Restructuring Inclusive Healthcare in India

Context 

The World Health Day was observed on 7th April. Under the aegis of this special day the World Health Organization (WHO) has declared health to be a fundamental human right. But still, there remains an alarming gap in healthcare access highlighted by the COVID-19 pandemic, environmental crisis and growing socio-economic gaps. The United Nations defines inclusive healthcare as “everyone, everywhere should have access to the health services they need without risk of financial hardship.”

Even though over 140 nations recognise health as a constitutional right, the WHO Council on the Economics of Health for All reports that more than half the world’s population needs complete access to essential health services.

What is Inclusive Healthcare?

• Inclusive healthcare refers to a healthcare system that aims to provide equitable access to quality healthcare services for all individuals, regardless of their socio-economic status, geographical location, gender, age, or any other demographic factor. 
• This concept emphasizes the importance of ensuring that no one is left behind in accessing essential healthcare services, and that healthcare is provided in a manner that respects the dignity and rights of every individual. 
• Various aspects of inclusive healthcare include: 
  • • Universal Health Coverage (UHC): Inclusive healthcare entails the implementation of policies and programs that ensure all individuals have access to essential healthcare services without suffering financial hardship. This is often achieved through the establishment of UHC schemes that provide financial protection against the cost of healthcare services.
    • Health Equity: Inclusive healthcare seeks to address health disparities and inequalities by ensuring that vulnerable and marginalized populations have equal access to healthcare services. This requires targeted interventions to reach underserved communities and address the social determinants of health that contribute to disparities.
    • Accessibility: Inclusive healthcare requires healthcare facilities and services to be physically accessible to all individuals, including those with disabilities or living in remote areas. This may involve the provision of accessible infrastructure, transportation services, and mobile healthcare clinics.
    • Affordability: Inclusive health care ensures that healthcare services are affordable for all individuals, regardless of their income level. This may involve subsidizing healthcare costs, providing financial assistance programs, or implementing fee waiver schemes for low-income populations.
    • Cultural Competence: Inclusive healthcare recognizes the diversity of populations and ensures that healthcare providers are culturally competent and sensitive to the needs of different communities. This includes providing language interpretation services, respecting cultural beliefs and practices, and engaging with community leaders to build trust and rapport.

Health Equity and its Importance

• Health equity ensures that every person has an equal opportunity to achieve their highest health potential, no matter what their circumstances.  
• Recognising that social, economic, and environmental factors impact health outcomes, this idea goes beyond genetics. WHO’s mission is to eliminate unfair and preventable disparities in health among different social and economic categories. 
• True health equity addresses the root causes of health inequities such as poverty, discrimination, limited access to high-quality education, a healthy diet, clean water, fresh air, and housing, and merely grants equal access to health care.

Challenges to Health Equity in India

• Risk from Pandemics – The fight for health equity confronts global challenges that transcend borders and call for collective international action. The COVID-19 pandemic has starkly revealed that infectious diseases target marginalized and vulnerable groups the most, thus widening the health equity gap.
  
• Climate Change Issues – Climate change poses a serious health risk since it disproportionately impacts low-income and vulnerable people. The health-care provision is severely hampered by conflicts, which destroy infrastructure, uproot communities, and shut off access to vital medical services.
• Diversified Population – With a large and diversified population, India faces persistent obstacles to health equity, including notable differences in health-care outcomes and access. Even though access to health care has improved over the past 20 years, there is still much work to be done in rural India. 
• Gender Issues – Disparities across caste and gender are profound. National Family Health Survey (NFHS)-5 (2019-21) data indicates that Scheduled Castes and Scheduled Tribes experience higher child mortality and lower immunization rates.
• Shortage of Doctors – A critical shortage of doctors exacerbates these issues, with WHO data indicating only 0.8 doctors per 1,000 people, which is below the advised ratio. Even though over 75% of health-care professionals work in metropolitan regions, which only account for 27% of the population, the shortage is particularly severe in rural areas.

Measures to be taken for providing Equitable Healthcare

• Comprehensive Approach – Achieving health equity requires raising health literacy. India should turn health equality into a shared, community-driven goal by including health education in the National Health Mission (NHM), , enabling its people to seek equitable care and make educated health decisions. 
• Government’s Intervention – Governments and officials may influence the state of health through funding, creative policies, and laws. For instance, India’s Ayushman Bharat initiative provides free health coverage to the bottom 40% economically, demonstrating a commitment to reducing health disparities. 
• Public and Private Sector Collaboration – Together with the government, the public and private health-care sectors provide services to underprivileged communities, emphasizing preventive education, workforce development, and infrastructure enhancement.

• Reliance on International Institutions – International institutions such as WHO, the Global Fund for AIDS, Tuberculosis and Malaria, and Gavi-Global Vaccine Alliance support health initiatives in places with limited resources and promote sharing information and resources to enhance health-care systems, especially in countries such as India. 
• Addressing Social Determinants of Health: Recognizing that social, economic, and environmental factors significantly impact health outcomes, interventions should address social determinants of health such as poverty, housing instability, food insecurity, and educational attainment. Initiatives aimed at improving socioeconomic conditions and creating healthy environments can mitigate health disparities.

Conclusion

Inclusive healthcare is not just a matter of providing medical treatment; it is about creating a healthcare system that respects the dignity and rights of every individual. It requires addressing the diverse needs of all people, including those who are marginalized or vulnerable, and ensuring that healthcare services are accessible, affordable, and culturally competent.

SOURCE: The Hindu

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