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Opinion: Heath tourism flourishes but Indian healthcare in bad shape

Some 30 children died within 48 hours of each other at the BRD Medical College Hospital in Gorakhpur on August 10 and 11. Photograph:( Reuters )

New Delhi, Delhi, India Jan 19, 2018, 07.32 AM (IST) Arshita Malhotra

More than 70 years have passed since India's independence. However, the world’s largest democracy is still far from its goals of providing accessible and affordable healthcare to its population. Moving between smart cities and a digitally equipped nation, one sector, which the government seems to have turned a blind eye to, is healthcare.


Most glaring example of the terrible condition of healthcare in India came late last year in August. Nestled in a remote corner, the tragedy in the town of Gorakhpur serves as a blot on India’s rich progressive fabric of 70. Over a span of five days, over 60 young children died in the local government-run hospital in Gorakhpur, dozens of them on a particular night. As oxygen supplies ran out, bills remain unpaid and authorities passed the buck – a pitiful state of one of the essential commodities of life glared in every Indian’s eyes. The government should study the lessons of Thailand’s rollout, in the early part of this century, of universal healthcare. Thailand spends 4.4% of its GDP on health, compared to 4.1% in India (when private spending is included) and has far better outcomes.


The Indian healthcare system is plagued with numerous problems and is in a dilapidated state. India spends less than 1.2%GDP and as per World Bank estimates, the per capita healthcare expenditure in India is around USD 60. 


Additionally, unequal distribution of limited health facilities poses a larger problem at hand. Though a majority of India’s population lives in rural areas (72% or 716 Million), 75% of the health infrastructure in India is concentrated in urban areas where only 28% of India’s population lives. To put the deplorable state in perspective – 60% of health expenditure is out of pocket; 21% of the global disease burden is represented by India and around 85% of the healthcare needs can be managed at the primary level.


Let’s look at the last statistic in close detail now. A cost you can afford, a distance you can travel and the dignity you deserve – three ingredients of all that the people in India, especially the poor want out of the healthcare system. Since 85% of the needs can be managed at the primary level, it’s important to strengthen effectiveness, reach and quality of such healthcare. 


From the evidence across the world, it appears that the countries that have a strong primary health care system have better health outcomes, lower inequalities in these outcomes, and lower costs of care. So what is the issue? Currently, primary health care services in India are located too far from the populations they serve, provide too little services, and have too little resources. Adding to this, the problem of healthcare professionals, adequate investment, population coverage and certifications make the entire primary healthcare system riddled with problems.


However, we saw this as an opportunity.


We at Enactus SRCC, decided to work at the primary level in the healthcare sector to bring about a turnaround in healthcare delivery and ensure last-mile connectivity for every Indian. Focusing on affordability and accessibility as two cornerstones of our health intervention, we aim to leverage existing communities and healthcare providers to revolutionize the healthcare system. 


We understand the pivotal role that communities play, and so, develop medical entrepreneurs to disburse health-related services and information at a community level. “Our community health workers are the most integral part of our model. They’re the real health change agents in the communities we work in. Through constant engagement, we believe our health workers can drive the idea of the importance of healthcare to each and every household”, said Rutwik Shah. Our aim is to improve the health-seeking behaviour of consumers and bring about a behavioral change in the mindset of people towards health.


As economist Amartya Sen has pointed out, no country can become rich—or even middle-class—with an unhealthy workforce. Now is the time to act, and to change.  


(Disclaimer: The opinions expressed above are the personal views of the author and do not reflect the views of ZMCL)