Fortifying the Healthcare Ecosystem

02 Sep 2020

Covid 19 has brought about immeasurable changes in almost all aspects of our lives, as well as in the society, Governments and businesses; the first touchpoint being the healthcare ecosystem. The virus has proven that health, both at the individual and collective level is the real asset and putting in place a strong healthcare system is an absolute necessity for all countries across the globe. 

Countries such as Japan, Thailand, and Vietnam that have strong primary healthcare systems have effectively been able to tackle the crisis better than others. Closer home, states like Karnataka and Kerala have responded better to the pandemic, with a relatively better public healthcare ecosystem and a concerted strategy. 

Low Spending on the Healthcare System

It has been observed that India’s share of public expenditure on health as a percentage of the GDP is low. In 2016, the public spend on health was 1. 17 percent of the GDP.  

In 2019 – 20, the country’s total healthcare spend, including public and out-of-pocket expenses, stood between 5.6 percent – 6.2 percent. Within this, the out-of-pocket healthcare spend is quite high; about 65 percent of the healthcare expenses are borne privately by individuals (approximately 2.5 percent of the GDP). 

The Union Budget 2017 – 18 and the National Health Policy 2017 prioritized creation of a network of Health Sub-centres and Primary Health Centres. While these are now present across the country, they need to function optimally.  

The launch of the Pradhan Mantri Jan Arogya Yojana (PM-JAY) under the Ayushman Bharat initiative is a major step towards Universal Health Coverage. It aims to provide healthcare facilities to 10.74 crore families, with INR 5 lakh cover each year, for secondary and tertiary care. It will be implemented along with State Government schemes. 

Gaps in Public Health Delivery Systems

Lack of funding of public healthcare systems is a major challenge across the world, including India. Let us look some short term challenges: 

Management of vaccine cold chain supply (storage, supply and administration) – According to UNDP India, there are challenges to immunisation, which is compounded by inconsistent vaccine coverage, which differs on the basis of individual, family coverage, demography and social coverage. 
Strong digital infrastructure needs to be built to support an effective healthcare system. 
Standardised medical equipment for proper diagnosis, treatment and care needs to be made available.
Proper training of community health workers for conducting Covid tests is required.
Issues related to human resources in healthcare should be addressed and a strong pool of human resource needs to be created. 

The long term challenges could be summed up as below. 

Covid has had an overwhelming impact on the primary health system. There is an urgent need to upscale budgetary allocation for healthcare, to at least 70 percent. 
Cleaning supplies for Infection, Prevention and Control (IPC) to avoid hospital infections must be provided in adequate amount. 
Disruptions caused in health and nutrition services and supplies due to manpower shortages can be taken up through stronger food supply systems. 
Infrastructure of the Public Health Centres needs to be upgraded. 

A stronger collaborative approach between the Government and the private sector can help to fortify the overall healthcare ecosystem. The Ministry of Health and Family Welfare and the State Governments play a crucial role in guiding India’s public health system. There is larger scope for the private sector to fill in critical gaps to strengthen the public healthcare system, which will help India to put up a strong fight against Covid or diseases like tuberculosis, etc. 

The vision document on Strengthening Public Heath Delivery – Role of Multiple Stakeholders prepared by CII looks into the pressing issues in public healthcare delivery in India and touches upon areas which include: What strategies corporates can adopt for effective collaboration with the public sector; how the collaboration can be facilitated; and why is it needed to be done effectively.