In a country such as India with its diverse realities, the challenge of providing healthcare equitably is a daunting one. However, this is one that the system is equipped to face. The only factors needed to enable growth are political and social will and enabling investment. Along with being an exacting litmus test, Covid-19 has played the role of a catalyst for the healthcare system in the country. An Outlook report.
In a large country such as India, with its diverse realities across various geographies, its striated socio-economic divisions and its range of cultural factors, providing equitable, accessible and quality healthcare has always been a formidable challenge. However, it must be said that this is a challenge that the system – both public and private – has met with mettle and vigor. Guided largely by comprehensive National Health Policies, there has been consistent work towards a more inclusive healthcare system.
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While access to quality healthcare remains a concern still in several parts of the country especially in remote areas, by and large the healthcare system in India has served its people and delivered well in spite of barriers that in any other country might have been insurmountable.
State of the past
Public healthcare in India has been and remains focused on delivering primary healthcare through community-level health programmes. A tiered infrastructure system with sub-centers and primary health centres providing basic health services at the bottom, and better equipped entities such as district hospitals and medical colleges deliver secondary and tertiary care. Large-scale vaccination drives to protect our children, mass awareness campaigns on reproductive health, mother and child welfare as well as basic health and hygiene practices to prevent the occurrence and spread of diseases such as malaria, dengue etc. have all been successful to a large degree, with consistently decreasing rates of both mortality and morbidity.
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On the other hand, the private sector has been concentrated largely in tier I and II cities, and has contributed to the overall system by taking the pressure off public universal healthcare delivery obligations by catering to those with the means to pay.
Pandemic Gains
Into this scenario of steady growth, exploded COVID-19. Worldwide, far more developed healthcare systems than India were brought to their knees by pandemic and India’s healthcare system also floundered in the beginning. However, the country’s healthcare system responded as one to the pandemic, with private players working in tandem with the government sector.
The contribution of the private healthcare sector to the pandemic response was significant – accounting for about 60 per cent of inpatient care by last statistics. Private organization’s initiated investments to upgrade their facilities to control and prevent the infection, build infrastructure for quarantine and treatment, and equip with appropriate medical supplies and increased workforce. It must be remembered and acknowledged that all this happened against the context of sharp decrease in revenue as medical tourism and OPDs (outpatient departments) were non-functional almost throughout the duration as per government advisories.
Tech Support
The response plan undertaken by the healthcare industry, along with the central and state governments, was a robust one. This involved setting up of dedicated COVID- 19 hospitals, isolation centres and resource mapping through technology.
Technology was leveraged such as the development of the Aarogya Setu mobile application. The CoWIn portal helped mobilise, manage and track the vaccination efforts and on the whole, the way technology was leveraged to manage the unprecedented needs thrown up by the pandemic serve as an example globally.
Investing in health
Overall, the Indian healthcare system managed the pandemic effectively. From manufacturing of medical equipment, disposables, drugs and of course the vaccines in every way the country has placed itself as a global leader by supporting other countries over and above fulfilling domestic requirements.
This has led to a significantly positive investment outlook for the sector. The factors influencing this promising outlook can be delineated further.
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Growing the medical infrastructure in Tier II and III cities
The shortfalls made visible by the pandemic such as number of beds, accessibility of advanced equipment have brought into focus the need for an ‘emergency-proof’ healthcare system. As a result, numerous hospital chains and specialty centres are building more capacity in Tier II and III cities. This aligns with the government’s efforts to increase the number of hospital beds per thousand population in order to narrow the accessibility gap.
Greater awareness about health insurance
An increased awareness about the need for health insurance and available products had already been noticed in the last few years. The data says that more people are investing in health insurance with each year.
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‘Health for all’ led government policies
Government policies and efforts towards universal health cover as well as schemes such as Ayushman Bharat and National Digital Health Mission were all in place before the pandemic. But the outbreak caused the gas pedal to be applied and the pace increased exponentially.
Harnessing technology
Post the pandemic, online consultations and technology platforms have become a way of life. Greater acceptance and higher value attributed to the possibility and presence of telemedicine and online consultations has decreased the gap in access, especially for senior citizens and also across geographies.This has translated to higher number of doctor consultations by eliminating the logistics involved in consulting a doctor.
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Growth and hope
All in all, higher healthcare awareness, rise in incomes, increased access to insurance and the increased incidence and diagnosis of lifestyle diseases, India’s healthcare market is expected to grow exponentially. Healthcare spending is slated to rise to 2.5 per cent of the GDP (gross domestic product) by 2025. Increased focus on telemedicine services, with it becoming legal for registered medical practitioners to provide healthcare services using telemedicine, is also a growth factor.
With both government and private players determined to harness technology and use heightened health and hygiene awareness to combat the challenges existing today, the future seems to be one of growth and hope.
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Mansukh Mandaviya, Union Health Minister
“I seek your continued partnership for connecting with the communities to take healthcare services to them. Your work will be pivotal in enhancing awareness and accelerating uptake of e-health services (such as e-Sanjeevani and tele-health services) among the masses.”
Adar Poonawala,CEO, Serum Institute of India
“A stronger healthcare system has boosted economic activity across the country, including a return to travel, return to consumption causing higher farm credit, the start-up ecosystem getting a boost and so on.”
Dr Devi Shetty, Eminent Cardiologist and Chairman, Narayana Hrudalaya
“Technology has the power to democratise healthcare delivery as even the top doctors could be consulted with a click of a button. With digital aid, people from all strata of society and even from the remotest locations across the country can reach out to top physicians in the country for consultation, which was not the case earlier.”
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Dr Randeep Guleria, Director, All India Institute of Medical Sciences
“To have a pandemic-resistant world, India needs to invest heavily in health infrastructure. If we need to have a pandemic-resistant world, we need to have a system which is sustainable and works even when the pandemic is over”
