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Health System in India: Bridging the Gap between Current Performance and Potential

Health System in India: Bridging the Gap between Current Performance and Potential
Start Date :
Apr 23, 2015
Last Date :
Jun 09, 2015
12:45 PM IST (GMT +5.30 Hrs)
Submission Closed

This discussion is now closed. To view the summation of content from this discussion visit our Blog. The topic has now been furthered into nine new discussions along the pillars of ...

This discussion is now closed. To view the summation of content from this discussion visit our Blog. The topic has now been furthered into nine new discussions along the pillars of health systems strengthening. You are invited to contribute actively to these discussions.

Health Information Systems
Human Resources for Health
Availability of drugs, vaccines and other consumables
Public Health
Service Delivery in Health
Using Available Financial Resources in Health as a Tool for Efficiency
Stewardship and Governance in Health
Regulation of Drugs, Food and Medical Practice
Increasing Financial Resources for Health

India has made remarkable achievements in areas like Polio elimination, lowering fertility and disease control. However, our progress in health outcomes has been slower in comparison to other countries with comparable incomes and at similar stages of development. Impressive gains in per capita income should match with increase in life expectancy or health status. We now face a triple burden of disease. Out of pocket expenditures in India is high (70 percent of total health expenditure). This is catastrophic for the poor and pushes an estimated 37 million into poverty every year.

Health is a subject allotted to the State List, under the Seventh Schedule of the Indian Constitution. The Central Government is jointly responsible for items in the Concurrent List.We have one of the most expansive publicly provided networks of health facilities yet issues of regional disparity, access and quality remain. The private sector despite being utilized by the majority of the population also has issues of quality and cost.

Even though the Union Budget allocation for the Ministry of Health and Family Welfare in 2015-16 has remained at the level of revised expenditure in 2014-15, an opportunity lies in encouraging States to spend more on the social sector with greater devolution of untied funds following the recommendations of the Fourteenth Finance Commission.

India is brimming with possibilities. Successful conduct of election, Census survey, projects in space and atomic sciences are some examples. India is termed as the “pharmacy of the global south”, providing affordable, life saving generic medicines to developed and developing countries. In the same way, there is potential for our health system to deliver optimal outcomes to the population.

The Twelfth Plan charts the path towards strengthening health systems so as to reach the long term objective of Universal Health Coverage (UHC). It is our belief that a Health System Strengthening approach is the solution to bridging the gap between our current status and potential performance. The Health Division of the NITI Aayog invites you to an open and informed discussion to elicit ideas for overcoming the enormous challenges in the sector with limited funds at hand and guide future action at all levels, in our system. Your opinion is important and valued.

Detailed note on the current status of health system in India

We invite your responses on these two questions:

1. How can we maximize health returns from available resources?
2. How can we increase investments in health?

This discussion is open for the next two weeks after which we will post a summary of the ideas generated on the forum. We will also follow-up with a more detailed note on the issues in health system and learning from best practices in the country as well as globally for further discussion. Informed briefs on the above mentioned questions will also be made available after the initial two weeks for more a targeted dialogue.

Comments made by our Division will appear as “NITIHealth”.

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Showing 585 Submission(s)
Dr Swapan  Kumar Banerjee
Dr Swapan Kumar Banerjee 11 years 2 months ago
Doctors, researchers and social workers can stretch the health service to the poorest, but we must understand that if 1 crore is added to the existing 125, new facilities can't match the teeming millions. So an EFFECTIVE POPULATION IS THE KEY TO EVERY PLAN/PROGRAM.
SUCHITRA RAGHAVACHARI
SUCHITRA RAGHAVACHARI 11 years 2 months ago
Sir, given the Prime Minister's thrust on "Make in India", potential for manufacturing medical equipment is immense. Government should establish health parks in all states / regions along with R & D centers. At present most of the amount spent on orthopedic prosthesis, angiographic catheters & coronary stents, Ureteroscpic / bronchoscopic / arthroscopic & endoscopic equipment, imaging technology, laboratory disposables, monitors, can be reduced if they are made in India, more value for money.
SUCHITRA RAGHAVACHARI
SUCHITRA RAGHAVACHARI 11 years 2 months ago
Sir, health insurance & a defensive practise of medicine has become the norm in most urban centres. However, even here there is no systematic criteria, many unnecessary tests are performed & over enthusiastic prescriptions are made. All hospitals should be brought under a hospital board with yearly audit of medical practise. All hospitals should conduct monthly audit to improve their functioning. RTI for hospitals is not the cure, possibility for misuse is rather high & should'nt be allowed.
SUCHITRA RAGHAVACHARI
SUCHITRA RAGHAVACHARI 11 years 2 months ago
Sir, another contentious area in healthcare is pharmaceuticals. We as a nation prescribe named / branded medicines & not the generic version. The government must insist on prescriptions bearing only generic terms & minimise the over reach of pharmaceutical companies in inducing at least some doctors / pharmacies to prescribe / stock their brand. Patient's should be able to purchase medicines with the health data card from any recognised pharmacy. The drug enforcement agency needs strengthening.
SUCHITRA RAGHAVACHARI
SUCHITRA RAGHAVACHARI 11 years 2 months ago
Sir, every citizen should have access to basic healthcare. Hence, the Aadhar card should be tagged with a digital health smartcard so as to enable better access across the nation, especially for migrants & for follow up. This smart card should be aligned with possible insurance coverage & health records that can be accessed by treating centres across India. It will also help the government to track the use of the cards to assess health care providers & to help people to the nearest centre.
SUCHITRA RAGHAVACHARI
SUCHITRA RAGHAVACHARI 11 years 2 months ago
Sir, para-medical courses - nursing / diagnostics / physiotherapy should be given adequate thrust in vocational education as the need for hospital staff is immense, both in India & abroad. However, there need to be a separate licensing board with All India syllabi, entrance & final exams so as to maintain rigorous quality standards. With increasing use of IT in healthcare, computer savvy personnel are required to operate equipment & for telemedicine, also a potential source for job generation.
SUCHITRA RAGHAVACHARI
SUCHITRA RAGHAVACHARI 11 years 2 months ago
Sir, medical & para-medical education needs change if more personnel are required. Courses have to be accredited and stream lined. Many fly by night operators run para-medical teaching institutions, resulting in inadequately qualified staff. Private medical colleges are here to stay, but, a uniform syllabus & common grading system & final exam are required to maintain quality of those passing out. Corporates who build & operate non-profit rural hospitals can be encouraged with tax exemptions.
SUCHITRA RAGHAVACHARI
SUCHITRA RAGHAVACHARI 11 years 2 months ago
Sir, health requires, physical, physiological & psychological well being. We need do devise a new plan to reach out to the multitudes that simply do not receive even reasonable medicare. The access to good medical aid is limited to probably the top 30% of society. Another 20% avails of some benefits, due to insurance. The rest have poor or inadequate access. To address this disparity, we need more medical personnel across the spectrum. The rural doctor to population ratio begs urgent attention.
SUCHITRA RAGHAVACHARI
SUCHITRA RAGHAVACHARI 11 years 2 months ago
Sir, for a nation aspiring for a seat at the high table, the reach of our medical resources is abysmal. The #HealthSysteminIndia which originally mirrored the British NHS has run into several problems, mainly because of our population, differences in rural & urban medicare, greater disparity across social strata, increasing proliferation of private medical centers. Also, despite having proven "Indian" medical systems, we do not sufficiently use them, nor is their sufficient quality control.