“Health equity” means every person has equal opportunity to remain healthy and no one is disadvantaged by their income, social position, location, or other circumstances to get the best healthcare available. The absence of high quality healthcare solutions during unprecedented times like the pandemic, or even during more normal times with accidents, natural disasters, and environmental factors puts people at risk. In many nations, access to health care is dictated by many factors, including affordability of services and proximity to healthcare facilities. Fundamentally, healthcare is a human right and all people should have access to it.
Data from the National Health Profile (NHP) shows that in India there is only one government employed allopathic doctor for every 10,189 people, and one state run hospital for every 90,343 people. The number of hospital beds per thousand people in India (0.5) is lower than some of the other emerging market countries such as Bangladesh (0.87), Kenya (1.4), and Chile (2.1). These figures are a cause for concern. A glaring spotlight illuminated the lack of hospital beds and resources in April 2021 as the healthcare system was overwhelmed with COVID-19 patients. Unfortunately, even when the limitation in hospital infrastructure is not national news, it still has an effect on people’s ability to access healthcare.
While India is known for being the world’s pharma capital, its unequal healthcare system has created a situation where the wealthy have access to some of the best care in the world, and the impoverished have limited options. According to Oxfam India’s Inequality Report 2021, constant underfunding of the public healthcare system in the last decade has worsened health infrastructure, not improved it even as India becomes wealthier. The lack of health equity has been a major problem for a long time. With the COVID-19 pandemic, more people than ever before are aware of what their healthcare needs and rights are, paving the way for improvements in health equity.
Health eamarquity in India
In India, social inequality is shaped by socioeconomic status, geography, class, religion, caste, gender, and sexuality. In general, Southern states are better off compared to Northern states in terms of human development. Despite the improvements in healthcare in India, true equity remains a long way off.
Health equity is important in India because the existing health care infrastructure has always been centred on those who can pay. There’s 2 types of healthcare – private and government – with vastly different services and level of quality, meaning that the access to healthcare is not equal. Even if we set aside healthcare is a fundamental human right, the cost to society of unequal healthcare is high. If people wait until the last minute before getting care, they are generally much sicker and require a much more expensive intervention. The direct costs of this are obvious in terms of needing higher cost hospital services, but also the indirect costs with respect to the human cost should not be overlooked. When people are diagnosed at a critical stage, the recovery takes longer so they are out of the workforce for longer. Chronic diseases like diabetes, chronic obstructive pulmonary disease (COPD), or sleep apnea are diagnosed later, delaying treatment, resulting in a lack of productivity and a shorter lifespan. These direct and indirect costs quickly add up taking a heavy toll on society.
Managing the health of 1.3 billion people is complex, but there is much we can do to change the lack of healthcare equity in India. This includes improving hospital and clinic infrastructure and looking at non infrastructure based interventions like telehealth, channel non-governmental resources in the most disadvantaged areas, and engaging with people to encourage them to prioritize their health.
When it comes to the general population, education is essential in building awareness around chronic diseases and the importance of early diagnosing. The need to increase advocacy around healthcare issues, address the challenges in improving access to healthcare, and building capacity in different communities is a must at local, regional, and national levels.
Good healthcare should be available at affordable prices and access should extend outside of bigger cities. There are four things to focus on when a country is trying to achieve health equity: one is ensuring access to primary care, especially maternal and childcare, second is increasing education and awareness around specific diseases and the value of early diagnosing, third is finding innovative or disruptive ways to improve access to healthcare without needing costly infrastructure projects like telehealth, and fourth is working directly in underserved areas to craft hyperlocal solutions to fit their unique needs.
Primary Health Centres, which are already found in many parts of rural India can be improved by adding to the quality and services offered. These can be great community outreach points as well for education and awareness activities on diseases that are prevalent in the population. The private healthcare sector also has a big role to play, especially in combination with another of India’s strengths in the IT sector. Telehealth and other remote healthcare solutions are an extremely effective intervention to improve access to high quality care.
Understanding community needs, focusing on education and awareness, and finding disruptive solutions in healthcare delivery is the way of the future in India. Fortunately, our healthcare system is now on the verge of a revolutionary shift, triggered by an unfortunate pandemic. Our response to COVID-19 is a stark reminder to us about the urgent need of making healthcare equitable in India. We can achieve health equity for all by working together and focusing on the most vulnerable among us. After all, healthcare is a fundamental human right.
Views expressed above are the author’s own.
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