Healthcare in India: Challenges and Innovative Solutions

Healthcare in India: Challenges and Innovative Solutions

Reenu Kumari (MIET, India)
DOI: 10.4018/978-1-7998-3576-9.ch010

Abstract

India facing some complex challenges in healthcare sectors like adaptation of hi tech (digital health), financing, approachability, and adaptability. Therefore, this chapter explores an overview of health and healthcare, source of financing in Indian healthcare, challenges and innovative solutions for the problems. This chapter also discussed the healthcare industry (global and India perspective) and found that total healthcare industry size will be increased US$ 160 Billion (2017) and US$ 372 billion (2022). Health financing is by a number of sources: (1) the tax-based public sector that comprises local, state, and central governments, in addition to numerous autonomous public sector bodies and the private sector. There are major challenges in Indian healthcare: population, non-commutation disease, new technology, inaccessibility to primary healthcare, and medical education. This chapter concluded by providing appropriate knowledge to the multidisciplinary groups such as researchers, policymakers, administrators, and politician.
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Introduction

Concept of Health and Healthcare

Health sector has a play vital role in Indian economy because contribution of healthcare in Indian GDP is 4.2% in 2012. At the time of independence Indian ministries developed one more ministry, which was known as the Ministry of Health. Basically, this ministry gives priority to health area and they have tried to consider healthcare in five year plans, each of which determinants state spending priorities for the coming five years. In 1983, Parliament countersigned to The National Health Policy and this policy was aimed global healthcare coverage 2000, and this program was renewed in 2002. On the basis of “World Health Organization (WHO, 1999)” global health report India spends on health only 20% of that of China’s. Healthcare sector has many social impacts. Among these the healthcare sector drives directly the GDP growth, because a strong and efficient healthcare system will augment GDP growth via an employment, productivity, export and entrepreneurship. Better healthcare in India will be possible when healthcare system becomes strong. The health-care system in India currently is multi-layered and complex, which makes it difficult to understand its true potential and appropriate quality of services. In India healthcare system is very approachable, but there remains many differences in quality of healthcare system between rural and urban areas. Most of the private hospitals are located in urban areas while public hospitals predominantly exist in rural areas. This is the main reason behind the unequal access to healthcare system in India. Private hospitals try to maintain their reputation in market through providing low cost medicine and high quality of services. On the other hand, the public hospitals provide low cost medicine, but are often short of basic hygiene and cleanness as well as such basic facilities and services as servant services, compounders, qualified doctors, appropriate infrastructure and equipment. Furthermore, a large number of private hospitals are not able to provide modern healthcare, because they are not fully aware and trained in modern medicine and, instead, rely heavily on traditional medicine and such practices as the ayurveda, siddha, unani and homœopathy.

According to FICCI, (2015) A robust healthcare system drives GDP growth in the presence of adequate investments and a conducive environment by not only acting as a productivity and employment generator, but also as a magnet to attract foreign exchange earnings and provide opportunities for innovation and entrepreneurship. Atun et.al, (2007 a) explored how policies help to access new medical technologies (like machines) and manage healthcare costs. Government polices tend to seek reductions in pharmaceutical budgets without having detrimental effects on health system.

Srinivisan (2012) mentions that positive scenario of Indian health system is largely premised on an average 8% rate of economic growth. Srinivisan further explained three sets of consequences of present shortcomings, the fist of which was related to low investment in water saving measures and low priority given to basic public health in terms of ignoring the role of personal hygiene as the basis of good health. Second consequences were related to inadequate levels of funding dedicated to facilities as public expenditures remain a sensitive issue. Lastly, third set of consequences is related to the availability of medicines. On the basis of the WHO report, Indian healthcare industry is not free from all kinds of challenges and presence of diseases (physical as well as mental ones). There are various indicators of health such as life expectancy at birth; the percentage of children being underweight; infant mortality rates (IMRs); the percentage of women with body mass index (BMI) below 18.5; quality-adjusted life years (QALYs); and disability-adjusted life years (DALYs). Similarly, in empirical studies (Kumari and Sharma, 2018; Woodward, 1992; Cheng and Kwan, 2000; Bouoiyour, 2007; Alsan et al. 2006; Kurtishi-Kastrati et al. 2016) health of population is measured by different indicators such as the Life expectancy rate; the Gender parity index (GPI) and the School enrollment rate, but here we have considered healthcare only, but it is important to remember that issues of health are closely related to other social issues and, therefore, it is important to pay attention to a broad range of indicators.

Balarajan, (2015) tried to find out how to best improve in healthcare and also make progress with equality in terms of both geography and socioeconomic status. He mentioned key challenges for achievement equity being especially in service provision, equity in financing and financial risk protection in India. These challenges included inequality with resource allocation, accessibility of high quality health services and high expenditure related to health equipment. Duggal and Gangolli (2014) discussed healthcare as a main factor, which affects the status of whole Indian population. If healthcare is not provided in an appropriate manner, it will have unsatisfactory consequences for the health whole population. NHA report “2004-2005” identified the financing of healthcare as being the most critical determinant of healthcare system in contemporary India. Problems with financing can push the whole population to danger zone. On the account of this type of situation health system in India needs quick improvement especially in decision-making related to health policy. India needs to adopt new strategies that will ensure the protection of health of all individuals. Similarly, Kumar et, al. (2011) mentioned that due to health financing problem in India there is marked health inequity, unequal accessibility to proper equipment and poor quality in terms of hospital services. In rural areas expenses of private hospitals are out of pocket and, on the other hand, in urban areas people can better afford such services. Moreover, rural citizens are not even aware about facilities and different types of medical insurances. So, every year government of India has tried to increase the amount of money allocated to healthcare (expenditure on healthcare) but these policies are not implemented in systematic and effective enough way. If the government increases public expenditure (including health) it should also be able to contribute to batter quality in the public and private healthcare sector. The healthcare also includes many other aspects such as the clinical trials, medical devices, telemedicine, health insurance, medical tourism and medical equipment. The Indian government faces a real challenge in bringing quality and good governance to all areas of public health.

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