essay on india health care system

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India health system review

India has made significant improvements in the health outcomes of its people. Life expectancy at birth increased to 69.6 years in 2020, from expected 47.7years in 1970. MMR declined from 301 to 130 per 100 000 live births between 2003 and 2014-16, and IMR declined from 68 in the year 2000 to 24 per 1000 live births in 2016. However progress is uneven across states, and demographic and epidemiological changes means, the country faces a double burden of disease and an ageing population. The top three causes of death in 2019 were ischaemic heart disease, COPD and stroke.

India has a mixed health-care delivery system. Policy recommendations in the 1940s laid the foundation for a government-funded, three-tiered public health system to deliver preventive and curative health care services. By the 1980s the private sector’s role in health began to gain prominence. Today, nearly 70% of all outpatient visits, about 58% of all inpatient episodes are provided by either for-profit or not-for-profit private providers. Quality of care, accessibility and affordability of health care services, medicines and diagnostics are a challenge. There are also differences in health outcomes between states. Several policy initiatives since the 2000s have been launched to strengthen India’s health system towards providing UHC and improving health outcomes and the Ayushman Bharat programme is attempting to tackle these issues at  both hospital and outpatient settings, it is still too early to look at its impact.

How to Cite this publication

Selvaraj S, Karan K A, Srivastava S, Bhan N, & Mukhopadhyay I. India health system review. New Delhi: World Health Organization, Regional Office for South-East Asia; 2022.

Health Care System in India : An Overview

• In book: International issues on Health Economics and Management (pp.215-218)
• Publisher: TISSL International Publications, New Delhi, India
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Essay on Health Care In India

Students are often asked to write an essay on Health Care In India in their schools and colleges. And if you’re also looking for the same, we have created 100-word, 250-word, and 500-word essays on the topic.

Let’s take a look…

100 Words Essay on Health Care In India

Introduction to health care in india.

The health care system in India is a mix of public and private providers. Public health care is free or low-cost, but it’s often crowded and has limited resources. Private health care offers more services, but it’s more expensive. This system is trying to meet the needs of over 1.3 billion people.

Challenges in Indian Health Care

One big challenge is that health care is not evenly spread across India. Urban areas have more doctors and hospitals than rural areas. Many people in rural areas must travel long distances for medical care. This can delay treatment and make health problems worse.

Government’s Role in Health Care

The Indian government is working to improve health care. It has launched programs to provide free health services and insurance. These programs aim to make health care more accessible and affordable. Yet, there is still a lot of work to do to ensure everyone has access to quality health care.

Private Sector’s Influence

The private sector plays a big role in health care in India. Many people prefer private hospitals because they offer better facilities and services. But these hospitals are often too expensive for the poor. This creates a gap in health care access between the rich and the poor.

Future of Health Care in India

250 words essay on health care in india, understanding health care.

Health care means looking after the health of people. It involves doctors, nurses, and other health workers. They help us when we are sick. They also help us stay healthy.

Health Care in India

In India, health care is a big challenge. There are not enough hospitals and doctors for all the people. This is more of a problem in villages than in cities.

The Government’s Role

The government of India is trying to improve health care. They have started programs like Ayushman Bharat. This program gives poor people money to pay for health care. The government is also building more hospitals.

Private Health Care

In India, there are also private hospitals and clinics. They often have better facilities than government hospitals. But they are also more expensive. Not everyone can afford them.

Challenges and Future

There are still many challenges to health care in India. There are not enough doctors. Many people cannot afford good health care. But the government is working to make things better. We hope that in the future, everyone in India will have access to good health care.

500 Words Essay on Health Care In India

Introduction.

Health care is a basic need for every human being. In India, the health care system is a mix of public and private providers. It includes a range of services from basic check-ups to complex surgeries. Let’s discuss more about health care in India.

Public Health Care

The government in India offers health care services through public hospitals and clinics. These are usually free or at a very low cost. This helps people who cannot afford expensive treatments. The government also runs special programs for mother and child health, disease control, and immunization.

Challenges in Health Care

India faces several challenges in health care. One big problem is the shortage of doctors and nurses, especially in rural areas. Many people have to travel long distances to reach a hospital.

Another challenge is the high cost of treatments in private hospitals. Not everyone can afford them. Also, there is a lack of awareness about health and hygiene in many parts of India. This leads to the spread of diseases.

Steps Towards Improvement

The government is also increasing the number of medical colleges. This will produce more doctors and nurses. Efforts are being made to spread awareness about health and hygiene too.

Health care in India has come a long way. But, there is still a lot of work to be done. Everyone should have access to good health care services. It is a basic right. The government, private sector, and society must work together to achieve this goal.

In the end, we can say that health care is very important. It helps us stay healthy and live a good life. We should all do our part to improve health care in India. We can start by taking care of our own health and helping others do the same.

If you’re looking for more, here are essays on other interesting topics:

Apart from these, you can look at all the essays by clicking here .

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Amid pandemic tragedy, an opportunity for change?

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Mittal Institute/Lancet commission to study universal care in India

With almost 11 million cases and more than 150,000 deaths, India is among the nations hardest-hit by the coronavirus pandemic. The Asian giant has also taken an economic hit, its gross domestic product expected to shrink 8 percent this year.

The figures have starkly highlighted the connection between a nation’s physical and economic health, and the Harvard chairs of a new panel seeking to overhaul and improve health care in India say today’s difficult times create a moment of opportunity because people who often tune each other out are now listening.

“For the first time the connection between health and economic outcomes has become transparent,” said Tarun Khanna , director of Harvard’s Lakshmi Mittal and Family South Asia Institute and one of four co-chairs of a new Lancet Citizens’ Commission to study how to bring universal health care to India. “The morality of universal health care has always been a driver of this urgency, but that’s not the new thing here. Rather, for the first time in 30 years GDP is expected to fall in response to a health crisis.”

The 21-member commission is a joint effort between The Lancet medical journal and Mittal Institute. The panel is chaired by Khanna; Vikram Patel , the Pershing Square Professor of Global Health at Harvard Medical School ; Professor Gagandeep Kang, vaccine researcher at Christian Medical College in Vellore, India; and Kiran Mazumdar-Shaw, executive chairperson of Indian biotech company Biocon Ltd and one of India’s top businesspeople. S.V. Subramanian , professor of population health and geography at the Harvard T.H. Chan School of Public Health , is a member of the commission.

The group’s charge is to report by August 2022 how India can achieve universal health care within a decade. The Mittal Institute is encouraging participation by the Harvard community and sponsoring an online panel discussion on Monday to introduce the effort.

Patel and Khanna said the commission has a challenging road ahead, one that has proven too difficult for an array of efforts studying the same question in the decades since India became independent in 1947.

Most of the nation’s 1.4 billion residents (a population second only to China) view the current publicly-funded system as so bad that even the poorest Indians would rather pay out-of-pocket for care in a network of private providers, itself sometimes seen as uncaring and untrustworthy. The end result is that more than 60 percent of Indian health care is paid for out-of-pocket, and a sudden illness can mean financial ruin for millions. Only the wealthy can afford regular, high-quality care.

Sandeep Praharsha (India Fellow) discussing preventive measures for malaria in Kerpai village in Thumul Rampur block of Kalahandi district in Odisha Swasthya Swaraj.

“Today, India’s health care system is routinely ranked as one of the worst in the world,” Patel said. “A few get expensive, world-class care, while a large part of the population doesn’t even get basic quality care.”

Where the current commission differs from prior efforts is that it is based on a consultative effort to seek input from an array of stakeholders, including representatives of the private health care sector, providers of traditional medicine, physicians, community health workers, and citizens from diverse communities across the country.

“It genuinely is a cross-section of society,” said Khanna, HBS’ Jorge Paulo Lemann Professor. “That makes consultation more complex, but the potential for achievement is large.”

The eventual report will focus on the “architecture” of a new system, according to an article by the initiative’s co-chairs and commissioners in The Lancet in December. It will include ways to provide preventive care for physical and mental health, offer financial protection for all health care costs, not just hospitalization, and ensure access to the same quality of care for all.

“We aspire for a health care system in which most people do not pay out-of-pocket for most health care needs,” Patel said. “The last thing a sick person needs is to have their care calibrated by how much they can afford to pay or to be impoverished by their medical bills.”

Resources are always a key issue in consideration of universal health care and India — whose proportion of GDP spent on health care is low compared with other middle-income countries — will likely have to spend more, Khanna said. But he also said that significant low-cost steps probably could be taken early in the process.

“I think we can improve outcomes with existing resources being better managed,” Khanna said. “We can get some victories in the next two to three years through optimization of existing structures.”

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Improving Health in India

As the world’s second-most-populous country and one of its fastest-growing economies, India faces both unique challenges and unprecedented opportunities in the sphere of public health.

For more than a decade, India has experienced record-breaking economic growth that has been accompanied by significant reductions in poverty. According to the World Bank, infant mortality in India fell from 66 to 38 per 1,000 live births from 2000 to 2015. Life expectancy at birth has increased from 63 to 68 years, and the maternal mortality ratio has fallen from 374 to 174 per 100,000 live births over the same period.

India also has dynamic pharmaceutical and biotechnology industries; world-class scientists, including a burgeoning clinical trials industry; and leading hospitals that attract foreign patients and treat its better-off citizens.

Yet Indian government and public health officials agree that the country also faces persistent and daunting public health challenges, particularly for the poor. These include child undernutrition and low birth weights that often lead to premature death or lifelong health problems; high rates of neonatal and maternal mortality; growth in noncommunicable diseases such as obesity, diabetes, and tobacco use, leading to cancer and other diseases; and high rates of road traffic accidents that result in injuries and deaths.

As the Indian government strives to provide comprehensive health coverage for all, the country’s rapidly developing health system remains an area of concern. There are disparities in health and health care systems between poorer and richer states and underfunded health care systems that in many cases are inefficiently run and underregulated. New government-financed health insurance programs are increasing coverage, but insurance remains limited.

Public and private health systems are placing huge demands on the country’s capacity to train exceptional health leaders and professionals. Rising to meet these challenges, the people of India have an opportunity to have a major influence on their own future health and on the future of public health and medical efforts globally.

Supporting Development of India’s Health Workforce

The Harvard T.H. Chan School of Public Health is collaborating with partners across India to address those challenges. Together, the School and its partners are introducing educational innovations to India to expand skills training, degree programs, and leadership development at new schools and institutes of public health. We seek to leverage the School’s resources to help strengthen public health training and build capacity across the health sector in India.

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Largest Compilation of Structured Essays and Exams

Essay on Health Care in India

December 16, 2017 by Study Mentor Leave a Comment

Health is wealth . It is more important than the wealth we have. Only when we have a proper health we will able to get the necessary wealth in our life. If we do not have a proper health, whatever wealth we have also goes into waste. We will not be able to use even the available wealth without a proper health.

This is the reason one should take important care of their health. We should focus more on our health. Then, automatically we will be able to work hard and earn according to the work we have been able to do. Thus, health is very important in our life.

First, people should learn to take care of their health and then focus on other areas of life. But we taking care of ourselves alone does not matter. We should have the facilities in order to take proper care of our health. We should have easy access to all the health facilities.

In order for people to maintain a proper health, they should have proper health care systems. Only then people will be able to take care of their health and get treatment when they are suffering from any sort of sickness.

But do we have access to proper health care. Many of us have easy access to the health care. But for those who have problem to access these health care ultimately lose their life.

Table of Contents

What do you mean by health care?

Health care means the process or way in which one is taking different procedures or medical measures to make a person’s health better. With proper health care a person’s health can become better. This will include dong the right treatment, taking medicine and altering one’s own life habits.

A proper health care will help to save so many people’s lives. These days because of unhealthy lifestyle people are getting prone to many sickness and diseases. Due to these reasons, treatment is on the light. But when a person does not get the right treatment there are chances of losing the life.

Health care system should be improved and regularly updated. In the previous years, very outdated machines and treatments were used. They are not still used in the present-day time because diseases these days have taken another turn compared to before. So obviously the treatment should also be changed.

There should be proper health care system so that everyone gets the treatment when needed. They will not have to run helter skelter when they need the treatment in emergency. There are still many places all over the world where there are no health care systems and people have lost their lives.

Why is health care important?

In order to remain healthy and be free or get treated from different sickness and diseases one needs to have access to health care. With time, new diseases are coming into action. More people are getting ill every single day of the life. In order to get diagnosed and treated, health care is needed for the people.

If people will have access to health care and more hospitals or health care systems are made, there will be growth in the medical sector.

Moreover, the medical sector contributes a lot to the GDP (Gross Domestic Product) of the country. Proper health care will help people to be free from sickness and their lives will be saved.

If the number of lives saved by proper treatment is increased, the death rate will start reducing. The production of the country will increase which will further improve the economy.

Health Care in India

The number of health care systems in India has increased from the past years. Facilities have also improved. More primary health centers have been opened in the rural areas as well. In the urban areas the hospitals have also increased with many advanced facilities. Many medical colleges have also been opened so that there are many aspiring doctors to treat the sick people.

We can see medical colleges and hospitals almost everywhere. But just opening medical colleges and hospitals alone is not enough. There should be proper treatment in the health care centers and hospitals. The doctors and staff should be dedicated to treat the people. They should not only focus on their benefit. In many hospitals we see that the doctors come late and leave early from their work.

They take leave very often. This does not happen. This will not only lead to reduction in the growth of the medical sector but also many people will be left untreated. It is also seen that in many places the staff are not good. They do not take proper care of the patients.

They behave rudely with the patients and their family members. No matter how many new centers and hospitals are made, there are still many people who do not get treatment. They are left untreated and ultimately they lose their life.

Another reason why everyone is not able to get proper treatment is because of high population. Fertility rate is increasing every year and every single day someone gets sick. As there are too many people getting sick there is not enough place in the centers and hospital to diagnose and treat everyone.

In private hospitals there will be rush because everything is according to the numbers and there is limitation. But one should go and visit the government hospitals and centers.

There is a huge rush everywhere. There is not even a single proper place to get fresh air. There almost same things are used for every patient. Cleanliness is not maintained properly. Every place is crowded like a fish market. Some of the staff members are very lazy to work while others are strict for everything.

Personal experience on health care

It was the month of March, 2007 I had got abscess on my chest. It could not be self treated so I visited a known doctor in a private hospital. The doctor examined the abscess and told us that operation would have to be done that day. So, I was admitted in the hospital.

I was kept in the female common ward till the operation time. I was given saline water till my operation was started and I was not allowed to eat anything. As I was in the common ward, too many patients were admitted there. The air smelled so foul that I could not even breathe properly. My father came to visit me. As I was in the common ward, he could see me every time he wanted.

So, they asked the staff to shift me to a private room. I realized the private rooms were cleaner than the common wards. Also the staff was more dedicated and caring for the private room patients. Some of them used to take their own sweet to finish their work. Well, this should not be done. They should not be bias to anyone. Soon, my operation time came and I was taken to the operation room.

After that I do not remember anything about the room. I only realized after I was being shifted to my room. I was kept in the hospital for one week. In this week I used to walk around the hospital when I used to get fed up resting in the room. I realized the hospital needs more doctors and staff.

There was no discipline maintained in the hospital. The staff should be taking care of all patients. One day some other nurse came to give me an injection. She gave me injection in such a way that she is giving it to some non living thing. It was very painful.

I did not like to see such conditions of the hospital. I just wished to be discharged from the hospital and go back home soon. After I went back home, I had to go to the hospital once a week to change the dressing in the operated area. The nurses who would come to change my dressing used to behave rudely with me.

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Healthcare Sector in India

Last updated on August 18, 2024 by ClearIAS Team

The healthcare sector in India has grown significantly in both employment and income. Over the past two years, technology and innovation in healthcare have become more prominent, and 80% of healthcare systems plan to increase their investment in digital healthcare technologies over the next five years. Read here to learn more about the Indian Healthcare sector.

The Healthcare sector in India comprises of hospitals, medical devices, clinical trials, outsourcing, telemedicine, medical tourism, health insurance, and medical equipment.

Due to improved services, coverage, and rising spending by both public and private entities, the Indian healthcare sector is expanding quickly.

Growing incidence of lifestyle diseases, rising demand for affordable healthcare delivery systems due to the increasing healthcare costs, technological advancements, the emergence of telemedicine, rapid health insurance penetration, and government initiatives like e-health together with tax benefits and incentives are driving the healthcare market in India.

Also read: National Medical Commission (NMC)

Table of Contents

Healthcare sector in India

The public and private sectors make up the two main components of India’s healthcare sector.

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• The government, or public healthcare system, concentrates on establishing primary healthcare centres (PHCs) in rural areas while maintaining a small number of secondary and tertiary care facilities in major cities.
• The bulk of secondary, tertiary, and quaternary care facilities are run by the private sector, with a focus on metropolises and tier-I and tier-II cities.

The abundance of highly qualified medical personnel in India is a competitive advantage. India’s costs are competitive with those of its neighbours in Asia and the West.

• Surgery in India costs roughly a tenth of what it does in the US or Western Europe.
• The low cost of healthcare has led to an increase in medical tourism in the nation, drawing people from all over the world.
• Further, due to its relatively low cost of clinical research, India has become a center for R&D activity for foreign businesses.

The Indian Medical Value Travel Market size is valued at $5-6 bn and is expected to grow to $13 bn by 2026.

• Over the years, India has become a premier and attractive destination for travelers from across the globe to attain best-in-class clinical treatment, recharge, and rejuvenate
• The high-end healthcare system in India is as good as the best in the world with complex surgical procedures being done in world-class global hospitals by acclaimed medical specialists at a much lower cost than what it normally takes in other countries
• India has also become a favored destination for Yoga and Wellness with its focus on traditional therapies through AYUSH.
• Indian hospitals are largely switching to AI for keeping health records & providing the best possible treatment to patients at the right time.

India is ranked 10th by the Medical Tourism Association on the Medical Tourism Index (MTI) for 2020-21 out of 46 destinations of the world, 12th in the top 20 wellness tourism markets globally, and 5th in wellness tourism markets in Asia-Pacific.

• India has a large number of accredited facilities, that provide care at par or above global standards.
• There are 40 Joint Commission International (JCI) accredited and 1400+ National Accreditation Board for Hospitals & Healthcare Providers (NABH) accredited hospitals that provide care of quality standards.

India offers the largest pool of doctors and paramedics with high-quality medical training received globally, along with fluency in English.

Also read: Palliative Care in India

Healthcare sector in numbers

The healthcare sector in India, accounting for 80% of the total healthcare market, is witnessing a huge investor demand from both global as well as domestic investors.

• In 2020, India’s Medical Tourism market was estimated to be worth $5-6 Bn and is expected to grow to $13 Bn by 2026.
• The healthcare sector in India is expected to grow to reach a size of $50 bn by 2025.
• The digital healthcare market is expected to more than 20% by 2023.
• The Telemedicine market is the maximum potential eHealth segment in India, which is expected to touch $5.4 Bn by 2025
• In the Economic Survey of 2022, India’s public expenditure on healthcare stood at 2.1% of GDP in 2021-22 against 1.8% in 2020-21 and 1.3% in 2019-20.
• Over the next 10 years, National Digital Health Blueprint can unlock the incremental economic value of over $200 bn for the healthcare industry in India
• India has the world’s largest Health Insurance Scheme (Ayushman Bharat) supported by the government.
• 100% FDI is allowed under the automatic route for greenfield projects.
• For investments in brownfield projects, up to 100% FDI is permitted under the government route.
• To promote medical tourism in the country, the government of India is extending the e-medical visa facility to the citizens of 156 countries.
• India is emerging as a strong market for wearables, with approximately 2 million units sold in 2017, expected to reach 129 million units in 2030.
• India’s surgical robotics market is estimated to expand to hit the size of $350 mn by 2025.

Also read: Indian Health Sector Problems – Can the National Health Policy 2017 Make a Change?

The healthcare sector still faces a variety of problems, such as inadequate budget, a scarcity of healthcare staff, and inadequate infrastructure, despite substantial advancements in recent years.

• India suffers from a hospital deficit, especially in rural areas, and many of the country’s current healthcare institutions need basic supplies and equipment.
• In India, the quality of healthcare varies greatly, with insufficient regulation leading to subpar care in some private healthcare facilities and rural areas with inadequate facilities and resources.
• Over 60% of all deaths in India are caused by non-communicable diseases (NCDs) , which also have high rates of chronic illnesses like diabetes , cancer , and heart disease.
• India is one of the countries with the least mental health specialists per person.
• The government spends very little money on mental health. Poor mental health outcomes and insufficient care for those with mental illnesses are the results of this.
• The imbalance in the doctor-patient ratio is one of the most important issues. The Indian Journal of Public Health estimates that India will require 20 lakh doctors by 2030.

Read:  Violence against healthcare workers (VAHCW) in India

Government initiatives for the healthcare sector

• Pradhan Mantri Swasthya Suraksha Yojana (PMSSY)
• National Health Mission
• Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)
• Pradhan Mantri-Ayushman Bharat Health Infrastructure Mission (PM-ABHIM) to strengthen India’s health infrastructure and improve the country’s primary, secondary and tertiary care services.
• Ayushman Bharat Digital Mission to connect the digital health solutions of hospitals across the country. Under this, every citizen will now get a digital health ID and their health record will be digitally protected.
• ‘National Medical & Wellness Tourism Board’ to promote medical and wellness tourism in India.
• National Ayush Mission, responsible for the development of traditional medicines in India, as a centrally sponsored scheme until 2026.
• MoU between India and Denmark on cooperation in health and medicine. The agreement will focus on joint initiatives and technology development in the health sector, to improve the public health status of the population of both countries.

Way forward

The healthcare sector in India is very diversified and offers numerous opportunities in each of the provider, payer, and medical technology segments.

Businesses are trying to investigate the newest dynamics and trends that will have a beneficial impact on their business as a result of the increased competition.

Medical device manufacturers have a lot of prospects in India.

• With significant capital expenditure for cutting-edge diagnostic facilities, the nation has also emerged as one of the top locations for high-end diagnostic services, serving a larger section of the populace.
• Additionally, Indian customers of medical services are more concerned with maintaining their health.
• Future demand for healthcare services is anticipated to increase due to factors such as advancing income levels, an aging population, rising health awareness, and shifting attitudes toward preventative healthcare.
• Healthcare spending increased as a result of more people having health insurance, and this trend is expected to continue over the next 10 years.

The Government aims to develop India as a global healthcare hub and is planning to increase public health spending to 2.5% of the country’s GDP by 2025.

Read:  Climate Resilient Health Systems

-Article written by Swathi Satish

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August 8, 2023 at 9:47 pm

Difference between positive aspects and negative aspects of healthcare issue in india….

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• Indian J Community Med
• v.43(3); Jul-Sep 2018

Challenges to Healthcare in India - The Five A's

Arvind kasthuri.

Department of Community Health, St John's Medical College, Bengaluru, Karnataka, India

The Indian healthcare scenario presents a spectrum of contrasting landscapes. At one end of the spectrum are the glitzy steel and glass structures delivering high tech medicare to the well-heeled, mostly urban Indian. At the other end are the ramshackle outposts in the remote reaches of the “other India” trying desperately to live up to their identity as health subcenters, waiting to be transformed to shrines of health and wellness, a story which we will wait to see unfold. With the rapid pace of change currently being witnessed, this spectrum is likely to widen further, presenting even more complexity in the future.

Our country began with a glorious tradition of public health, as seen in the references to the descriptions of the Indus valley civilization (5500–1300 BCE) which mention “Arogya” as reflecting “holistic well-being.”[ 1 ] The Chinese traveler Fa-Hien (tr.AD 399–414) takes this further, commenting on the excellent facilities for curative care at the time.[ 2 ] Today, we are a country of 1,296,667,068 people (estimated as of this writing) who present an enormous diversity, and therefore, an enormous challenge to the healthcare delivery system.[ 3 ] This brings into sharp focus the WHO theme of 2018, which calls for “Universal Health Coverage-Everyone, Everywhere.”

What are the challenges in delivering healthcare to the “everyone” which must include the socially disadvantaged, the economically challenged, and the systemically marginalized? What keeps us from reaching the “everywhere,” which must include the remote areas in our Himalayan region for instance, where until recently, essentials were airlifted by air force helicopters?.[ 4 ]

While there are many challenges, I present five “A's” for our consideration:

Why is the level of health awareness low in the Indian population? The answers may lie in low educational status, poor functional literacy, low accent on education within the healthcare system, and low priority for health in the population, among others.

What is encouraging is that efforts to enhance awareness levels have generally shown promising results. For instance, a study in Bihar and Jharkhand demonstrated improved levels of awareness and perceptions about abortion following a behavioral change intervention.[ 9 ] A review on the effectiveness of interventions on adolescent reproductive health showed a considerable increase in the awareness levels of girls with regard to knowledge of health problems, environmental health, nutritional awareness, and reproductive and child health following intervention.[ 10 ]

The message is clear – we must strive to raise awareness in those whom we work with and must encourage the younger generation to believe in the power of education for behavior change.

Physical reach is one of the basic determinants of access, defined as “ the ability to enter a healthcare facility within 5 km from the place of residence or work”[ 13 ] Using this definition, a study in India in 2012 found that in rural areas, only 37% of people were able to access IP facilities within a 5 km distance, and 68% were able to access out-patient facilities[ 14 ] Krishna and Ananthapur, in their 2012 paper, postulate that in general, the more rustic (rural) one's existence – the further one lives from towns – the greater are the odds of disease, malnourishment, weakness, and premature death.[ 15 ]

Even if a healthcare facility is physically accessible, what is the quality of care that it offers? Is that care continuously available? While the National (Rural) Health Mission has done much to improve the infrastructure in the Indian Government healthcare system, a 2012 study of six states in India revealed that many of the primary health centers (PHCs) lacked basic infrastructural facilities such as beds, wards, toilets, drinking water facility, clean labor rooms for delivery, and regular electricity.[ 14 ]

As thinkers in the disciplines of community medicine and public health, we must encourage discussion on the determinants of access to healthcare. We should identify and analyze possible barriers to access in the financial, geographic, social, and system-related domains, and do our best to get our students and peers thinking about the problem of access to good quality healthcare.

A 2011 study estimated that India has roughly 20 health workers per 10,000 population, with allopathic doctors comprising 31% of the workforce, nurses and midwives 30%, pharmacists 11%, AYUSH practitioners 9%, and others 9%.[ 16 ] This workforce is not distributed optimally, with most preferring to work in areas where infrastructure and facilities for family life and growth are higher. In general, the poorer areas of Northern and Central India have lower densities of health workers compared to the Southern states.[ 17 ]

While the private sector accounts for most of the health expenditures in the country, the state-run health sector still is the only option for much of the rural and peri-urban areas of the country. The lack of a qualified person at the point of delivery when a person has traveled a fair distance to reach is a big discouragement to the health-seeking behavior of the population. According to the rural health statistics of the Government of India (2015), about 10.4% of the sanctioned posts of auxiliary nurse midwives are vacant, which rises to 40.7% of the posts of male health workers. Twenty-seven percentage of doctor posts at PHCs were vacant, which is more than a quarter of the sanctioned posts.[ 18 ]

Considering that the private sector is the major player in healthcare service delivery, there have been many programs aiming to harness private expertise to provide public healthcare services. The latest is the new nationwide scheme proposed which accredits private providers to deliver services reimbursable by the Government. In an ideal world, this should result in the improvement of coverage levels, but does it represent a transfer of responsibility and an acknowledgment of the deficiencies of the public health system?

As trainers and educators in public health, how are we equipping our trainees to deliver a health service in the manner required, at the place where it is needed and at the time when it is essential? It is time for a policy on health human power to be articulated, which must outline measures to ensure that the last Indian is taken care of by a sensitive, trained, and competent healthcare worker.

It is common knowledge that the private sector is the dominant player in the healthcare arena in India. Almost 75% of healthcare expenditure comes from the pockets of households, and catastrophic healthcare cost is an important cause of impoverishment.[ 19 ] Added to the problem is the lack of regulation in the private sector and the consequent variation in quality and costs of services.

The public sector offers healthcare at low or no cost but is perceived as being unreliable, of indifferent quality and generally is not the first choice, unless one cannot afford private care.

The solutions to the problem of affordability of healthcare lie in local and national initiatives. Nationally, the Government expenditure on health must urgently be scaled up, from <2% currently to at least 5%–6% of the gross domestic product in the short term.[ 20 ] This will translate into the much-needed infrastructure boost in the rural and marginalized areas and hopefully to better availability of healthcare– services, infrastructure, and personnel. The much-awaited national health insurance program should be carefully rolled out, ensuring that the smallest member of the target population is enrolled and understands what exactly the scheme means to her.

Locally, a consciousness of cost needs to be built into the healthcare sector, from the smallest to the highest level. Wasteful expenditure, options which demand high spending, unnecessary use of tests, and procedures should be avoided. The average medical student is not exposed to issues of cost of care during the course. Exposing young minds to issues of economics of healthcare will hopefully bring in a realization of the enormity of the situation, and the need to address it in whatever way possible.

• Accountability or the lack of it: Being accountable has been defined as the procedures and processes by which one party justifies and takes responsibility for its activities.[ 21 ]

In the healthcare profession, it may be argued that we are responsible for a variety of people and constituencies. We are responsible to our clients primarily in delivering the service that is their due. Our employers presume that the standard of service that is expected will be delivered. Our peers and colleagues expect a code of conduct from us that will enable the profession to grow in harmony. Our family and friends have their own expectations of us, while our government and country have an expectation of us that we will contribute to the general good. A spiritual or religious dimension may also be considered, where we are accountable to the principles of our faith.

In the turbulent times that we live in, the relationships with all the constituents listed above have come under stress, with the client-provider axis being the most prominently affected. While unreasonable expectations may be at the bottom of much of the stress, it is time for the profession to recognize that the first step on the way forward is the recognition of the problem and its possible underlying causes. Ethics in healthcare should be a hotly discussed issue, within the profession, rather than outside it.

Communication is a key skill to be inculcated among the young professionals who will be the leaders of the profession tomorrow. As leaders in community medicine and public health, we may be the best placed to put this high up in the list of skills to be imparted. A good communicator is better placed to deal with the pressures of the relationships with client, employer, peer, colleague, family, friend, and government.

The five as presented above present challenges to the health of the public in our glorious country. As we get ready to face a future which is full of possibility and uncertainty in equal measure, let us recognize these and other challenges and prepare to meet them, remembering that the fight against ill health is the fight against all that is harmful to humanity.

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Healthcare Sector in India

• 08 Sep 2022
• GS Paper - 2
• Government Policies & Interventions
• GS Paper - 3
• Government Budgeting

For Prelims: Government Policies & Interventions, Healthcare Sector in India and related Initiatives.

For Mains : Healthcare Sector in India, Challenges and Potential.

Why in News?

Healthcare has become more focused on innovation and technology over the past two years and 80% of healthcare systems are aiming to increase their investment in digital healthcare tools in the coming five years.

What is the Scenario of the Healthcare Sector in India?

• Healthcare industry comprises hospitals, medical devices, clinical trials, outsourcing, telemedicine, medical tourism, health insurance and medical equipment.
• The government (public healthcare system), comprises limited secondary and tertiary care institutions in key cities and focuses on providing basic healthcare facilities in the form of Primary Healthcare Centres (PHCs) in rural areas.
• The private sector provides a majority of secondary, tertiary, and quaternary care institutions with major concentration in metros, tier-I and tier-II cities.
• The Indian healthcare sector is expected to record a three-fold rise, growing at a CAGR (Compound Annual Growth Rate) of 22% between 2016–22 to reach USD 372 billion in 2022 from USD 110 billion in 2016.
• In the Economic Survey of 2022, India’s public expenditure on healthcare stood at 2.1% of GDP in 2021-22 against 1.8% in 2020-21 and 1.3% in 2019-20.
• In FY21, gross direct premium income underwritten by health insurance companies grew 13.3% YoY to Rs. 58,572.46 crore (USD 7.9 billion).
• The Indian medical tourism market was valued at USD 2.89 billion in 2020 and is expected to reach USD 13.42 billion by 2026.
• Telemedicine is also expected to reach USD 5.5 billion by 2025.

What are the Challenges with the Health Sector?

• Inadequate access to basic healthcare services such as shortage of medical professionals, a lack of quality assurance, insufficient health spending, and, most significantly, insufficient research funding.
• One of the major concerns is the administrations' insufficient financial allocation.
• Even neighbouring countries like Bangladesh and Pakistan have over 3% of their GDP going towards the public healthcare system.
• Preventive care is undervalued in India, despite the fact that it has been shown to be quite beneficial in alleviating a variety of difficulties for patients in terms of unhappiness and financial losses.
• In India, R&D and cutting-edge technology-led new projects receive little attention.
• Policymaking is undoubtedly crucial in providing effective and efficient healthcare services. In India, the issue is one of supply rather than demand, and policymaking can help.
• In India, there is a shortage of doctors, nurses, and other healthcare professionals.
• According to a study presented in Parliament by a minister, India is short 600,000 doctors.
• Doctors work in extreme conditions ranging from overcrowded out-patient departments, inadequate staff, medicines and infrastructure.

What is the Potential of the Indian Health Sector?

• India's competitive advantage lies in its large pool of well-trained medical professionals . India is also cost competitive compared to its peers in Asia and western countries. The cost of surgery in India is about one-tenth of that in the US or Western Europe.
• India has all the essential ingredients for the exponential growth in this sector, including a large population, a robust pharma and medical supply chain, 750 million plus smartphone users, 3 rd largest start-up pool globally with easy access to VC (Venture Capital Fund) funding and innovative tech entrepreneurs looking to solve global healthcare problems.
• India will have about 50 clusters for faster clinical testing of medical devices to boost product development and innovation.
• The sector will be driven by life expectancy, shift in disease burden, changes in preferences, growing middle class, increase in health insurance, medical support, infrastructure development and policy support and incentives.
• As of 2021, the Indian healthcare sector is one of India’s largest employers as it employs a total of 4.7 million people. The sector has generated 2.7 million additional jobs in India between 2017-22 -- over 500,000 new jobs per year

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).

Way Forward

• There is an urgent need to improve the infrastructure of public hospitals, which are overburdened as a result of India's large population.
• The government should encourage private hospitals because they make a significant contribution.
• Because the difficulties are severe and cannot be tackled just by the government, the private sector must also engage.
• To improve the sector's capabilities and efficiency, more medical personnel must be inducted.
• Medical gadgets in hospitals and clinics, mobile health apps, wearables, and sensors are only a few examples of technology that should be included in this area.

UPSC Civil Services Examination, Previous Year Questions (PYQs)

Q. 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:

(a) 1 and 2 only (b) 1, 2 and 3 only (c) 1, 2 and 4 only (d) 3 and 4 only

• National Nutrition Mission (POSHAN Abhiyaan) is a flagship programme of the Ministry of Women and Child Development, GoI, which ensures convergence with various programmes like Anganwadi services, National Health Mission, Pradhan Mantri Matru Vandana Yojana, Swachh-Bharat Mission, etc.
• The goals of National Nutrition Mission (NNM) are to achieve improvement in nutritional status of children from 0-6 years, adolescent girls, pregnant women and lactating mothers in a time bound manner during the next three years beginning 2017- 18. Hence, 1 is correct.
• NNM targets to reduce stunting, under-nutrition, anaemia (among young children, women and adolescent girls) and reduce low birth weight of babies. Hence, 2 is correct.
• There is no such provision relating to consumption of millets, unpolished rice, coarse cereals and eggs under NNM. Hence, 3 and 4 are not correct.
• Therefore, option (a) is the correct answer.

Q. “Besides being a moral imperative of a Welfare State, primary health structure is a necessary precondition for sustainable development.” Analyse. (2021)

Source: PIB