Transformation Over the Past Decade
- India has made major progress in healthcare over the past 11 years, driven by the National Health Mission, Ayushman Bharat, and Ayushman Arogya Mandirs (1.77 lakh+).
- Emphasis has shifted toward universal, digital, and equitable healthcare access, backed by the Ayushman Bharat Digital Mission (ABDM).
Current Healthcare Structure
- Primary Healthcare:
- First point of contact; focuses on prevention and health education.
- Delivered via Sub-Centres, PHCs, and HWCs under state/district governance.
- Secondary Healthcare:
- District hospitals and CHCs for more specialized care.
- Tertiary Healthcare:
- Specialized services via AIIMS, PGIMER, medical colleges.
- Managed by both Central and State Governments.
Key Healthcare Regulatory Bodies & Policies
- CDSCO, NMC, PCI, NABH, IRDAI regulate drugs, education, insurance, and hospital standards.
- Acts like Drugs and Cosmetics Act (1940), NMC Act (2019), National Health Policy (2017) provide a legal and policy framework.
- Recent reforms include e-pharmacy regulation, telemedicine guidelines, and ABDM.
Major Challenges in Indian Healthcare
- Rural-Urban Disparity: 80% of doctors in cities; 68% of population lives in rural areas.
- High Out-of-Pocket Expenditure (OOPE): Still ~47.1% in FY23.
- Inconsistent Quality of Care: Public sector overcrowded; substandard drugs recalled.
- NCD Burden Rising: 5.8 million deaths/year from NCDs; rising obesity and diabetes.
- Underutilization of Health Schemes: Low awareness, frauds in Ayushman Bharat as per CAG.
- Infrastructure Gaps: Many HWCs still lack doctors/equipment.
- Low Insurance Penetration: Insurance-to-GDP ratio dropped to 3.7% in 2023–24.
- Unregulated Private Sector: 70% patients prefer private care, often unaffordable.
Reform Measures & Way Forward
- Strengthen Primary Healthcare: Upgrade HWCs with staff and equipment.
- Boost Health Workforce: More CHOs, rural postings, and medical colleges.
- Expand Telemedicine: Leverage platforms like eSanjeevani to serve remote areas.
- Enhance PPPs: Encourage private sector in building and running healthcare facilities.
- Universal Insurance: Expand Ayushman Bharat to outpatient care and informal sectors.
- Focus on Preventive Care: Screenings, awareness campaigns, and school-based health programs.
- Raise Public Health Spending: Aim for 2.5% of GDP.
- Regulate Private Healthcare: Cap service charges, ensure transparency.
- Integrate Traditional Medicine: Include Ayurveda, Siddha with modern medicine.
- Promote Innovation: Support health-tech startups, AI diagnostics, wearable tech.
Global Lessons for India
- UK: Tax-funded Universal Healthcare.
- Brazil: Community-based Primary Care.
- Estonia: Nationwide Digital Health Records.
- Singapore: Effective Public-Private Partnerships.
- Japan: Preventive Health Focus and early screenings.
🎯 Conclusion
India’s healthcare transformation is underway—driven by digital health, structural reforms, and public-private collaborations. Aligning reforms with SDG 3 (Good Health and Well-being) and the Global Pandemic Treaty is crucial to building a resilient, inclusive, and equitable health system for 1.4+ billion citizens.
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