Healthcare System in India & National Health Policy

Healthcare System in India & National Health Policy

Healthcare System in India

“Lancet Report on healthcare – India is the poorest performer in BRICS nations” 

Challenges faced by Indian Healthcare System 

• A weak primary health care sector + care provided in these facilities is also not up to the mark.
• Unequally distributed skilled human resources & shortfall of specialists across country
• Services inequitably distributed – Urban areas command 73% of the public hospital beds, even when 69% of India’s population resides in rural areas
• Large unregulated private sector – Private practitioners have become first point of contact in both rural & urban areas – concern lies with Unethical and irrational practices widespread among private hospitals
• Low public spending on health – Public health expenditure as a proportion of GDP remains low i.e. 1.15 %
• Fragmented health information systems – weak systems for collecting data + non-inclusion of the private sector in data gathering
• Poor Health Cover & high out of pocket expenditure – 80 % no health insurance
• Weak governance and accountability owing to corruption in health care

There is a greater need of radical restructuring of the healthcare system in India to address challenges including weak primary healthcare and dismally low public spending on health – to assure health for all Indians by 2022.

India needs to adopt an integrated national health-care system built around a strong public primary care system with a clearly articulated supportive role for the private and indigenous sectors.

National Health Policy, 2017

• Strengthening role of public sector by increasing public health spending to 5% of GDP by 2025 from current 1.15%
• Recognizes need for state intervention to control NCDs as they are reason for more than 60% death in India
• Collaborating & regulating the private sector as over 2/3^rd of services are provided by it
• Seeks to invest in preventive healthcare viz.

• early screening and diagnosis have been made a public responsibility
• advocates 2/3rd or more allocation of health budget for Primary Health Care
• affordable quality healthcare for all 

• Intersectoral approach involving various ministries
• Prioritizes addressing primary health care needs of urban population with special focus on poors
• Mainstreaming AYUSH systems inline with allopathic professionals

Concerns

• It leaves too much to the states on maintaining standards
• Would require more human resources and funds
• Health care target spending still Much lower than even other developing countries’ spending on health
• It does not speak about social determinants of health
• Various progressive measures under Draft NHP 2015 such as Right to Health and imposing health cess have been ignored

Thus, to achieve SDG on health, i.e., health and well-being to all by 2030, there would be need for greater and stronger Centre-state coordination and commitment for effective implementation.

✅ 10 Key Points on Healthcare System in India & National Health Policy:

1. Structure of Healthcare in India:

   • A three-tier system: Primary (PHCs & Sub-centers), Secondary (CHCs & District Hospitals), and Tertiary (Specialized Hospitals).

2. Public vs Private Healthcare:

   • Public sector provides low-cost healthcare but is often underfunded.

   • Private sector is dominant in urban areas but is expensive and profit-driven.

3. Challenges in Indian Healthcare:

   • Inadequate infrastructure, rural-urban disparity, shortage of healthcare professionals, and low public spending on health (~1.3% of GDP).

4. Burden of Diseases:

   • India faces a dual burden of communicable and non-communicable diseases (NCDs), along with emerging lifestyle diseases.

5. Out-of-Pocket Expenditure (OOPE):

   • High OOPE pushes millions into poverty due to healthcare expenses.

6. National Health Policy, 2017 Goals:

   • Achieve Universal Health Coverage (UHC).

   • Increase government spending on health to 2.5% of GDP by 2025.

7. Key Focus Areas of NHP 2017:

   • Strengthen primary healthcare.

   • Promote preventive, promotive, and curative care.

   • Digital health and e-health initiatives.

   • Public-private partnerships.

8. Ayushman Bharat Scheme:

   • Launched under NHP 2017 to provide health insurance coverage and establish Health and Wellness Centers (HWCs) for comprehensive primary care.

9. Initiatives for Maternal and Child Health:

   • Mission Indradhanush, Janani Suraksha Yojana, and POSHAN Abhiyaan for improving MCH indicators.

10. Way Forward:

    • Enhance healthcare financing.

    • Focus on quality and affordable healthcare.

    • Strengthen preventive care and health literacy.

    • Promote equity and address social determinants of health.

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