Health is a primary factor that reflects the quality of human life. It is a basic need along with food, shelter and education. Healthcare has become one of India’s largest sectors, both in terms of revenue and employment. Healthcare infrastructure includes hospitals, medical devices, clinical trials, outsourcing, telemedicine, medical tourism, health insurance, medical educational institutes and medical equipment. The Indian healthcare sector is growing at a steady yet slow pace due the increasing number of services and expenditure by public and private investors.
The overall health of the population impacts the economic development of a country in three principal ways. increasing the number of man-hours of work available, increasing the quality of productivity of the existing workforce, and changing the attitudes towards innovations and entrepreneurship. Although health is considered a fundamental human right according to the Alma Ata Declaration (1978), expenditure on health in India is often lower than expected and the condition of health infrastructure in the country is comparably inadequate.
In the United Nations Development Programme’s (UNDP) Global Human Development Report 2020, India ranks at 131 among the countries with medium human development out of 177 countries of the world. Though there has been an increase in health care infrastructure available, progress is not satisfactory, as there is a shortage of health centers and infrastructure to the existing population norm.
Following are some of the reasons for the poor growth of health infrastructure in India.
- Inadequate financial resource: The scarcity of financial resources because of poor allocations has often proved to be a major obstacle in the execution of health programmes. The state health sector only partially serves the needs of rural and urban poor in the informal sector. So lack of adequate finance has become the strong reason for the under development of the infrastructural facilities.
- Inadequate buildings: Health sector also faces the problem of shortage of buildings for health centers. Many health centers are functioning in buildings whether government or rented which have limited available space. Residential accommodation is insufficient in remote rural areas, which acts as a deterrent in motivating medical officers to work in such areas.
- Inadequate physical infrastructures: Health facilities in India face many operational difficulties. These include inadequate funding for drugs supplies, diagnostic facilities, laboratory equipment, urinals, latrines, bathrooms, ambulances, phone, fax etc. Lack of adequate hospitals and clinical persons is another problem.
- Absence of effective personnel and materials planning: In most of the hospitals there is no personnel planning resulting in the under utilization of resources. The hospital authorities must ensure that the existing staff in the various departments are to be consistent with the workload and the prescribed norms. Periodic studies of the functioning of hospitals are needed to enable the administrators to manage them effectively.
- Imbalance between the rural and urban areas: There has been an imbalance in the availability of medical facilities and health manpower in rural areas and urban areas. The National Health Policy (NHP) 1983 envisaged a three-tier structure of primary, secondary and tertiary healthcare facilities to bring the services within the reach of the rural population. In spite of the three-tier system of rural health infrastructure the condition of rural health infrastructure has been deplorable. There is even a lack of telemedicine resources in the rural areas.
Improvements so far:
- Considering that the private sector is the major player in healthcare service delivery, there have been many programs aiming to harness private expertise to provide public healthcare services. The latest is the new nationwide scheme proposed which accredits private providers to deliver services reimbursable by the Government.
- During the pandemic, governments and institutions have been recruiting medical graduates and final year students to take care of the shortage of healthcare professionals to treat patients. State governments and respective authorities have allocated funds and manpower to various centers across the country in order to address the imbalance.
- The emergence of various telemedicine and telehealth platforms have helped with the accessibility of services not only within India but also worldwide. Telemedicine has opened up an array of various new and innovative solutions through telerobots and telesurgery.
- Committed and reputed NGOs have come up which helps with funding and availability of drugs for various and rare diseases to those who are unable to access or afford them. These organizations have reach to remote and rural areas in order to spread awareness and increase availability of various services in such areas.
The infrastructure and manpower aimed at providing healthcare to the population has grown by leaps and bounds throughout the decades in India. Several programmes for healthcare are evolved and implemented both at national and state level. However, there is still a prominent imbalance which was very evident during the pandemic. Health policy and strategies of its implementation should be geared towards strengthening the state-run health infrastructure by increased allocation of funds and community involvement to ensure an efficient and effective healthcare system.