Government policies and interventions for development in various sectors and issues arising out of their design and implementation.
Issues relating to development and management of Social Sector or Services relating to Health, Education, Human Resources.
Healthcare needs to meet Skilled India
India’s public health care system is patchy, with underfunded and overcrowded hospitals and clinics, inadequate rural coverage, and a shortage of qualified medical practitioners and personnel.
The shortage of qualified medical professionals is one of the key challenges facing the Indian health care industry.
India’s ratio of 0.7 doctors and 1.5 nurses per 1,000 people is dramatically lower than the WHO average of 2.5 doctors and nurses per 1,000 people.
There is an acute shortage of paramedical and administrative professionals.
Excessive concentration of medical professionals in urban areas, which have only 30 percent of India’s population
Patients living in rural and semi urban areas receive services from unqualified practitioners
The industry needs an additional 1.54 million doctors and 2.4 million nurses to match the global average
Quality over Quantity
Quality health care is easily defined as doing the right thing (getting the health care services you need), at the right time (when you need it), in the right way (using the appropriate test or procedure), to achieve the best possible results.
Pillars of Quality Healthcare:
Safety – patients should not be harmed by the care that is intended to help them
Patient-centered – care should be based on individual needs
Timely – waits and delays in care should be reduced
Effective – care should be evidence-based
Efficient – reduce waste
Equitable – care should be equal for all people
Quality should be a “look in the mirror” incentive—
Proper communication and documentation: Right from the registration of patients and discharge of patients
Transparency: By properly displaying charges and miscellaneous costs to the patients as well as standardizing outcomes measurement, really emphasizing outcomes over processes, and starting the hard work of measuring real costs
Instead of finding faults with others on treatments, they should approach the bodies concerned for remedy.
Weak enforcement of regulation is a major impediment in ensuring quality of care and this should be done away with.
Measuring quality has to be an inclusive strategy that takes into account various paradigms like— A patient may receive poor-quality care but may recover fully, or a patient may receive high-quality care for a complicated illness (such as cerebral malaria or tuberculosis) and still not recover.
Laws: Hospitals and practitioners should have clear understanding on the prevailing laws on medical practices, hospitals and clinics
Emotional Labour: Healthcare organizations can do the work more reliably and more effectively by organizing to create “social capital” and by using social network science to spread empathy as a core value
Ethical Treatment: The ethical code and the concept of ethical treatment should be kept on a high pedestal by the medical practitioners.
Need to upgrade medical education infrastructure—
There exists widening demand—supply gap of medical professionals in the country.
Medical education infrastructure in the country has witnessed rapid growth during the last 19 years. However, despite this rapid growth, this supply of medical professionals is insufficient to meet the estimated requirement of doctors.
The quality of medical education is defined by the availability and quality of teachers. The shortage of teachers is estimated at approximately 30-40 percent in medical colleges
There are limited formal teacher training programmes and the absence of a monitoring mechanism for faculty learning; leading to a static medical learning system
Continuous focus on upgrading the quality of existing infrastructure—it therefore requires concerted efforts of the public as well private sector.
Capacity Building and Training – Capacity building for formal, informal and continuing education of professional, para-professional and ancillary staff engaged in the delivery of healthcare
Improvement in Skills—the starting point
They can be blended with the flagship scheme ‘Skill India’ training courses to counter the shortage of nursing staff—accessible, affordable and quality training. It is expected that to meet the global average of 2.56 nurses per 1000 population in the coming 15 years India needs to add 1500 nursing colleges.
Some steps taken:
Establishment of ANM/GNM schools,
Up-gradation of institutions from School of Nursing to College of Nursing,
Training of Nurses,
Development of 11 one year specialisation courses,
Revision of curriculum for all nursing programmes
Establishment of national PhD consortium for Nursing Research
Launch of courses:
Nurse practitioner in critical care programme will be a two-year residential M.Sc degree which on completion will make nurses qualified to assume responsibility for the care of critically ill patients
Nurse Practitioner in Primary Health care Programme will be a one-year residential Post Graduate diploma programme
‘Live Register’: Accurate data of active and registered nurses will be made available online—helping the Government in better planning, rationalisation and optimum utilisation of manpower, and for making policy level decisions for the nursing professionals in India
Stress needs to be laid upon the importance of adequate skill enhancement through appropriate training related to the field of the Indian health care landscape—
Introduction of informal education in addition to formal education can provide a holistic and rounded understanding of the various issues
Sensitisation towards the laid down protocols in treatment should be initiated and made part of the curriculum
Connecting the Dots:
Critically analyse the shortcomings in public health policy of India. Give suggestions to overcome the same.
Is there a need for an integrated health care information mechanism to exist in India? What will be the importance of such a move, if taken, by the Government?