Healthcare Sector in India
Context:
- Over time, the Indian healthcare system has improved despite difficulties that initially looked insurmountable and insoluble.
- We currently have the youngest population in the world and will do so for at least another 30 years. We must tackle certain challenging health issues if we are to fully benefit from this advantage.
The statistical state of health in India:
- as shown by the results of the newest National Family Health Survey (NFHS-5). Even under the best-case scenario, national and international demographers predicted that India will only have a total fertility rate of 2.1 (replacement level) by 2041. India had accomplished this by 2020.
- High rates of mother and infant mortality seemed inevitable as recently as 2010. Despite evidence showing that it is urgently necessary for women to give birth in a hospital, the response was consistently the same: “Sadiyon se humare dai yeh kaam karti arahi hai.” We cannot change the fact that infants have been born traditionally on dais for decades. Ten years later, even in the so-called BIMARU states, hospital deliveries have increased to 89 percent, as shown by the most recent NFHS-5 figures.
The entire population is impacted by five overlapping health issues:
- Today’s globe is plagued by at least five interrelated issues that are all significant from a macro perspective.
- A bad diet, insufficient exercise, smoking and drinking, and diabetes are all four behavioural risk factors that are on the rise, as are chronic respiratory diseases, cancers, cardiovascular diseases, and malignancies.
- The percentage of mortality related to non-communicable diseases (NCDs) increased from roughly 38% in 1990 to 62% in 2016, per the study “India: Health of the Nation’s States.” In both urban and rural areas, the obesity rate increased from 19 to 23% between NFHS-4 and NFHS-5.
- Large swaths of the population are obese, which increases the risk of CVD, diabetes, and hypertension.
- Millions of illnesses can be avoided and the rate of early mortality can be slowed by spreading knowledge and encouraging people to lead healthy lives. Governments must prevent millions from becoming ill since doing so is more cost-effective than finally treating chronic medical diseases in hospitals, despite the fact that it may not sound thrilling.
Strong health infrastructure is necessary for better healthcare facilities:
- The state of the infrastructure is critical. The state and federal governments have been working to improve primary healthcare since 2018 by constructing health and wellness centres. (The updated form of primary care centres and sub-centers.)
- However, a 2022 analysis by the AIIMS’s Centre for Community Medicine, which looked at a few districts in 18 states, found substantial variations among the states.
- The three northeastern states of Mizoram, Arunachal Pradesh, and Nagaland were found to have superior arrangements, followed by Gujarat and Chhattisgarh.
- The lowest percentages of primary healthcare facilities running at full institutional capacity were found in Jharkhand, Karnataka, and Uttar Pradesh. By now, a concept proposed in 2018 ought to have acquired greater popularity. Governments should exert greater effort.
- Closing the hospital care gap between big urban agglomerations and tier II and tier III cities is difficult in urban environments.
- The district hospitals managed by the state do not all offer the same fundamental healthcare services, according to a recent Lancet report (2023).
- About 16% of district hospitals in Tamil Nadu provide all necessary services. In states like Assam, Punjab, Madhya Pradesh, Mizoram, and UP, it was found to be just 1%. Whether people want to or not, they must rely on the private sector, which controls two thirds of the country’s hospital beds.
- These institutions provide a much-needed service, but they are unable to provide multi-specialty, much less tertiary and quaternary care.
- The gaps between the services provided in districts, metros, and large cities must be filled. The district hospitals and hospitals under central administration, where a 40% vacancy was noted just a few months ago, must be completely functional.
Issue with low health insurance takeup:
- The low percentage of persons with health insurance and the high expense of personal healthcare are further problems. Yet, during the past three years, more than 4 crore Indians have bought health insurance.
- The Ayushman Bharat insurance programme, which covers 10 crore low-income individuals, will begin offering protection against hospitalisation in 2018 for up to Rs 5 lakh per family annually.
- Even if it is only insurance and not healthcare, the fact that over 74% of Indians are either covered by or eligible for health insurance through the Employees State Insurance (ESIC), group insurance, and the CGHS is a significant improvement over the situation in place before to 2018.
- Despite this, millions of individuals remain without health insurance. The majority of out-of-pocket (OOP) personal expenses are spent on prescription drugs, diagnostic procedures, and outpatient medical consultation fees.
- Currently, it’s thought that this represents 50% of all healthcare expenses. The unorganised middle class must therefore be provided with insurance, and the costs of some outpatient operations must also be covered.
Conclusion:
- Concern is developing over the use of digital technologies and artificial intelligence (AI). Robotic surgery, the use of genetic codes, clinical decisions based on AI, and even pandemic forecasting are currently widespread and should be welcomed.
- Although ethical and regulatory concerns are frequent, the Indian Council of Medical Research recently offered suggestions anticipating problems with a lack of accountability for machine-made medical judgements.
- The case for healthcare regulation is strengthened when medical negligence performed in poor settings and by incompetent clinicians is yet unregulated.
- India has proven that the impossible is actually possible. It takes creative thinking and the desire to manoeuvre the ship before a storm arrives.
