India’s Health Sector

Context: Recently the Government of India and World Bank signed two complimentary loans worth $1 billion to support and enhance India’s healthcare infrastructure.

About India’s healthcare sector at glance:

• In the Economic Survey of 2022, India’s public expenditure on healthcare stood at 1% of GDP in 2021-22 against 1.8% in 2020-21 and 1.3% in 2019-20.
• India had 7 physicians per 1,00,000 people in 2017 (in contrast to 98 in Pakistan, 100 in Sri Lanka and 241 in Japan).
• 53 beds per 1,00,000 people(in contrast to 63 in Pakistan, 79.5 in Bangladesh, 415 in Sri Lanka and 1,298 in Japan).
• 7 nurses and midwives per 1,00,000 people(in contrast to 220 in Sri Lanka, 40 in Bangladesh, 70 in Pakistan, and 1,220 in Japan).
• India has among the highest out-of-pocket (OOP) expenditures of all countries in the world- 62% of the total health expenditure in India is OOP.
• According to the World Health Organization (WHO), India ranks 184 out of 191 countries in health spending.
• The US spends over 16% of its total GDP on healthcare, while Japan, Canada, Germany etc. spend over 10% of their GDP on healthcare.

Health Index for states developed by Niti Aayog:

• The Health Index for States developed by Niti Aayog in consultation with the health ministry and the World Bank has rankings for large states, smaller states and Union territories.
• It is based on 23 health parameters ranging from mortality rate and sex ratio to functioning cardiac care units.
• In 2019, Kerala was the top performer followed by Andhra Pradesh and Maharashtra.
• The index results indicated that states even with a lower economic output are performing better on health and well-being.

Challenges associated with India’s healthcare sector:

• Low Budget Spending: India’s public expenditure on healthcare is only 2.1% of GDP in 2021-22 while Japan, Canada and France spend about 10% of their GDP on public healthcare.
• Unequal distribution: India’s health care system is concentrated in urban areas with very little presence in the rural areas where majority of the population lives.
• Lack of Medical Research: In India, R&D and cutting-edge technology-led new projects receive little attention.
• Low doctor-patient ratio: The doctor patient ratio in India is about 1:1500 much higher than the WHO norm of one doctor for every 1,000 people.
• Lack of Affordability: The contribution of private sector in healthcare expenditure in India is around 80 percent while the rest 20 percent is contributed by Public Sector.
  • The private sector also provides for 58 percent of the hospitals and 81 percent of the doctors in India.

Govt of India Initiatives to improve healthcare sector in the country:

• Pradhan Mantri-Ayushman Bharat Health Infrastructure Mission (PM-ABHIM): it aims to strengthen India’s health infrastructure and improve the country’s primary, secondary and tertiary care services.
• Ayushman Bharat : Follows a two- pronged approach by Creation of health and wellness centres to bring health care closer to homes.
• formulation of a Pradhan Mantri Jan Arogya Yojana (PMJAY) to protect poor and vulnerable families against financial risk arising out of health episodes.
• Ayushman Bharat Digital Mission: aims 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 Ayush Mission: it is a centrally sponsored scheme for the  development of traditional medicines
• Pradhan Mantri Swasthya Suraksha Yojana (PMSSY):aims to correct regional imbalances in the availability of affordable/reliable tertiary healthcare services and also to augment facilities for quality medical education in the country.

Way Forward:

There is an urgency to focus on all the three levels of primary, secondary and tertiary healthcare, it is imperative that the government look towards improving primary health care as a public good.

The lesson emerging most unequivocally from the pandemic experience is that if India does not want a repeat of the immeasurable suffering and the social and economic loss, we need to make public health a central focus.

There is also a need to declutter policy dialogue and provide clarity to the nomenclatures.  India needs to move beyond the doctor-led system and Para medicalise several functions. India should focus on technology upgradation and preventive care to further its march towards healthy India.

Source: The Hindu

Previous Year Questions

Q.1) Consider the following:

1. Aarogya Setu
2. COWIN
3. DigiLocker
4. DIKSHA

Which of the above are built on top of open-source digital platforms? (2022)

1. 1 and 2 only
2. 2, 3 and 4 only
3. 1, 3 and 4 only
4. 1, 2, 3 and 4

Q.2) With reference to recent developments regarding ‘Recombinant vector Vaccines’, consider the following statements:

1. Genetic engineering is applied in the development of these vaccines.
2. Bacteria and viruses are used as vectors.

Which of the statements given above is/are correct? (2021)

1. 1 only
2. 2 only
3. Both 1 and 2
4. Neither 1 nor 2