Making of a healthier India: Care delivery, technology & innovations to eliminate health inequalities

World Health Day 2021 provides an opportunity to all for expressing gratitude to health professionals who worked relentlessly to save the lives of coronavirus patients. The pandemic has pushed a large number of people into poverty and amplified health inequalities.

Inequality in health delivery in India is a major concern that needs the serious attention of all stakeholders. This has pushed India, facing the characteristic parallel dual burden of communicable and non-communicable diseases (NCDs), backwards in terms of accessibility and affordability. 

The surge of NCDs such as heart ailments, hypertension, diabetes and stress along with old age infections, and malnutrition have become conspicuous by this change. The emergence of COVID-19, Dengue, and Swine flu has further enhanced the burden of diseases. 
While policymakers say that health is a priority but that is yet to reflected strongly in their funding pattern. Currently, the private sector has been spending more than double compared to the government funding. High out of pocket expenses (nearly 65 per cent) indicates its potential to push a large number of people into poverty. Hence eliminating health equalities remain a dream for the country.

“COVID-19 has made us realize the need to achieve Universal Health Coverage, sooner than later. We have realized there are big gaps in making healthcare available, accessible and affordable. The public sector is always the first line of defence in tackling pandemic like COVID-19. Unfortunately, the public sector health system lacks adequate resources for critical care including ICU beds and manpower, where the private sector has the edge. Government hospitals need to adopt the best hospital management practices from the private sector. Private hospitals similarly need to optimize their cost structure in a bid to eliminate health inequalities. It is therefore required that public and private sectors develop working synergy by which the Indian health system can dramatically improve. There are more than 3000- private hospitals with a bed size of 100+ having adequate tertiary care infrastructure. Then there are 25000 hospitals having bed size between 30-100 and another 40,000 smaller hospitals with a bed strength of less than 30. If the Centre and state governments rope in these providers, India can easily build up its capacity to deal with both NCDs and Communicable diseases including COVID-19,” says Dr Girdhar Gyani, Director General, Association of Healthcare Providers-India (AHPI)
 
“We need to bring in affordability of government hospitals and the best practices of private providers together to eliminate inequalities for a healthier India. The current national agenda calls for an immediate focus on the rural health delivery systems including tribal and inaccessible areas, which constitute nearly 60% of the population hitherto deprived of the advancements in health and disease management and this can come by quickly establishing health & wellness centres as envisaged under Ayushman Bharat,” says Dr Alexander Thomas, National President AHPI.”

For a healthier India, technology can be a game-changer. India recently launched Integrated Health Information Platform (IHIP), the revised next-generation Integrated Disease Surveillance Programme (IDSP) digital platform which is the world's biggest online disease surveillance platform. Earlier Aarogya Setu and COWIN Apps have proved India’s capabilities in digital health.  

A recent McKinsey report projected that by 2025, 50 million households will be doing virtual consults under a subscription model. It will dramatically impact the current healthcare delivery systems.  

Rajneesh Bhandari, Founder, NeuroEquilibrium points out that Telehealth is disrupting hospital OPDs. In the US, telemedicine is up from less than 1% of total OPD consults to more than 50%, with over 1 billion telehealth interactions in 2020. In India, the number may be even higher. 

“Innovations would be the force multiplier to solve both problems of accessibility and affordability. The marginal cost of providing super-speciality services can reduce dramatically,” he adds. 

“Inequality has to be removed for a fairer world for everyone and all stakeholders need to work collectively to achieve this goal. A robust care delivery system supported by technology and innovations can help in creating a new healthcare economy wherein accessibility, affordability, awareness, and quality would be the main components,” emphasizes Dr Archana Dawan Bajaj, Nurture.