A new India under able and charismatic leadership, is aspiring to be a superpower across the spectrum. But in healthcare, its worse than third world countries.
An epidemic that has claimed lives of over 120 children while thousands of doctors are protesting across the country for more safety in a resourceless working environment – the problem is a third world focus on healthcare for the billions that make up India.
Hundreds of dying children, thousands of protesting doctors: India’s third world healthcare infrastructure
The Acute Encephalitis Syndrome (AEM) in Bihar’s Muzaffarpur is a problem that has been prevalent for over decades without able to arrive at a proper consensus.
The country’s research quality is so underdeveloped that it has been that even after four decades, we haven’t been able to identify reasons behind the fatal brain fever that kills hundreds.
On the other hand, the country witnessed wide-spread protests and stagnation of healthcare infrastructure in multiple states when mob violence in a West Bengal hospital left a doctor with a fractured skull.
Doctors from India’s apex medical institutes like AIIMS, and other hospitals from Mumbai, Delhi, Patna, Raipur, Rajasthan, and Punjab joined the protests demanding more security for the fraternity.
The cause was the death of a 75-year old patient which aggravated a 200-strong mob to allege medical negligence and pounce on the doctors and medical staff at the facility.
Tremendous goals but unflattering progress
India has set tremendous goals for itself in the healthcare sector but is still to meet the goals it set for 9 years ago.
The health expenditure in India at 1.2% is lower than in many low-income countries.
The poor expenditure on health by the Indian government is visible in the quality of infrastructure and availability of public healthcare services. Considering the sustainable development goal of Universal Health care, India is lagging behind by miles, even from its close neighbours like Sri Lanka which is at 1.6%, Bhutan at 2.5%, Thailand at 2.9% and the Maldives at a staggering 9.6%.
The serious dearth of infrastructure
The 2017-18 health index by NITI Ayog shows a variety of health outcomes including available resources, infant mortality rate and infrastructure facilities. Mizoram has the highest per capita expenditure among all the states at Rs. 5,862 per capita, five times the India average while states like Bihar and UP lag behind at Rs. 491 and Rs. 733 per capita health expenditure respectively.
To put this into perspective, each doctor in Bihar serves an average population of 28,391, and in Uttar Pradesh, the average is about 20,000 per doctor. Putting this in context, each doctor in Tamil Nadu serves about 9,544 people. Bihar has one hospital bed per 8,645 people and Uttar Pradesh has 2,904 people per bed. Tamil Nadu has 899 people per bed.
While the central government has tried launching various schemes in the budgetary expenditure, the latest being Ayushman Bharat scheme by the Modi government. The scheme plans to cover up to Rs. 5 Lakh for 40% of the population, 500 Million Indian that is below the poverty line.
But where is the impact of execution on the country’s healthcare?
Superpower with third world focus on healthcare
India aims at being a superpower but the fact that India doesn’t compare to the closest competition, let alone countries that are high on Public Health expenditure like Switzerland, USA. High-income countries that are well-developed spend an average of 5.2% of total GDP, USA goes a step beyond this – spending over $10,422 per person on public health. India spends roughly Rs. 1112.
The expenditure on public health varies from state to state.
India is the sixth biggest out-of-pocket spender on healthcare, it stands as the fourth lowest per capita spender at $16 in the South-East Asia region.
Limited spend + lack of resources = Increased outbreaks
The limited spend, which culminates into limited resources reserved for healthcare, outbreaks and epidemics always lead to mismanagement, chaos and higher number of casualties as a result. Bihar and UP’s tales of vomiting, suffering and unconsciousness children admitted to shabby hospitals year after year is collateral to that.
The serious lack of resources for proper healthcare administration makes handling medical emergencies and tricky cases all the more challenging for doctors, where there is a stark dearth of doctors. This gave rise to the West Bengal incident and nation-wide protests that brought the healthcare infrastructure to a standstill.
Poor hospital facilities result in the ballooning death toll due to medical negligence, delay and inability to cater to mounting number of cases.
Several petitions have been filed with the Supreme Court over the years criticizing inaction on numerous instances by governments.
But India continues to suffer from a serious inadequacy of medical staff, hospital beds, research and drug development. Still, the expenditure on healthcare remains meager and the country unable to take care of its billion citizens.