Public Healthcare In India: Gaps, Solutions And Future Outlook

Muskaan Gupta Tanya Gupta Oct 08, 2024

# Public Healthcare

Addressing these concerns would call for ongoing efforts at the policy and implementation levels

“A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity," is how the World Medical Association defines health. Investments in health are part of human resource development, which is crucial for the security and prosperity of the nation. Therefore, improving health is essential for raising the quality of life and societal development of a nation.

India, as the world's most populous nation, faces significant public healthcare challenges. Even while the healthcare industry has made significant progress, access to high-quality and affordable services has remained elusive for the country's rural and poor population. India has a much lower doctor-to-population ratio than the rest of the world, with just 64 per 100,000 inhabitants. A persistent lack of professionals harms a nation's healthcare system. An uneven distribution of healthcare services, with the majority of specialists and top-notch institutions concentrated in urban regions, exacerbates the problem with essential necessities such as medications, and medical personnel in low supply in rural areas.

The Indian government has taken preventive and curative health as a top priority and has introduced much-desired schemes to address these issues. In a research paper published by the author (https://epistemia.org/index.php/jhsr/article/view/2), some of these schemes, including Ayushman Bharat, Pradhan Mantri Matru Vandana Yojana (PMMVY), and the Accredited Social Health Activist (ASHA) programme have been analysed in depth. While these initiatives reflect the government's commitment to improving healthcare, systemic challenges such as awareness gaps and constrained resources continue to hinder their desired outcomes.

Ayushman Bharat: ensuring affordable healthcare
Ayushman Bharat, A flagship healthcare initiative by the Indian government, aimed at ensuring healthcare access for millions of poor families, has two main components: establishing 150,000 Health and Wellness Centers (HWCs) across the country and providing health insurance coverage through the Pradhan Mantri Jan Arogya Yojana (PM-JAY).

The HWCs initiative seeks to bring primary healthcare closer to people by upgrading existing facilities like Sub-Centres (SCs) and Primary Health Centres (PHCs) to Health and Wellness Centers. In order to help millions of people close the healthcare gap, these clinics are designed to provide necessary medications and services.

The Ayushman Bharat PM-JAY, the world’s largest government-funded healthcare program, aims to provide free treatment up to Rs 5 lakh per family per year, for secondary and tertiary hospital services, covering over 10 crore poor families and expanded to support senior citizens.

The ASHA Programme: adopting a grassroot approach
The other pillar of India's public health system is the Accredited Social Health Activist (ASHA) programme. ASHA workers are community-based health volunteers who play a vital role in bridging the gap between rural people and the medical community. In order to improve mother and child health outcomes, ASHA workers—who are usually community-dwelling women—serve as healthcare facilitators by providing first-contact services like child healthcare, maternal care, and health education.

Research has shown that ASHA employees greatly enhance healthcare results. Pregnant women who interact with ASHA workers, for example, have a 17% higher likelihood of giving birth in a medical facility.

Pradhan Mantri Matru Vandana Yojana: Addressing Maternal Health
Another program to enhance maternal health is the Pradhan Mantri Matru Vandana Yojana (PMMVY), which provides monetary rewards of ₹5000/- to expectant and nursing mothers, guaranteeing that they obtain adequate nourishment and medical attention both during and after their pregnancies. By providing women with financial assistance to take time off during and after pregnancy, the program improves the health of expectant mothers and their unborn children. With the high rate of malnutrition among women, particularly in rural regions, the PMMVY is essential for addressing health issues pertaining to maternal health.

Implementation Gaps
India's public healthcare efforts, such as Ayushman Bharat, PMMVY, and the ASHA program, reflect the government's commitment towards improving healthcare access for its inhabitants. While these programs have made tremendous progress in expanding healthcare coverage, they continue to face challenges with implementation, such as fraudulent claims and personnel shortages.

PMVVY also faces issues like lack of awareness amongst the eligible women beneficiaries and delayed disbursement of monetary payments due to lack of enrolment in direct benefits systems. Furthermore, some contend that the financial support offered by PMMVY is insufficient to pay for all of the expenses associated with providing maternity care.

ASHA workers are highly engaged in their communities, but they lack updated skills and training and are frequently underpaid, only getting paid for work that is directly tied to hospital visits and the intangible aspects of their efforts and engagement goes unappreciated.

Addressing these concerns would call for ongoing efforts at the policy and implementation levels. The success of these programs depends on strengthening public health infrastructure, enhancing healthcare delivery in rural regions, and ensuring that payments are disbursed on time. Collaboration among the government, NGOs, and communities will be critical in overcoming these challenges and fulfilling the aim of universal healthcare for all Indians.