03 Jul HEALTHCARE IN INDIA
(GS PAPER-2, GOVERNMENT POLICY, AND INTERVENTION, WELFARE SCHEME FOR VULNERABLE SECTIONS
SOURCE- THE HINDU)
Introduction
Health in ancient India was defined as the physical, mental, emotional, spiritual, and social well-being of an individual. Thus, the system of medicine was not about illness and standalone treatment. It combined many concepts such as diet, climate, beliefs, supernatural, empirical, and culture into the treatment of the person. The emphasis was on a natural and preventive approach to healing. It was aimed at treating the illness from the root cause.
(Arogyam parmam bhagyam, swasthyam sarvartha sadhanam)
{It means that Good health is the greatest blessing. Health is the means of everything.}
Thus, health cannot be seen in isolation but needs to be seen in a wider perspective of human life, as a part of human life, as an instrument for fruitful human life. Being healthy is a process.
Paradoxes & Contradictions Related To Health in Indian Society
- June 21st is celebrated every year as ‘Yoga Day, an acknowledgment for one of the greatest contributions of India to healthcare systems, especially in wake of emerging lifestyle diseases like depression, diabetes, etc.
- However, among all this, was another fact – India was declared as the Diabetes Capital of the world by the International Diabetes Federation (IDF) with the highest number of people suffering from Type-2 diabetes.
- It is a huge travesty that the land of Susruta, Charvaka, Vagbhata, Ram Chandra Sharma (Designer and developer of Jaipur foot) and the Generic pharmacy of the world in modern times has been ranked 145 out of 195 countries on the Healthcare Access and Quality Index (HAQ) of The Lancet.
Why Health – Importance /Dimensions to Health
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Health as a Social good
o Social good refers to any good which benefits the largest number of people in the largest possible way.
o Health as a social good enables a society to become a more egalitarian, tolerant, sustainable, sensitive, and moral-based society.
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Health as Political good
o Political good refers to any good which enables the participation of people in the political process.
o Health as a political good enables the political discourse of society to become more democratic, more accountable, more decentralized.
o In addition, it becomes very easy to develop consensus on critical issues especially on critical issues like clean energy, sustainable development, etc.
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Health as an Economic good
o Economic good refers to a good which enables economic growth, prosperity etc.
o Health as an economic good helps in better absorption of skills, better productivity of workforce, better involvement of workforce in industries, better decision making regarding technologies, etc.
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Health as an Ecological good
o Health as an ecological good can enable sustainable development, sustainable consumption, and environment-friendly policymaking.
o The recent Sterlite protests in Tamil Nadu were owing to the impact on the health of the people around. Similar protests have also been in Delhi because of growing pollution and increasing adverse impact on health.
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Health expenditure:
- General Government expenditure on health as a percentage of GDP in 2019-20 was 1.6% (up from 1.5% in 2018-19.
- Out-of-Pocket Expenditure (OOPE) as a percentage of Current Health Expenditure fell down to 58.7% in 2016-17 from 60.6% in 2015-16.
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Life Expectancy:
As per the 2019 Human Development Report released by United Nations Development Programme (UNDP), between 1990 and 2018, life expectancy at birth increased by 11.6 years in India.
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Child Health:
o Under-five mortality rate (U5MR) (deaths of children less than 5 years per 1,000 live births) has declined from 126 in 1990 to 34 in 2019, with an annual rate of reduction (ARR) of 4.5 percent in the time period 1990-2019.
o Infant mortality rate (deaths of children less than 1 year per 1,000 live births) has declined from 89 in 1990 to 28 in 2019.
Challenges in Health in India
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Inadequate Healthcare Personnel and Infrastructure
o India has 8.5 hospital beds per 10,000 citizens, one doctor for every 1,456 citizens (WHO’s prescribed norms 1:1000), and 1.7 nurses per 1,000 people (WHO’s prescribed norm is 3:1000).
o In addition, there is a clear rural-urban divide, regional divide, gender divide etc. regarding healthcare facilities.
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Weak primary health care sector
o Expansion of public services has been inequitably distributed eg. There is one government hospital bed for every 614 people in Goa compared with one government hospital bed for every 8789 people in Bihar.
o India’s doctor to population ratio remains dismal at less than 1 doctor per 1,000 population in-spite of being a hub for medical tourism and an exporter of healthcare experts.
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Social Reasons
o Healthcare can’t be seen in isolation but needs to be studied in a social context.
o Discrimination on the basis of diseases is also a huge problem in Indian society esp in case of TB, leprosy, HIV/AIDS, etc
o For example, Diarrhoeal diseases which are closely linked to open defecation kill 1 lakh children under 11 months old in India each year.
Status of Indigenous systems
o While, there has been increasing emphasis on the indigenous system of Yoga, Ayurveda, etc., their supporting system for implementation remains weak.
o There is an absence of a proper regulatory framework, certification benchmarking, and research into these systems.
Emerging Health Issues
o Modern way of life, increasing violence, increase individualism, reproductive health facilities, urban lifestyle, exam pressure, work pressure, corporate culture is giving way to new challenges in healthcare discourse and rise of non-communicable diseases.
India’s Achievements in Health Sector
- As a Generic Pharmacy of the World
o India accounts for close to 10% of the global pharmaceutical industry in terms of volume. This number goes to 20% for generic-drug exports by volume.
o The Indian pharmaceutical sector has many advantages – Low cost of land, labor, utilities and equipment; Favourable domestic laws, etc.
Cost-effective solutions
o India has been a hub for cost-effective solutions for medical issues.
o The Jaipur Foot was designed and developed in India by Ram Chandra Sharma in 1968.
o India has also emerged as a hub for research and development in vaccines. More than 60% of the world’s vaccines are being made by India.
o Recently, for the first time, a vaccine named the Rotavac vaccine has been conceived and developed from scratch. India has been “pre-qualified” by the World Health Organisation.
Efforts of Civil Society Organisations
o Smile India foundation – It is aimed at bringing quality healthcare services to the doorsteps of the needy and to promoting healthcare awareness.
o Rural Health Care Foundation – It is aimed at addressing the gap in the availability of low cost primary health care in rural areas.
o Seva Nilayam – It is working in partnership with the Government of Tamil Nadu with an objective to reduce the maternal mortality rate in its rural area.
International Organisations
o Some of the international organizations working in the health sector include WHO, UNDP, FAO etc.
o Apart from this, Bill and Melinda Gates foundation is aimed at enhancing healthcare and reducing extreme poverty.
Way forward –
While the conventional reforms like increasing expenditure, strengthening public health systems, strengthening health regulation etc. are indispensable, some areas of reforms which haven’t been given adequate attention but are important and can be game-changer:
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Shift to Preventive healthcare
o India’s health system continues to be guided by curative healthcare. There is a need to shift to preventive healthcare which is more inclusive, cheaper, and offers a better life experience.
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Change in the conception of Health
o There is a need to view health, not as an absence of illness but a state of well-being. There is a need to shift from a hospital-centered model of health.
o Thus, the value system needs to be re-oriented to inculcate the importance of sports, right surroundings, the right food, right sleep, etc.
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Women as an agency of health
o One of the major ways of reforming healthcare has been through the agency of Women. Amartya Sen in his capability approach has highlighted how Women empowerment has led to significant improvements in fertility rates, IMR and MMR.
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Use of technology
o Information Technology can be a huge game-changer in the healthcare sector. New technologies like Big Data, Artificial Intelligence, and Machine Learning can enable us to strengthen and enhance the reach of healthcare delivery.
o India needs to put more emphasis on research and innovation especially in biotechnology which can enable healthcare to be more affordable, available, and accessible.
Conclusion
- A healthy productive population is an enabler for sustainable development and hence it is critical that the Government remains committed to improve public health delivery, reduce health inequities and ensure affordable health care for all. Indian healthcare currently stands at a critical juncture.
- To borrow the Amartya Sen analogy, India’s healthcare represents an island of California (achievements) in a sea of sub-Saharan Africa (Challenges).
- However, there is a need for an overhaul of the healthcare sector in India. This also includes a completely different perception of healthcare, where it is seen as a process, as a part of life.
-Khyati Khare
Download Plutus IAS Daily Current Affairs of 3rd July 2021
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