CONTEXT  

• India’s health care consists of 70% private and 30% public in a country where 80% people do not have any protection for health the out-of-pocket expense is as high as 62%.
• Public spending in health care is merely 1.13% of GDP and there exists a huge shortage of health-care workers particularly nurses and midwives.

CHALLENGES WITH PUBLIC HEALTH SYSTEMS IN INDIA

• The existing public primary health care model in the country is limited in scope, as only services related to pregnancy care, limited childcare and certain services related to national health programs are catered on priority basis. This represents only 15% of all morbidities for which people seek care.
• Poor health management skills and lack of appropriate training and supportive supervision for health workers prevent delivery of the desired quality of health services.
• Expenditure on public health funding has been consistently low in India (approximately 1.3% of GDP), while as per OECD, India’s total out-of-pocket expenditure is around 2.3 % of GDP.
• Issue of Overlapping Jurisdiction as there is no single authority responsible to issue guidelines and enforce compliance of the health standards.
• Inability to make early detection and timely prevention of diseases. Thus, diminishes preparedness and effective management for new and emerging threats such as pandemic like Covid-19.

GOVERNMENT INITIATIVES

The government has made several efforts to address the shortcoming in the public health system through various schemes like the Pradhan Mantri – Jan Arogya Yojana, Pradhan Mantri Bhartiya Janaushadhi Pariyojana, National Medical Commission (NMC) Act, 2019, NITI Aayog’s National Health Stack, etc.

WAY FORWARD

• Need to enable Preventive health Care. In this direction the Union government has announced the conversion of primary health care centers into Health and Wellness Centers (HWCs). These HWCs will act as the pillar of preventive care and ‘gateway’ for access to secondary and tertiary health services.
• There is a need to bring behavioural change to ensure that people eat right, sleep right, maintain good hygiene, exercise, and adopt a healthy lifestyle that necessitates concerted interventions at various levels of the system.
• Catalyse people’s participation for healthy India, through programmes like Swasth Bharat Jan Andolan on lines of Swach Bharat Abhiyan.
• Cooperative Federalism: Given the major role that States have to play in creating strong health systems across the country, allocations provided by the Finance Commission can become the critical catalyst for transforming the nation’s health.
• Need to increase the Public funding on health to at least 2.5% of GDP as envisaged in the National Health Policy, 2017. Extra funding can be mobilised through Corporate Social Responsibility (CSR).
• Need to incentivise state and local governments to invest in creating a dedicated cadre for public health at the state, district and block levels.

The novel coronavirus pandemic has revealed the mismatch existing in India’s health care system. Thus, there is an urgent need to take immediate actions to make adequate investment, for creating a health system that can withstand any kind of public health emergencies.

Reference:

1. https://www.thehindu.com/opinion/op-ed/stopping-the-slide-of-health-care-in-india/article33379641.ece