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Meanwhile, rising population, inadequate resources and insurance are key roadblocks for India’s healthcare industry, according to a report from IndiaSpend, the country’s first data journalism initiative.
On the population front, the news is not very rosy either. India has the world’s second-largest population, rising from 760 million in 1985 to an estimated 1.3 billion in 2015. Migrants from rural areas continue to flock to urban settlements; roughly 32% of them inhabiting cities–although estimates of this migration vary–that are already bursting at the seams.
India’s existing infrastructure is just not enough to cater to the growing demand for affordable quality health care, say experts from IndiaSpend (http://www.indiaspend.com).
While the private sector dominates healthcare delivery across the country, a majority of the population living below the poverty line (BPL)–the ability to spend Rs 47 per day in urban areas, Rs 32 per day in rural areas–continues to rely on the under-financed and short-staffed public sector for its healthcare needs, as a result of which their healthcare needs remain unmet.
Moreover, the majority of healthcare professionals happen to be concentrated around urban areas where consumers have higher paying power, leaving rural areas underserved.
India meets the global average in number of physicians, but 74% of India’s doctors cater to a third of the urban population, or no more than 442 million people, according to a KPMG report.
India compares unfavourably with China and the US in number of hospital beds and nurses. The country is 81% short of specialists at rural community health centres (CHCs), and the private sector accounts for 63% of hospital beds, according to Indian government health and family welfare statistics.
The rural healthcare infrastructure is three-tiered and includes a sub-center, primary health center (PHC) and CHC. Indian PHCs are short of more than 3,000 doctors, with the shortage up by 200% over the last 10 years to 27,421, as reported in 2016.
There are, however, potential catalysts to improve the quality of healthcare in India. IndiaSpend has identified three: The government, information technology and innovation
The Union Budget 2017–18 includes measures to boost rural development, infrastructure and macroeconomic stability, and although the health budget has been increased 27%, allocations could have been matched more holistically with the government’s ambitions, particularly when considering adjustment against inflation and new health-program announcements.
Analysts argue that the national insurance scheme (the Rashtriya Swasthya Suraksha Yojana) is a minor improvement on the existing one, with the annual limit per family increased from Rs 30,000 to Rs 100,000, with an additional “top-up” of Rs 30,000 for senior citizens. IndiaSpend estimates suggest that enrolling all BPL families in the country in health-insurance programmes would cost anywhere from Rs 2,460 to Rs 3,350 crore, or less than the cost of two French Rafale fighters.
Information Technology (IT) is set to play a big role with IT applications being used for social- sector schemes on a large scale. Beneficiaries are issued a biometric-enabled smart card containing their fingerprints and photographs. Hospitals empaneled under the government insurance scheme are IT enabled and connected to servers in districts. Beneficiaries can use a smart card that allows them to access health services in any empaneled hospital across India.
Additionally, the ministry of health and family welfare launched several new computer and mobile-phone based e-health and m-health initiatives on World Health Day in 2016. These include the Swastha Bharat mobile application for information on diseases, symptoms, treatment, health alerts and tips; ANMOL-ANM online tablet application for health workers, e-RaktKosh (a blood-bank management information system) and India Fights Dengue.
Individual states are adopting technology to support health-insurance schemes. For instance, Remedinet Technology (India’s first completely electronic cashless health insurance claims processing network) has been signed on as the technology partner for the Karnataka Government’s recently announced cashless health insurance schemes, according to IndiaSpend.
India added 450 million people over the 25 years to 2016, a period during which the proportion of people living in poverty fell by half. This period of rising prosperity has been marked by a “dual-disease burden”, a continuing rise in communicable diseases and a spurt in non-communicable or “lifestyle” diseases, which accounted for half of all deaths in 2015, from 42% in 2001-03.
The result of this disease burden on a growing and ageing population, economic development and increasing health awareness is a healthcare industry that has grown to $81.3 billion (Rs 54,086 lakh crore) in 2013 and is now projected to grow by 17% (compounded annual growth rate, or CAGR) by 2020, up from 11% in 1990, IndiaSpend added.
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- B. John Bosco
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