Blogs

Resources » News » Analysis of Policy Gaps in the Health Infrastructure in India

Analysis of Policy Gaps in the Health Infrastructure in India

Health infrastructure in India is an important indicator for understanding the country’s health care policy and welfare mechanism. It signifies an investment priority with regards to the creation of health care facilities. India has one of the world’s largest populations, with widespread poverty becoming a serious problem in India. As because of the cumulative effect of poverty, population load, and climatic factors, they are severely susceptible to diseases.

Five components of health infrastructure in India can be broadly classified as:

  • skilled workforce;
  • integrated electronic information systems;
  • public health organizations,
  • resources
  • research

The government hospitals are facing a problem of lack of resources and healthcare infrastructure; there is an inadequate number of beds, rooms, and medicines.  On the part of the government, there is a lack of monitoring of the funds and resources devoted to improving the healthcare sector. The government must prepare a comprehensive strategy to deal with epidemics, including a universal vaccination policy (in affected areas), the establishment of special medical care centers, emergency response plans, and measures to improve inhabitation.

There is also a requirement for the improvement of healthcare facilities in rural areas. Generally, there are very few government hospitals, and even those are devoid of most medical facilities. Moreover, in the rural areas, most people are poor, and these areas are most prone to be affected by different types of epidemics as the people are unaware of the better hygiene practices and other disease preventive measures.

Problems Today in Healthcare Infrastructure in India

Problems Today in Healthcare Infrastructure in India

Insufficiency of Hospital Beds

There are serious problems commonly faced by the hospitals during the covid times, i.e., insufficient beds in the hospitals. India is a country with the largest population due to which the healthcare infrastructure does not meet the requirement as per the population. The average Population served per Government Hospital is 90,972, and the average population served per government hospital bed is 2,012, which is a serious concern.

Less Number of Healthcare Centres

The healthcare centers in India are very less in number in comparison to other countries around the world. The National Commission on Health has been recommended a sub-center for every 5,000 population, a Primary Health Centre for every 30,000 population, and a Community Health Centre for every 1,00,000 population. However, there is an increase in the number of temporary healthcare centers at the pandemic to provide better facilities.

Insufficient Number of Blood Banks

The total number of the licensed Blood Banks in the country is another serious problem. The States like North East India are severely low on Blood Banks’ availability as these states together have only 43-50 licensed Blood Banks. The rural regions of the country are also facing the same issue. These days, people use social media platforms and various campaigns to donate blood to provide those in need.

Other Significant Problems

Urgent Need for More Medical Colleges

In terms of Medical education infrastructures, the country has 314 medical colleges, 289 Colleges for BDS (Bachelor of Dental Surgery) courses, and 140 colleges that conduct MDS (Master of Dental Surgery) courses. Public hospitals and clinics are understaffed by 15-20 %. In several places, the nursing school was functioning more as appendages of the district hospitals. Nurses and midwives are not properly trained due to inadequate infrastructure.

Non-Availability of Urgently Needed Vaccines

The availability of life-saving vaccines is also not up to the mark, e.g., the gap between demand and supply is below 26%. Substandard drugs are also a concern for India. Poor enforcement of regulations is due to weak and inadequate drug control infrastructure at the State and Central levels. Only 17 of the 31 States and Union Territories have drug testing facilities. This is coupled with a lack of manpower for enforcement of the regulations. Health infrastructure in India is also inadequate in production for medical equipment because, according to an estimate, India imports about 65 % of its medical equipment.

Role of Government and Need for an Integrated Approach

As per the Constitution of India, health care delivery is in the hands of the States. In reality, States have struggled to maintain and administer health care facilities; they have become dependent on the Central Government for financial and programmatic assistance to implement health policies. There is a structural mismatch in the institutions at the Centre and State levels, with many departments and agencies duplicating work or working at cross-purposes, make governance in health ineffective, e.g., de-recognition of certain nurse training institutions by the Indian Nursing Council (INC) had no impact as they continue to function with the permission of the State Nursing Council.

The health programs mooted by the center do not necessarily address the people’s local and community problems. These programs concentrate on achieving policy objectives and ignore problems at the micro-level, which vary from place to place depending on geographic and other demographic factors. Thus they end up becoming ineffective and unsustainable.

Suggestions for Better Health Infrastructure

  1. Geocoding: It involves the introduction of data systems for monitoring health status. Such systems would allow entities at all levels to have a geographic information system capable of showing diseases portrayed through maps, risk of spread of diseases, environmental hazard, and service delivery.
  2. Health Policy budgets– It should include and integrate infrastructure plans. A mere request for infrastructure funding may face opposition because they are generic in nature and do not have the effect of directly addressing health problems that are overt in nature, such as prevention of the spread of infectious diseases, maternal and child health, etc.
  3. Reduce Urban Bias: Health facilities should be developed in the rural sector by public authorities, and private hospitals should provide incentives.
  4. Public Health Facilities: They have poor infrastructure as regards equipment used for medical tests (e.g., X-ray, blood tests, and other complicated tests). Such equipment which is mostly imported is very costly. The government can solve this problem by reducing or complete waiver of import duties and taxes. The equipment should be made available to the public at large by public-private cooperation and by encouraging indigenous production of such equipment by both public and private bodies at competitive prices.
  5. Medical Education Institutions: A substantial increase is needed in the number of medical education institutions, and the government should make provisions for a better quality of medical professionals to serve the masses.

According to the report, the three components of the basic public health infrastructure in India are:

Workforce Capacity and Competency: The expertise of the professionals who work in Federal, State, and local public health agencies to protect the public’s health.

Information and Data Systems: The up-to-date guidelines, recommendations, and health alerts and modern, standards-based information and communication systems that monitor disease and enable efficient communication among public and private health organizations, the media, and the public.

Organizational Capacity: The consortium of local and State public health departments and laboratories, working side-by-side with private partners, to provide the essential services of public health.”

Need to Strengthen Rural Health Infrastructure in India

The rural health infrastructure in India is in a very sad state of affairs. Although the government initiated the National Rural Health Mission Programme (NRHM) aims to bring qualitative and quantitative changes in the rural health infrastructure in India. However, the goal to provide universal access to healthcare facilities remains a distant dream in rural India. Under the NHRM, some steps have been taken to transform rural health infrastructure in India, and undoubtedly some changes have been ushered in.

At the ground level, it has been realized that the funds which have been created for the NHRM are hardly sufficient to meet its stated objectives, namely to provide affordable, equitable, and good quality healthcare service to the rural poor. Moreover, the central government must also focus on some non-medical expenditure issues, which are nevertheless related to citizens’ good health as making people aware of the hygienic practices, sanitation, cleanliness creation of infrastructure for safe availability of drinkable water for rural India.

Some Recommendations to Improve Healthcare Infrastructure

 Government Vaccination Policy

The government must provide universal vaccination to all the needy people. The government must not come under pressure from the international institutions and the developed world and must not give up the vaccination policy in favor of the private hands. There is a need for proper cold storage facilities to conserve the vaccines and to retain their effectiveness. Still, unfortunately, the government hospitals in rural areas lack sufficient cold storage facilities. Many times a large number of vaccines are spoiled during transportation or because of lack of adequate storage facilities. Therefore the government should provide adequate facilities to preserve the vaccines and further train the staff of government hospitals with regard to cold storage as the appropriate temperature.

Need for Special Medical Research Centres to Upgrade Health Infrastructure in India

There are very few medical centers or hospitals specializing in the matters of research about epidemics. Hence the government should establish new medical research centers and hospitals specializing in treating specific epidemic diseases and being devoted to research. These special medical research centers must be adequately equipped with the proper testing facilities and special drugs required to treat the epidemics. There must be coordination and corporation between different research centers and other medical institutions (including district-level hospitals). Moreover, in big hospitals, special departments must be created to deal with epidemic diseases.

The Need for a Comprehensive Emergency Epidemic Response Plan

If a quick policy response is provided in case of an epidemic outbreak, we can substantially reduce the number of causalities. An emergency epidemic response plan must be prepared, which can provide the government guidelines for quick action; it must include different aspects as risk assessment of epidemics, preventive measures to stop further spread of infection, a plan to provide an adequate number of staff, and medicines.

Improvement in Habitation Conditions

Most of the epidemics (including Dengue, Malaria, Cholera, Diarrhea, Arsenicosis, Encephalitis, etc.) spread because of lack of availability of safe water, sanitation, and other related issues. The living conditions in several rural areas and slum areas in cities are very poor, and once a disease has been spread out, it infects a large number of people in a very short time. The government must invest in improving the public’s access to safe drinking water, creating sanitation facilities, and improving the standards of living of the general public. It would reduce the incidence of epidemic spreads, and in turn, it would decrease the government’s expenditure on the treatment of different epidemics.

Hindrise is Supporting Health Infrastructure in India

The Hindrise has been at the forefront of responding to the rapidly escalating human need during the pandemic times by saving lives and helping them throughout this covid-19 situation. Hindrise has taken care of migrant workers, our contribution to them by providing food, water, and transport during the “difficult time” of the COVID-19 pandemic. Our volunteer has come forward to help the migrant workers to fight the pandemic and extend help by providing healthcare facilities to them. We are also indulging in the following roles, especially in the times of pandemic.

Distributing Mask and Sanitizers– We have been distributing medicines, masks, and sanitizers to the people for free. At the time of the pandemic, we are helping the poor and needy people by providing them medical awareness and aid.  We started manufacturing units for the sanitizers, and we have also installed the foot sanitizing machines in nearby regions of Delhi NCR.

Emergency Support– We have to tie up with the hospitals the providing emergency support for the people who are critical and in need of a hospital. We are extending our facility to take people to the hospitals without any delay who want immediate medical support.

Takeaway

The inadequate government health infrastructure in India costs high for the treatment at the private medical institutions. The Central Government should increase the share of healthcare expenditure from one percent of GDP to around three percent of GDP; the state governments should also increase their share of healthcare funds. To provide equitable access to healthcare services and continuously raise healthcare services standards must be the government’s twin goals.