Context

• India has made significant strides in health and nutrition, with over 500 million citizens currently benefiting from the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), which facilitates access to healthcare services. 
• The establishment of 173,000 Ayushman Aarogya Mandirs (AAMs) has further enhanced the provision of primary healthcare. 
• Out-of-pocket health expenses have reduced from 63% in 2014 to 39% in 2024.
• Despite these advancements, India still faces challenges in meeting global health standards.
  • The average life expectancy in India is currently 71 years, compared to 77 years in China and 84 years in Japan.
  • The Infant Mortality Rate (IMR) in India is 28 per 1,000 live births, significantly higher than China’s 5 and Japan’s less than 2. 
  • Additionally, out-of-pocket health expenditure in South Africa is approximately 8%, starkly contrasting with India’s 39%.

Problems associated with India’s Health System

• Lack of funding: Securing consistent and sufficient funding for healthcare initiatives poses a major challenge.
• Infrastructure Deficiencies: Significant infrastructure deficiencies exist in many rural and remote regions, where hospitals, clinics, and diagnostic facilities are absent. 
• Complex regulatory frameworks: Such frameworks and bureaucratic processes can hinder the timely execution of reforms.
• Shortage of professionals: The healthcare sector is facing a critical shortage of doctors, nurses, and allied health workers, making the training and retention of skilled personnel, particularly in underserved areas, a persistent concern.
  • Currently, India has 10 doctors and 17 nurses and midwives for every 10,000 people.
• Lack of awareness: The absence, inaccessibility or inaccuracy of information may stop people from taking preventive action or meeting the healthcare workers.

Reforms needed in Healthcare system

• Allocation of sufficient resources: The National Health Policy (NHP) 2017 stipulates that India’s healthcare spending should reach 2.5% of GDP by 2024-25. Strong policy support at all government levels are necessary to secure adequate funding, enact supportive legislation. Additionally, increased investment in nutrition, clean drinking water, and sanitation is vital for eliminating childhood undernutrition and addressing anaemia among women and children.
• Leveraging the demographic dividend: It can lead to significant economic advancement through the adoption of forward-thinking policies that empower youth to make informed health decisions.
• Tackling the deficit of healthcare professionals: 
  • It can be done by expanding medical education by increasing the number of institutions and student admissions. 
  • Enhancing working conditions, including better salaries and job security, is crucial for retaining existing professionals.  
• Strengthening the existing 1.4 million Anganwadi Centers and equipping staff with adequate training in child development and learning could yield significant benefits.
• Targeted interventions: Developing targeted interventions for vulnerable populations, such as pregnant women,lactating mothers, and young children, is critical to meet their specific nutritional requirements.
• Prioritising the health of school children: Establishing a school environment that fosters health and nutrition through activities such as physical education, mental health support, counselling, and regular health check-ups is crucial in shaping the future workforce should be a primary objective.
• Enhancing monitoring and evaluation systems: Tracking progress with regular audits and feedback mechanisms fosters accountability and transparency. 
• Capacity building: Building the capacity of frontline workers, including Anganwadi workers and ASHAs, is vital for effectively delivering nutrition services and educating beneficiaries.
• Public Awareness Campaigns: Extensive public awareness campaigns can inform the population about the significance of nutrition and the availability of government programmes, thereby enhancing participation and adherence.
• Embracing technology: The use of technology, including digital tools and platforms, can optimise service delivery, facilitate progress monitoring, and enable efficient information dissemination.
• Collaborative Efforts: Collaborating with Non-Governmental Organisations (NGO’s) and the private sector can provide India with additional resources, expertise, and innovative solutions. Effective coordination between public and private healthcare providers is also essential for ensuring comprehensive coverage and efficient service delivery.
• Climate resilience: By prioritising climate resilience initiatives, India can advance significantly towards the goal of universal access to safe drinking water and improved sanitation.
• Establishing a resilient and inclusive healthcare system demands a collaborative effort from both Central and State governments, alongside active involvement from the private sector and civil society. The integration of technology is also a focal point.