Health development is an integral part of social development. In a vast country such as India, there is a huge need for healthcare. Government alone cannot meet this demand. Therefore, it becomes obligatory on the part of non-governmental, voluntary and private institutions to supplement its efforts.
Looking at the vast canvas, one rightly feels India has come a long way. But still there are miles to go. Health indices since 1947 give us ample reasons to feel happy. At the time of Independence, the average life expectancy was 32 in India; today it is 72. In 1947, infant mortality rate was 160 for every 1,000 babies born. Today it is 24. The maternal mortality rate (MMR) was 2,000 per 1,00,000 live births. Now, it is 97, better than the global average of 158. And since 2005, India has showed a 77% decline in MMR, steeper than the 43% at the world level. We are looking at the glass as half full, instead of saying half empty. Nevertheless, our ultimate goal is to ensure that the glass is full and brimming.
India’s healthcare system has primary, secondary and tertiary levels. The coordination among them is far from satisfactory. There is a strong imbalance in rural India. Unavailable, unaffordable and inaccessible healthcare of quality has put rural India on the back foot.
A well-thought-out, well-coordinated and strongly monitored public private partnership (PPP) model will be the key to success in the sector. Towards a road map, let us zero in on primary and secondary healthcare systems and enumerate the challenges and the solutions. To achieve the vision of quality, affordable and accessible healthcare, particularly for the underprivileged, a multi-pronged approach is needed. There is a need to establish more primary and community health centres in rural areas, upgrade district hospitals to tertiary-care standards, encourage private sector investment in underserved regions through PPPs and persuade and prompt corporates to adopt primary health centres or establish them and monitor them with government guidance.
More colleges
The country needs to enhance the number of medical and nursing colleges, especially in remote areas. It needs to introduce training programmes in basic nursing, advanced medical technologies and emergency care. There is an imminent urgency to retain medical and health talent through better working conditions and incentives. Apart from the regular nursing cadre, a mid-level support system has to be created with students trained in a diploma course after Plus Two. They will become the backbone of the centre.
There is a need to focus on preventive healthcare through health and wellness centres and induce heavy investment in sanitation, nutrition, and immunisation programmes to reduce the disease burden. Universal health coverage is a vital consideration in an impoverished country such as India and expanding the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana to include a broader population base is without doubt a crucial initiative.
India needs to see a significant and sharp increase in government spending on healthcare to at least 2.5% of the GDP by 2025 (as per the National Health Policy, 2017). Health insurance coverage needs to be expanded rapidly to cover the informal sector. Out-of-pocket expenditure needs to be reduced drastically by regulating drug prices and promoting generic medicines.
Promoting awareness campaigns for lifestyle diseases, mental health, and substance abuse are urgent interventions, given the vast scale of problems in these domains. There is no second opinion that accredited social health activists and community health volunteers need to be empowered to act as the first line of care. Initiatives have to be taken to guarantee inter-sectoral collaboration among health, education, and sanitation departments.
Given that it’s the digital era, implementing the National Digital Health Mission to create digital health IDs and integrating healthcare systems, and leveraging AI, telemedicine and big data to address the rural-urban divide are vital for equal and easy access to healthcare, especially in underserved areas.
India has great technical and technological competency and hence promoting domestic manufacturing under the “Make in India” initiative to reduce dependence on imports will help make the country self-reliant and self-dependent in healthcare, reducing dramatically sky-rocketing healthcare costs, which rise especially in the wake of imports. This endeavour will further get buttressed by scaling up research and development for vaccines, biotechnology, and indigenous innovations.
India needs to focus on the establishment of innovation hubs for affordable medical solutions that are vital in a country with a huge population, expand telemedicine services to remote regions as people may not be able to travel long distances owing to a variety of factors such as high costs, non-availability of transport infrastructure or broken roads or deep inaccessibility, simply put. And in the era of mass disease, we have to strengthen epidemiological research to prepare for future pandemics.
The National Health Policy, 2017 needs to be effectively strengthened. There has to be greater enforcement of accountability through data-driven decision-making and there is an urgent need to promote decentralised governance to empower local healthcare providers.
While executing initiatives to improve healthcare in the country, India needs to have key performance indicators. What will they be? There has to be further reduction in maternal and infant mortality rates and enhancement in life expectancy, massive upgrade of health infrastructure in underserved regions and enhanced financial protection for the economically weak. If a country can fulfil these objectives and meet these goals, we can surely say that performance on health indicators is positive and that a country will develop well. A healthy population ensures greater productivity.
A robust and resilient healthcare system is key to India’s economic growth and social well-being. By addressing gaps and implementing innovative solutions, India can achieve a healthcare model that is inclusive, sustainable and futuristic, setting a global example for emerging economies.
The author is the founder & managing trustee of Sankara Eye Foundation India
Published – January 05, 2025 04:35 am IST
