treatment within India has contributed to this shift.
- Boosting the Economy:
- The influx of international patients generates over $9 billion annually, benefiting related sectors such as hospitality, transportation, and pharmaceuticals.
- The “Heal in India” initiative aims to bolster India’s position as a global healthcare leader.
- State-of-the-Art Infrastructure
- Infrastructure and Expertise: India’s modern hospitals and skilled medical professionals, combined with affordable treatments, make it a preferred destination for complex medical procedures.
A Comparative Overview of India’s Health Sector:
- Health System Review by WHO
- Mixed Health System: India’s health system varies significantly across states, reflecting the country’s diverse health and development indicators.
- Public Expenditure: Public health expenditure in India remains below 1% of GDP, contrasting sharply with higher spending levels in developed countries.
- Healthcare Infrastructure: Despite progress, gaps in healthcare infrastructure persist, particularly in rural areas compared to urban centres.
- Human Resources: Shortages of healthcare professionals, including doctors and nurses, continue to impact service delivery.
- Selected Indicators and International Comparisons
- Life Expectancy: India’s life expectancy has improved but is still lower than in developed nations, influenced by factors such as nutrition and healthcare access.
- Infant Mortality: India’s infant mortality rates are higher compared to developed countries, indicating challenges in healthcare system effectiveness.
- Healthcare Costs: India remains cost-competitive in healthcare services, contributing to its thriving medical tourism sector.
Key Concerns and Challenges:
Violence Against Healthcare Workers (VAHCW)
- Rising Incidents:
- Reports of violence against healthcare workers have increased, with younger and female professionals disproportionately affected.
- Only 19 states had enacted laws against such violence as of 2020.
- Lack of Uniformity and Loopholes in Existing Laws
- Legal Gaps: There are inconsistencies in state laws aimed at preventing violence against healthcare workers, reflecting a need for more robust and uniform legal frameworks.
- Expenditure on Primary Healthcare
- Decreased Investment: Despite rising private health expenditure, the share allocated to primary and secondary care has declined, necessitating a renewed focus on primary healthcare investment.
- ‘One Health’ Approach for Emerging Diseases
- Integrated Approach: Addressing diseases originating from non-human sources requires an integrated ‘One Health’ approach that encompasses human, animal, and environmental health.
- Health Inflation and Expenditure
- Inflation Trends: Medical inflation, currently at 15%, outpaces general inflation rates, with health expenditure constituting 5% of private final consumption expenditure.
Significant Initiatives:
Ayushman Bharat Digital Mission (ABDM)
- Digital Health Ecosystem:
- ABDM aims to establish a comprehensive digital health system, enhancing accessibility, efficiency, and safety.
- The Ayushman Bharat Health Account (ABHA) facilitates digital health records and interactions with healthcare providers.
- CoWIN App
- Vaccine Management: CoWIN played a critical role in managing COVID-19 vaccinations, including registration, scheduling, and tracking, improving distribution and administration efficiency.
- Aarogya Setu
- Health App Evolution: Originally a COVID-19 contact tracing app, Aarogya Setu has evolved into a national health app, supporting digital health ID registration and healthcare interactions.
- e-Sanjeevani and e-Hospital
- Telemedicine Platforms: These platforms have revolutionised healthcare delivery, enabling remote consultations and medical advice, with e-Sanjeevani for outpatient services and e-Hospital for inpatient consultations.
- PM Jan Aushadhi Kendras and AMRIT
- Affordable Medicines: PM Jan Aushadhi Kendras provide generic medicines at lower costs, while AMRIT ensures access to quality medicines and medical devices.
- Increased Budget Allocation
- Funding Boost: The 2024-2025 budget allocated Rs. 90,958.63 crore to the Union Health Ministry, marking a 12.9% increase and exempting customs duty on specific cancer treatment drugs.
- Addressing Obesity and Mental Health
- Health Challenges: Rising obesity and mental health issues were highlighted, with initiatives such as the National Tele Mental Health Programme receiving Rs. 90 crore for support.
- One Health Initiative
- Cross-Sectoral Collaboration: This initiative aims to improve health outcomes by addressing interlinked issues related to human, animal, wildlife, and environmental health.
- Citizens’ Commission on Reimagining India’s Health System
- Universal Health Coverage: This citizen-led initiative seeks to achieve universal health coverage through sectoral collaboration and community involvement.
Way Forward:
- Heal in India” Initiative: Position India as a global healthcare leader through strategic efforts to enhance its reputation as a preferred medical destination.
- Youth Engagement: Encourage youth involvement in healthcare careers to ensure innovation and sustain sector growth.
- Investment in Public Healthcare: Increase spending to improve infrastructure, particularly in rural areas, and reduce the urban-rural healthcare disparity.
- Focus on Medical Device Manufacturing: Promote domestic production under “Make in India” to reduce import dependency and bolster healthcare infrastructure.
UPSC Civil Services Examination Previous Year Questions (PYQs)
Prelims
Q:1 Which of the following are the objectives of ‘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:
- 1 and 2 only
- 1, 2 and 3 only
- 1, 2 and 4 only
- 3 and 4 only
Ans: (a)
Mains
Q:1 Appropriate local community-level healthcare intervention is a prerequisite to achieve ‘Health for All’ in India. Explain. (2018)
Q:2 Besides being a moral imperative of a Welfare State, primary health structure is a necessary precondition for sustainable development.” Analyse.(2021)
Source: TH
FAQs
Q: What is the current state of health care in India?
- Answer: Health care in India has made significant progress over the years, but it still faces challenges. While there are world-class hospitals and doctors in the country, access to quality health care can be uneven, especially in rural areas where facilities are often limited.
Q: Why is health care access an issue in India?
- Answer: Access to health care is an issue due to factors like a shortage of medical facilities in rural areas, lack of trained health care professionals, and the high cost of treatments. Additionally, many people are not covered by health insurance, making it harder for them to afford necessary care.
Q: What are the government initiatives to improve health care in India?
- Answer: The Indian government has launched several initiatives to improve health care, such as Ayushman Bharat, which aims to provide affordable health care to millions of low-income families. Other programs focus on building more hospitals, increasing medical education, and promoting preventive care.
Q: How does the private sector contribute to health care in India?
- Answer: The private sector plays a significant role in health care by providing advanced treatments and technology, running hospitals, and offering specialized care. Many people in urban areas rely on private hospitals for their medical needs, although these services can be expensive.
Q: What can be done to improve health care in India?
- Answer: Improving health care in India requires a combination of better infrastructure, more trained health professionals, increased government funding, and wider health insurance coverage. Focusing on preventive care, promoting public health awareness, and ensuring equitable access to medical services across all regions are also key steps.
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