Transforming India’s healthcare system is a multifaceted challenge that requires comprehensive policy reforms and effective implementation strategies. The current state of healthcare in India is characterized by a dual burden of communicable and non-communicable diseases, underfunded public health infrastructure, and significant disparities in access and quality of care between urban and rural areas. Key to transforming this sector is increasing public healthcare spending to at least 2.5% of GDP, as recommended by the National Health Policy 2017. This would enable the expansion of universal health coverage, enhance primary healthcare services, and address the acute shortage of healthcare professionals. Strengthening the use of technology through digital health initiatives, such as telemedicine and health information systems, can bridge gaps in service delivery and improve efficiency. Furthermore, the integration of traditional and modern medicine, coupled with a robust regulatory framework, can ensure comprehensive and affordable healthcare for all. Public-private partnerships, investment in healthcare infrastructure, and a focus on preventive care are also crucial for sustainable healthcare transformation. Addressing social determinants of health, such as sanitation, nutrition, and education, remains essential to improving overall health outcomes and achieving the vision of a healthy India.
Tags: GS- 2, Health – Government Policies & Interventions, GS – 3, Government Budgeting – Planning
Context:
- India’s healthcare system comprises a complex network of public and private facilities, striving to cater to its large population.
- While the private sector plays a significant role in providing healthcare services, recent events such as the fire at a nursing home in Delhi underscore a crucial challenge to the inadequacy of healthcare regulations in India.
What is the Framework of Healthcare Regulation in India?
Historical Regulatory Landscape:
- During Colonial Times: Fragmented regulations influenced by colonial governance, such as the Madras Public Health Act of 1939.
- Bhore Committee Report (1946): Advocated for the integration of preventive, promotive, and curative healthcare services and the establishment of Primary Health Centres in rural areas.
- Economic Liberalisation (1991): Led to the expansion of private healthcare, necessitating updated regulations.
Key Regulatory Bodies:
- Ministry of Health and Family Welfare (MoHFW): Formulates overarching healthcare policies.
- National Medical Commission (NMC): Regulates medical education and licensure, replacing the Medical Council of India under the NMC Act, 2019, to enhance transparency.
- Others: Include the Nursing Council and Pharmacy Council.
Major Regulatory Laws and Policies:
- Pre-Conception and Pre-Natal Diagnostic Techniques Act, 1994: Aims to prevent female foeticide.
- Clinical Establishments (Registration and Regulation) Act, 2010: Mandates registration and standard treatment guidelines for clinical facilities.
- Drugs and Cosmetics Act, 1940: Regulates pharmaceuticals.
- Consumer Protection Act, 1986: Initially did not explicitly cover healthcare services, but subsequent court rulings interpreted its scope to include healthcare.
- National Health Policy, 2017: Sets out a vision for universal health coverage.
What are the Major Challenges Related to India’s Healthcare System?
- Public Health Expenditure Gap: Despite ranking as the world’s fifth-largest economy, India allocates only 2.1% of its GDP to healthcare in FY23, leading to high out-of-pocket expenses for citizens, amounting to 47.1%.
- Urban-Rural Healthcare Disparity: India’s healthcare infrastructure heavily favours urban areas, leaving rural regions underserved. While 65% of the population resides in rural areas, they have access to only 25-30% of healthcare facilities, challenging India’s constitutional commitment to equality.
- Rising Non-Communicable Diseases (NCDs): NCDs account for 64% of India’s disease burden, with diabetes alone affecting 77 million people in 2019 and projected to rise to 134 million by 2045. Despite this, public health efforts remain primarily focused on infectious diseases, neglecting the growing NCD burden.
- Mental Health Crisis: India faces a severe shortage of mental health professionals, with only 0.75 psychiatrists per 100,000 people and minimal allocation (0.05%) of the health budget towards mental health. Consequently, India grapples with 36.6% of global suicides.
- Telemedicine Disparity: While telemedicine emerged as a solution during the Covid-19 pandemic, India’s digital divide hampers its effectiveness. Rural areas, despite having the second-largest number of internet users globally, lag behind urban areas, exacerbating healthcare inequities.
- Climate Change Impact: Climate change poses significant health risks, with air pollution alone contributing to 1.67 million deaths in India in 2019. Additionally, heatwaves affect crop yields, directly impacting nutrition and public health.
- Governance Challenges: India’s healthcare sector faces governance disparities, with bureaucratic hurdles and favouritism towards large corporate hospitals. This governance conundrum hinders efficient healthcare delivery, particularly for smaller clinics and nursing homes.
- Pharmaceutical Credibility Crisis: Despite being a major supplier of generic drugs globally, India’s pharmaceutical industry faces credibility issues, as highlighted by incidents like the 2022 cough syrup tragedy in Gambia.
- Neglect of Preventive and Primary Care: India’s healthcare system prioritises curative, hospital-based care over preventive measures and primary care. This neglect results in escalating costs and a burden of preventable diseases, perpetuating a cycle of illness and expenditure.
What Measures can be Adopted to Revamp India’s Health Sector?
- Risk-Based Regulatory Reform: Introducing a tiered regulatory system based on facility complexity and risk to streamline approvals and ensure stringent oversight, with a focus on outcome-based regulations.
- Health-Education-Livelihood (HEL) Campuses: Establishing integrated rural campuses with health centres, skill development centres, and health-tech incubators to boost healthcare human resources and local economies.
- “Pharma-to-Plate” Integrity Chain: Implementing a blockchain-based tracking system for pharmaceutical products to combat counterfeit drugs and ensure high-quality medications, supported by a global tracking app.
- Mental Wealth Initiative: Promoting mental health as an economic asset through corporate tax breaks, integrating mental health modules into professional courses, and training local providers to offer counselling services.
- Ayush Integration: Increasing AYUSH practitioners in allopathic healthcare settings and introducing wellness sessions in schools and workplaces to foster holistic healthcare and prevent non-communicable diseases.
- Climate Clinics: Deploying mobile clinics in climate-vulnerable areas, upgrading primary healthcare centres for climate resilience, and utilising health data to predict climate-related impacts and improve farming practices.
- Expansion of ABHA: Nationwide promotion of Ayushman Bharat Health Accounts (ABHA) and the use of artificial intelligence for hyperlocal public health strategies to enhance preventive care and overall healthcare outcomes.
- Women-Led Health Panchayats: Establishing all-women health councils in every panchayat to audit local health facilities, allocate health funds, and improve rural health governance, empowering women and improving health outcomes.
| UPSC Civil Services Examination Previous Year Questions (PYQs) Prelims Q:1 Which of the following are the objectives of the ‘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) MainsQ: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
1. What are the primary challenges facing India’s healthcare system?
Answer: India’s healthcare system faces several primary challenges, including:
- Infrastructure Deficiencies: There is an inadequate number of healthcare facilities and many existing facilities are in poor condition, especially in rural areas.
- Workforce Shortages: There is a significant shortage of healthcare professionals, including doctors and nurses, with an uneven distribution favoring urban areas.
- Financial Constraints: Public spending on healthcare is low (less than 2% of GDP), leading to high out-of-pocket expenditures for patients.
- Accessibility and Quality of Care: Access to quality healthcare is limited in rural and remote areas, and there is significant variability in the quality of care provided.
- Disease Burden: India faces a high burden of both communicable and non-communicable diseases, alongside emerging threats such as antimicrobial resistance.
2. What is the Ayushman Bharat initiative and how does it aim to transform healthcare in India?
Answer: Ayushman Bharat is a flagship healthcare initiative launched by the Indian government with two main components:
- Health and Wellness Centers (HWCs): These centers aim to provide comprehensive primary healthcare services, including maternal and child health services and non-communicable diseases management.
- Pradhan Mantri Jan Arogya Yojana (PM-JAY): This component provides health insurance coverage of up to ₹5 lakh per family per year for secondary and tertiary care hospitalization. It targets over 10 crore vulnerable families (approximately 50 crore beneficiaries).
The initiative aims to improve access to healthcare, reduce financial burden on patients, and enhance the overall quality of healthcare services.
3. How does the government plan to address the shortage of healthcare professionals in India?
Answer: The government plans to address the shortage of healthcare professionals through several measures:
- Increasing Medical Education Capacity: By establishing new medical colleges and increasing the number of seats in existing institutions.
- Strengthening Training Programs: Enhancing training for allied health professionals and paramedics.
- Incentivizing Rural Service: Offering financial incentives and career advancements for healthcare professionals willing to work in rural and underserved areas.
- Leveraging Technology: Utilizing telemedicine and digital health platforms to extend the reach of healthcare services to remote areas.
4. What role does technology play in transforming India’s healthcare system?
Answer: Technology plays a crucial role in transforming India’s healthcare system by:
- Telemedicine: Facilitating remote consultations and follow-ups, particularly benefiting rural and remote areas with limited access to healthcare facilities.
- Digital Health Records: Implementing electronic health records (EHRs) to improve the accuracy and efficiency of patient care.
- Mobile Health Applications: Providing health information, appointment scheduling, and reminders for medication and vaccinations.
- Health Management Information Systems (HMIS): Enhancing data collection, monitoring, and analysis to inform policy decisions and improve healthcare delivery.
- Artificial Intelligence and Machine Learning: Assisting in early diagnosis, personalized treatment plans, and efficient management of health resources.
5. What are the expected impacts of transforming India’s healthcare system on its socio-economic development?
Answer: Transforming India’s healthcare system is expected to have several positive impacts on socio-economic development:
- Improved Health Outcomes: Reduction in morbidity and mortality rates, leading to a healthier population.
- Increased Productivity: Healthier individuals can contribute more effectively to the economy, improving overall productivity.
- Poverty Reduction: Reduced out-of-pocket healthcare expenditures can prevent families from falling into poverty due to medical expenses.
- Enhanced Human Capital: Better health contributes to improved educational outcomes and workforce skills.
- Economic Growth: A robust healthcare system attracts investment, boosts medical tourism, and creates employment opportunities in the healthcare sector.
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