Healthcare in India has made great progress, but Challenges remain

In Context

• Experts deliberate on the progress of the Indian health system and the challenges it still faces.

About

• Over the years, the Indian health system has overcome seemingly insurmountable problems, long considered hopeless.
• As per National Family Health Survey (NFHS-5) even under the best-case scenario, India would achieve a total fertility rate of 2.1 (replacement level) only by 2041.
• Healthcare in India is on the cusp of significant transformation, with its changing demographics, increasing consumer spending and rising lifestyle diseases.
• At a time when India is having the youngest population for more than three decades to come, there is a need to confront health challenges to redeem that advantage fully.

Healthcare Sector of India

• India’s healthcare sector is one of the largest in terms of revenue and employment, encompassing hospitals, medical devices, clinical trials, outsourcing, telemedicine, medical tourism, health insurance, and medical equipment. 
• The healthcare sector in India is growing rapidly, driven by increased expenditure by public and private players, and strengthening coverage and services. 
  • The Indian healthcare sector is expected to reach US$ 372 billion in 2022, recording a three-fold rise and growing at a CAGR of 22% between 2016-22.
  • India’s public expenditure on healthcare stood at 2.1% of GDP in 2021-22 with a poor doctor-population ratio of 1:854.
  • The hospital industry in India is forecast to increase to Rs. 8.6 trillion (US$ 132.84 billion) by FY22 from Rs. 4 trillion (US$ 61.79 billion) in FY17 at a CAGR of 16–17%.
  • Premiums underwritten by health insurance companies grew to Rs. 73,582.13 crores (US$ 9.21 billion) in FY22.
  • The Indian medical tourism market was valued at US$ 2.89 billion in 2020 and is expected to reach US$ 13.42 billion by 2026 while the e-health market size is estimated to reach US$ 10.6 billion by 2025.
  • FDI inflow for the drugs and pharmaceuticals sector stood at US$ 19.90 billion between 2020-22.

Major challenges of Healthcare Sector in India:

India has made significant strides in its healthcare sector, however, there remain several challenges that need to be addressed.

• Health Challenges:
  • Five main interrelated challenges facing India’s population: cardiovascular diseases, cancers, chronic respiratory diseases, diabetes, and obesity.
  • Rising obesity rates, particularly in Delhi, Tamil Nadu, Kerala, Punjab, Telangana, Andhra Pradesh, and Karnataka, increase the risk of other health issues.
  • Building awareness and promoting healthy lifestyles is necessary to save lives and prevent chronic medical conditions.
• Infrastructure:
  • The state of infrastructure varies across states with some having better arrangements than others.
  • Urban areas need to bridge the gap in hospital services between large urban areas and tier II and III cities.
  • Standalone hospitals and nursing homes provide much-needed service but are unable to provide multi-speciality, leave alone tertiary and quaternary care.
  • The gaps between services available in metros and big cities and in districts must be bridged.
• Health Insurance:
  • Over the past three years, more than four crore Indians have bought health insurance.
  • Ayushman Bharat insurance scheme for 10 crore poor families provides insurance against hospitalization for up to Rs 5 lakh per year per family.
  • Nearly 74 per cent of Indians are either covered or eligible for health insurance coverage, but millions remain uninsured.
  • Out-patient doctor consultation costs, diagnostics, and drugs remain a financial burden for many.

Steps taken by Government:

• Ministry of Health and Family Welfare (MoHFW) allocated Rs. 86,200.65 crores (US$ 11.28 billion) in the annual budget 2022-23 for major health schemes including:
  • Pradhan Mantri Swasthya Suraksha Yojana, National Health Mission, Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and PM-ABHIM to strengthen India’s health infrastructure
• E-medical visa facility extended to citizens of 156 countries to promote medical tourism
• Ayushman Bharat Digital Mission was launched to connect digital health solutions of hospitals across the country
• ‘Medicine from the Sky’ project launched in 2021 for drone delivery of life-saving medicines and jabs in far-flung regions of the country
• The Ministry of Tourism established the ‘National Medical & Wellness Tourism Board’ to promote medical and wellness tourism in India.
• The government introduced the National Ayush Mission for the development of traditional medicines in India, as a centrally sponsored scheme until 2026.

What more can be done?

• Address lifestyle risk factors: Promote awareness among the population about the need for a healthy lifestyle to prevent cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes.
• Improve infrastructure: Ensure that primary healthcare facilities are fully functional and equipped with basic facilities, and improve the provision of core health services in state-run district hospitals.
• Bridge the gap in hospital services: Ensure that private hospital chains, standalone hospitals, and nursing homes provide multi-speciality, tertiary, and quaternary care to the population, especially in tier II and tier III cities.
• Increase health insurance coverage: Encourage more people to buy health insurance, particularly the uninsured population, by expanding the coverage of the Ayushman Bharat insurance scheme and other state-run insurance schemes.
• Use AI and digital technology: Leverage the benefits of AI and digital technology in healthcare to improve clinical judgments, surgical procedures, and pandemic forecasting.
• Implement policies and regulations: Develop and implement policies and regulations to ensure the quality, safety, and affordability of healthcare services across the country.
• Increase government spending on healthcare: Increase the government’s spending on healthcare to ensure that people can access quality healthcare services at affordable costs.

Way ahead

• India has successfully achieved its replacement fertility rate in 2020, much earlier than expected. However, there is a need to build awareness about healthy lifestyles and improving infrastructure can save millions from illness and premature death.
• India’s healthcare sector is highly diversified and full of opportunities in every segment, including providers, payers, and medical technology and is a leading destination for high-end diagnostic services with tremendous capital investment for advanced diagnostic facilities.
• Rising income levels, an ageing population, growing health awareness and a changing attitude towards preventive healthcare is expected to boost healthcare services demand in the future.

Source: IE