Editorial Analysis 12 July 2022 à The Hindu
Public Health Sector in India
Challenges Related to India’s Public Health Systems:
- Lack of Primary Healthcare Services: The country’s current public primary health care model has a small geographic reach.
- Only services linked to prenatal care, restricted childcare, and specific services related to national health programs are offered, even in areas with well-functioning public primary health centers.
- Only 15% of all morbidities for which patients seek medical attention fall under this category.
Deficiencies on the supply side: The provision of the intended level of health services is hindered by poor health management abilities, a lack of adequate training, and unsupportive supervision of health personnel.
- Insufficient Funding: In India, public health budget expenditures have consistently remained low (approximately 1.3 percent of GDP). India’s whole out-of-pocket spending amounts to about 2.3 percent of GDP, according to the OECD.
Cross-border jurisdiction: There is no one body in charge of public health with the legal ability to make regulations and compel adherence to health standards.
- Due to the subpar public health system, it is difficult to combat non-communicable diseases, which are all about early detection and prevention.
- It reduces readiness and efficient management for new and emerging dangers like the Covid-19 pandemic.
Steps to Follow:
- Enabling Preventive Care:The Union government has announced the transformation of primary health care facilities into Health and Wellness Centers in order to encourage preventive care (HWCs).
- These HWCs will serve as the “portal” to secondary and tertiary health services as well as the cornerstone of preventative care.
- Thus, in order to mobilise this additional revenue through corporate social responsibility (CSR), it is necessary to hasten the construction of a network of HWCs.
- Changing Behaviour:To guarantee that individuals eat well, sleep properly, maintain excellent cleanliness, exercise, and adopt a healthy lifestyle, deliberate interventions at many levels of the system are required.
- A campaign similar to the Swachh Bharat Abhiyan is needed, called Swasth Bharat Jan Andolan, to encourage individuals to contribute to a healthier India.
- Cooperative Federalism:Given the crucial role that States must play in building robust health systems across the nation, funding supplied by the Finance Commission may serve as the key trigger for improving the health of the entire country.
- At the state, district, and block levels, state governments should be encouraged to invest in building a specialised cadre for public health.
- More Money is needed:As stated in the National Health Policy of 2017, public health spending should be increased to at least 2.5 percent of GDP.
- Decentralization:Panchayati raj institutions and municipalities need to include WASH (water, sanitation, and hygiene) as one of their primary responsibilities.
- To perform the tasks of disease surveillance, information gathering on the health effects of policies of important non-health departments, maintenance of national health statistics, enforcement of public health regulations, and public information dissemination, it is necessary to establish a designated and autonomous focal agency.
- The National Health Stack from NITI Aayog is a step in the right way in this regard and has to be operationalized as soon as possible.
Conclusion:
- We are starkly reminded by pandemics like COVID-19 that public health services are fundamental social institutions in every community.
- By implementing programs like the National Medical Commission (NMC) Act, 2019, Pradhan Mantri Bhartiya Janaushadhi Pariyojana, Pradhan Mantri – Jan Arogya Yojana, etc., the government has attempted to fill the gap in the public health system on a number of occasions.
- A sufficient investment is required, nevertheless, to build a health system that can survive any public health emergency, provide universal health care, and achieve the Sustainable Development Goals.
