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UPSC Editorial Analysis

Revolutionizing India’s Healthcare

GS Paper 2 - Health, Govt. Policies and Interventions

Context

India’s healthcare system is a big and complex network that combines public and private services to serve its massive population. While the private sector bears a significant responsibility of providing care, recent instances such as the fire at a Delhi nursing home show a key issue in India’s healthcare system: a failure to follow health-care standards.

This tragedy is not an isolated incident, but rather a result of systemic inadequacies in regulatory structures. Despite several rules, the Indian healthcare sector struggles to comply due to unrealistic expectations and bureaucratic inefficiency. To address these issues, India must adopt a pragmatic approach to healthcare. This includes aligning different rules, streamlining approval processes, democratizing healthcare facilities, and revamping fundamental health services.


Challenges with India’s Healthcare System

  • Inadequate Public Health Expenditure – Despite being the world’s fifth-largest economy, India’s healthcare expenditure remains one of the lowest internationally, accounting for 2.1% of GDP in FY23. Furthermore, while India supplies 20% of the world’s generic medications, its inhabitants face a 47.1% out-of-pocket expense, indicating a serious deficit in public health service. 
  • Urban-Rural Healthcare Divide – India’s healthcare infrastructure disproportionately benefits metropolitan regions, resulting in a ‘two-tier’ system. Despite the fact that 65% of India’s population lives in rural regions, only 25-30% of hospitals are accessible. This is more than simply a resource concern; it is a fundamental threat to India’s constitutional guarantee of equality. 
  • Problems with Non-Communicable Diseases – While India combats infectious illnesses, NCDs account for about 64% of the disease burden (WHO, 2021). India’s diabetes load (77 million in 2019, predicted to reach 134 million by 2045) demonstrates this dilemma. As India’s economy expands, so does its NCD burden, which is a result of lifestyle changes. 
  • Ignoring Climate Change Impacts – Climate change is a health crisis as well as an environmental problem. In India, air pollution was a contributing factor in 1.67 million fatalities in 2019, or 17.8% of all deaths in the nation (WHO). The effect of the 2022 heat waves on crop output confirms the relationship between nutrition and climate. 
  • Governance Conundrum – India’s health challenges are exacerbated by governance disparities. Many states have over 50 approvals under various regulations, creating a bureaucratic nightmare for facilities. Also, some states often prioritize large corporate hospitals, neglecting the needs of smaller clinics and nursing homes. 
  • Neglect of Preventive and Primary Care – India’s health system is tilted towards curative, hospital-based care, neglecting the foundation of public health – prevention and primary care. The number of doctors at Primary Health Centres has shrunk to 30,640 in 2022

Measures to Revamp India’s Health Sector

  • Regulatory Reform with Risk-based Approach – Putting in place a tier-based regulatory structure that divides healthcare institutions into groups according to risk and complexity. This ensures strict control for high-risk facilities (big hospitals) while streamlining licensing for lower-risk facilities (small clinics, assisted living facilities). 
  • Health-Education-Livelihood (HEL) Campuses – Establishing integrated campuses in rural areas with community health centers, skill development centers, and health-tech incubators. Offering basic accounting public healthcare jobs to graduates of the village to boost healthcare human resources and local economies. 
  • Mental Wealth Initiative – Redefining mental health as an asset of economic value, or “mental wealth.” Give corporations who adopt comprehensive mental health programs corporate tax benefits. including lessons on mental health into all professional courses—not just those in the medical field. 

 

  • Climate Clinics – putting in place mobile clinics that double as meteorological stations in regions vulnerable to climate change. 30% of PHCs will be upgraded to become self-sufficient, climate-resilient buildings with solar energy, water harvesting, and drone delivery capabilities. forecasting the effects of climate change, such as illness outbreaks after natural disasters like floods, using health data.
  • Expansion of ABHA – There is a need for nationwide expansion and advertisement of Ayushman Bharat Health Accounts (ABHA) to rationalize India’s healthcare data. Employing artificial intelligence to track hyperlocal public health strategies. 
  • Women-Led Health Panchayats – Establishing all-women health councils in every panchayat to audit local health facilities, allocate health funds, and organize health melas. Empowering these councils to improve local health governance and reward panchayats with the best health indicators with additional development grants.


Way Forward


To forge a robust healthcare system, India must prioritize regulatory harmonization, infrastructure equity, and preventive healthcare. Streamlining approvals and adopting a risk-based regulatory approach will enhance compliance and service quality. Investment in rural healthcare infrastructure is crucial to bridge the urban-rural divide. Moreover, bolstering preventive care through public health campaigns and accessible primary care services will mitigate the burden of non-communicable diseases. Emphasizing climate-resilient healthcare facilities and data-driven public health strategies will further strengthen the system’s responsiveness to environmental challenges and emerging health threats.

SOURCE: The Hindu

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