(GIST OF KURUKSHETRA) Augmenting Rural Healthcare Infrastructure

[July-2021]

Context:

The current global pandemic of COVID-19 necessitates a public health strategy with more emphasis on epidemiology, especially with regards to understanding the causes as well as identifying appropriate population-based behavioural and educational programmes.
It is important to realise that the pandemic had initially started in well-developed countries. However, the virus does not differentiate between rich-poor or rural urban dichotomies. It is particularly a threat to a country like India, where 68-70 percent of the population lives in rural areas that also has the highest overall burden of disease globally.
India’s public health expenditure has increased from 0.9 percent of GDP in 2015-16 to 1.1 percent of GDP in 2020-21.
The National Health Policy, 2017 aims to increase public health expenditure to 2.5 percent of
the GDP by 2025.

Pradhan Mantri Jan Arogya Yojana (PMJAY):

The Ayushman Bharat programme – PMJAY was launched in September 2018-19. It aims to provide an insurance cover of Rs. Five lakh per family per year to 10.7 crore poor families. The scheme subsumed two centrally sponsored schemes, namely, Rashtriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme.

Benefits:

The scheme provides insurance coverage for secondary and tertiary healthcare.
The scheme provides 1,350 medical packages such as surgery, cost of medicines, day care treatments, and diagnostics. In addition, the scheme provides for pre- and post-hospitalisation expenses.

Allocation:

In 2021-22, PMJAY has been allocated Rs 6,400 crore, which is double the actual spend two years ago (Rs 3,200 crore in 2019-20).

Pradhan Mantri Swasthya Suraksha Yojana:

Pradhan Mantri Swasthya Suraksha Yojana (PMSSY) was introduced in 2003 with aim of:
Correcting regional imbalances in the availability of affordable and reliable tertiary healthcare service, and
Augmenting facilities for quality medical education in the country. This includes establishing AIIMS like institutions and upgrading certain state government hospitals. Over the years, the scheme has been expanded to cover 20 new AIIMS and 71state government hospitals.
The future of healthcare lies in our ability to provide access to quality healthcare to all. India’s healthcare policy must continue to focus on long term healthcare priorities despite the setback from the pandemic. Both demand and supply side constraints in the healthcare sector need to be addressed.
Effective handling of communicable disease by building adequately trained health emergency
response teams and setting up dedicated control rooms at district level.
Controlling rising non-communicable diseases prevalent in India, partially through awareness
campaigns on healthy lifestyle.
Strengthening the primary healthcare facilities with adequate human resource and equipment.
Providing universal health coverage and extensive promotion and utilization of Ayushman Bharat’s PMJAY and health and wellness centres.
A standardised system for quality reporting on healthcare for hospitals, physicians and
insurance companies is a must to benchmark such services.
Last but not the least, to root out quacks from the system and tackle information asymmetry in the healthcare sector. Regulation and supervision of the healthcare sector needs to brought in with more vigour, such as an independent sectoral regulator.

Conclusion:

The impact of the pandemic, especially the lockdown strategy in the social sphere is multi-dimensional. India’s healthcare system has been improving with well-meaning policy reforms, however, there is substantial potential by making use of technological advances in order to improve health outcomes.
Increasing access and utilisation; bringing down high out-of-pocket health expenditure; dealing with inequity in availability of healthcare; increasing budget allocation for healthcare and human resource for health; will benefit in the long term. Both the supply and demand side factors of healthcare needs urgent attention. The supply side of the health sector in terms of physical infrastructure and human resource needs to be scaled up significantly.