Posted in Editorial Analysis

India is at a pivotal moment in its health-care journey

 September 18, 2023  Leave a comment

Syllabus

Issues Relating to Development and Management of Social Sector/Services relating to Health, Education, Human Resources(GS 2)

Source

The Hindu,18/09/2023

Content

  • Healthcare comprises hospitals, medical devices, clinical trials, outsourcing, telemedicine, medical tourism, health insurance and medical equipment.
  • A well-functioning healthcare system should be accessible, affordable, and sustainable over the long term.
  • The Indian healthcare system is a complex and diverse network made up of the public and private sectors, which offer a range of medical services and infrastructure to people living in India.
  • India’s public expenditure on healthcare touched 2.1 % of GDP in FY23 and 2.2% in FY22, against 1.6% in FY21, as per the Economic Survey 2022-23.

Healthcare system in India

The healthcare system in India is structured as a three-tier system.

  • Primary Level: This is the most peripheral and first contact point between the primary health care system and the community.
  • It includes Sub Health Centres (Urban and Rural) and Primary Health Centres (Urban and Rural).
  • They are tasked with providing services related to maternal and child health, family welfare, nutrition, immunization, diarrhea control, and control of communicable diseases
  • Secondary Level: This level of healthcare includes Community Health Centres (CHCs), which constitute the First Referral Units (FRUs), and the Sub-district and District Hospitals.
  • For instance, a Community Health Centre in an urban area provides an integrated curative and preventive health care to the population with emphasis on preventive and promotive aspects of health care.
  • Tertiary Level: This level involves specialized consultative care, usually on referral from primary or secondary medical care personnel.
  • These services are provided by specialists working in a central area of expertise, such as a center of excellence in tertiary hospitals.

Achievements of Indian healthcare system

  • Improved Life Expectancy:In 1947, the expectancy of an average Indian citizen was around 32 years and it  has increased to 70.19 years in 2022.Several studies have revealed that India’s life expectancy has increased due to the better availability of treatments, medicines, and evolving technology.
  • Decline in Child and maternal Mortality Rate:According to United Nation projections, India’s current infant mortality rate in 2022 is 27.695 deaths per 1000 live births, a 3.74 percent decline from 2021.
  • Control of Communicable Diseases:India was declared Polio free in 2014 and no new case of Polio has been reported in the country since January 2011. With respect to Leprosy, India is running one of the largest leprosy eradication programme in the world, the National Leprosy Eradication Program (NLEP).
  • Healthcare policies and government schemes:A centrally-sponsored scheme called Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) was launched which is the largest Government funded health assurance/insurance scheme in the world.Moreover, the government has launched several other schemes like Pradhan Mantri Swasthya Suraksha Yojana (PMSSY), enhanced the quality of medical education in the country and the extensive improvement in healthcare infrastructure since independence.
  • Telemedicine: Telemedicine has made healthcare more accessible and affordable, and has increased patient engagement. Eg: eSanjeevani

Potential

  • Healthcare is one of India’s largest sectors both in terms of revenue and employment.
  • The Telemedicine market is the maximum potential eHealth segment in India, which is expected to touch $5.4 Bn by 2025.
  • Over the next 10 years, National Digital Health Blueprint can unlock the incremental economic value of over $200 Bn for the healthcare industry in India.
  • India has the world’s largest Health Insurance Scheme (Ayushman Bharat) supported by the government.
  • Availability of a large pool of well-trained medical professionals in the country.
  • India is emerging as a popular medical hub for patients(medical tourism)

Challenges

  • Inadequate Public Expenditure: There is a need for increased public expenditure on health to ensure Universal Health Coverage.
  • Shortage of Skilled healthcare professionals: There is a shortage of qualified healthcare professionals and unequal accessibility to healthcare across India.
  • Lack of Infrastructure: Rural primary care is underfunded and has shortages of staff, equipment, drugs, and infrastructure in many parts of the country.
  • Poor Sanitation: Poor sanitation levels contribute to health issues.
  • Rise in Non-Communicable Diseases (NCDs): Cardiovascular diseases (CVDs), cancers, chronic respiratory diseases (CRDs), and diabetes are increasing tremendously.
  • Inadequate Insurance Coverage: Despite the presence of government schemes like Ayushman Bharat, many Indians still lack adequate health insurance coverage.
  • Inequitable Healthcare Access: There is a significant urban-rural divide in healthcare access, with rural areas often suffering from lack of access to high-quality healthcare.

Govt Initiatives

Artificial Intelligence in Healthcare

Pros

  • Provides real-time data:With AI, doctors and other medical professionals can leverage immediate and precise data to expedite and optimize critical clinical decision-making.
  • Streamlines Tasks:AI is enabling healthcare facilities to streamline more tedious and meticulous tasks.
  • Saves time and resources:AI is accelerating operations to save medical establishments precious productivity hours.New natural language processing (NLP) and deep learning (DL) algorithms can assist physicians in reviewing hospital cases and avoiding denials.
  • Assists Research:It enables researchers to amass large swaths of data from various sources.
  • Reduce physician stress:AI helps streamline procedures, automate functions, instantly share data and organize operations, all of which help relieve medical professionals of juggling too many tasks.

Cons

  • Human surveillance is still essential even after the introduction of AI . For example, surgery robots operate logically, as opposed to empathetically.
  • As AI is generally dependent on data networks, AI systems are susceptible to security risks.
  • Limitations and bias in data can reduce the safety and effectiveness of AI tools.
  • Obtaining the high-quality data needed to create effective AI tools can be difficult.
  • AI tools can be challenging to scale up and integrate into new settings because of differences among institutions and patient populations.
  • As more AI systems are developed, large quantities of data will be in the hands of more people and organizations, adding to privacy risks and concerns.
  • The use of AI-enabled tools in health care raises a variety of ethical, legal, economic, and social concerns.

Way Forward

  • Adoption of AI and Digital Health: AI and digital health technologies are transforming the healthcare sector in India. They can help in timely epidemic outbreak prediction, remote diagnostics and treatment, and optimize health resource allocation.
  • Strengthening Primary Health Care: The focus should be on strengthening primary health care, health workforce, and essential health services.
  • Genomics and Personalized Medicine: Genomics can improve clinical care and health outcomes through effective diagnosis and personalized treatment.
  • Public-Private Partnerships(PPP):Affordability and accessibility are two major concerns in India. The PPPs can help address these issues by pooling in the expertise and finances of the private sector with the access and subsidies of the public sector.

Reference

Practice Question  
Critically analyze the current state of the healthcare system in India. Discuss the challenges faced by the healthcare sector and suggest measures to improve the accessibility and affordability of healthcare services in rural and urban areas. Substantiate your answer with relevant examples.

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