Roadmap to improve Health System

Roadmap to improve Health System

Public Health and hospitals being a State subject, the primary responsibility of provision of public healthcare and strengthening it to address the shortage of hospitals and doctors lies with the respective State/ UT Government. However, under National Health Mission (NHM), technical and financial support is provided to States/UTs for strengthening their healthcare systems on the basis of proposals received from States/ UTs in their Programme Implementation Plans (PIPs).

Also, shortage of doctors in public health facilities varies from State to State depending upon their policies and context. However, as per the Rural Health Statistics (RHS) 2017-18, the state-wise details of shortfall of public healthcare facilities viz, Sub Health Centres (SHCs), Primary Health Centres (PHCs) & Community Health Centres (CHCs).

As per information provided by Medical Council of India (MCI), there are a total 11,59,309 allopathic doctors registered with the Medical Council of India as on 31st March, 2019. Assuming 80% availability, it is estimated that around 9.27 lakh doctors may be actually available for active service. It gives a doctor-population ratio of 1:1456 as per current population estimate of 1.35 billion, which is lower than the WHO norm of 1:1000.

Besides, there are 7.88 lakh Ayurveda, Unani and Homeopathy (AUH) doctors in the country. Assuming 80% availability, it is estimated that around 6.30 lakh Ayurveda, Unani and Homeopathy (AUH) doctors may be actually available for service and considered together with allopathic doctors, it gives a doctor population ratio of 1:867.

NITI Aayog has released the report on “Health Systems for a New India: Building Blocks – Potential Pathways to Reforms”. The report consolidates global findings on key health system themes of financing and provisioning with a focus on risk pooling, strategic purchasing, and health service provisioning and digital health. With insights to transform the Indian health system in the 21st Century, the report presents a preliminary menu of strategic choices available before India to reform its healthcare system. The detailed report is available in public domain at https://niti.gov.in/node/916.

Under NHM, financial support is provided to public healthcare facilities in primary and secondary health sector in the States/ UTs to provide majority of services free of cost to all those visiting the facilities including middle class. Further, Ayushman Bharat, Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) scheme provides health coverage up to Rs. 5.00 lakh per family per year to around 10.74 crore poor and vulnerable families as per Socio Economic Caste Census (SECC).

National Health Policy, 2017 outlines the priorities and targets along with time frames to achieve it in healthcare systems. The detailed NHP, 2017 is available in public domain at https://www.nhp.gov.in//NHPfiles/national_health_policy_2017.pdf.

The Minister of State (Health and Family Welfare), Sh Ashwini Kumar Choubey stated this in a written reply in the Lok Sabha