For the people living in the urban parts of India,
healthcare is a very small issue. According to them India faces a lot of other
issues that are more important than healthcare such as such as economic
development, infrastructure, jobs, and border disputes with Pakistan.
1. Rural Versus Urban Divide: At the same time the chance
to enter the market may be extremely ripe, India at present gives just around
4. 2% of its national GDP towards medication and healthcare facilities
(compared to 18% by the US). Additionally, there is also a huge difference
between the rural and urban health care which makes the problem worse. 7-% of
the total population of India still lives in rural areas and a very less access
to adequate healthcare and medication. Most of the people who are below poverty
line rely on government healthcare facilities. One of such government approved
healthcare program is National Urban Health Mission which has been proven ineffective.
While the urban centres have a large number of private hospitals which
provide good quality services but at a very high price which is not affordable
to many. These healthcare facilities have better doctors, access to almost
all-important medicines and better clinics.
2. Need for Effective Payment Mechanisms: Other than the
rural-urban divide, another key aspect for the present scenario of India’s
healthcare facilities is the easy out-of-pocket expenditure (roughly 70%). This
implies that the vast majority Indian patients pay for their healthcare
facilities with direct cash with no payment arrangements. As stated by World
Bank and National Commission’s report on Macroeconomics, only 5% of the total
population of India has health insurance. Such a low figure in healthcare
insurance has made the service available only to people with high income.
Coming to the administrative side, the Indian government plays a very
important role in running several health insurance programmes for the
population with high-risk of health issues and also regulates private insurance
markets. Presently there are few such programmes such as Community Health
Insurance programme for the population below poverty line (like Medicaid in the
US) and Life Insurance Company (LIC) policy for senior citizens (like Medicare
in the US). All of these programs are controlled by General Insurance
Corporation which is a government controlled organisation. According to these
schemes, people have to pay upfront cash and get reimbursed by filing a claim.
3. Demand for Basic Primary Healthcare and Infrastructure: One
of the main issues that India is facing is to fix the basic health concerns of
HIV, malaria, TB and diarrhoea. Also most of the children are born underweight
and around 7% of them die before their fifth birthday. Also a very small
portion of the population have access to quality sanitation.
For healthcare, the Indian government spends only about 30% of the country’s
total healthcare budget. The need for skilled medical graduates keeps growing,
especially in rural areas which fail to attract new graduates because of
financial reasons. A sizeable percentage of the graduates also go abroad to
pursue higher studies and employment.
4. Growing Pharmaceutical Sector: According to the Indian Brand
Equity Foundation (IBEF), India is the third-largest exporter of pharmaceutical
products in terms of volume. Around 80% of the market is composed of generic
low-cost drugs which seem to be the major driver of this industry.
The increase in the ageing population, rising incomes of the middle class,
and the development of primary care facilities are expected to shape the
pharmaceutical industry in future. The government has already taken some
liberal measures by allowing foreign direct investment in this area which has
been a key driving force behind the growth of Indian pharma.
5. Underdeveloped Medical Devices Sector: The medical
devices sector is the smallest piece of India’s healthcare pie. However, it is
one of the fastest-growing sectors in the country like the health insurance
marketplace. Till date, the industry has faced a number of regulatory
challenges which has prevented its growth and development.
Recently, the government has been positive on clearing regulatory hurdles
related to the import-export of medical devices, and has set a few standards
around clinical trials. According to The Economic Times, the medical
devices sector is seen as the most promising area for future development by
foreign and regional investors; they are highly profitable and always in demand
in other countries.
There are multiple factors including lifestyles that influence the burden of
disease. The burden of communicable diseases has been declining. The focus of
the Government is to provide accessible, affordable and accountable quality
healthcare facilities to all sections of society especially the marginalized
sections in the country.
While there are multiple challenges, the availability of Primary
Health Centres, human resources, number of medical colleges and medical seats,
have been improving.
Public health and hospitals being a State subject, the primary responsibility
to address healthcare challenges is that of State Governments. However, under
National Health Mission (NHM), financial and technical support is provided to
States/UTs to strengthen their healthcare systems including support for
strengthening health infrastructure, deployment of medical personnel, ASHAs,
creating awareness about health issues and lifestyles, and support movement
towards Universal Health Coverage.
The Central Government has enacted the Clinical Establishment (Registration and
Regulation) Act, 2010 and also notified Clinical Establishments Rules 2012 to
provide a legislative framework for the registration and regulation of clinical
establishments in the country and also seeks to improve the quality health
services by prescribing minimum standards of facilities and services which may
The Government has also taken steps for strengthening and upgrading district
hospitals and making available tertiary health care services in the public
sector through strengthening of hospitals, establishment of AIIMS institutions
in the States and up-gradation of existing Government medical colleges across
With regard to increasing awareness about the health issues, the Ministry of
Health and Family Welfare regularly releases print advertisement and TV and
radio spots in National/regional media for generating awareness among
population about various Health and Family Welfare issues and programmes of
Ministry of Health and Family Welfare. These include Mission Indradhanush,
World Health Day, World No Tobacco Day, Yoga Day, Intensified Diarrhoea Control
Fortnight, World Population Day, Breastfeeding, Tuberculosis, etc.
The Government has formulated the National Health Policy 2017 which has laid
emphasis on the role of the Government in regulation, governance, and quality
assurance, healthcare infrastructure and in leveraging information technology.
The policy also envisages raising public health expenditure to 2.5% of the GDP
in a time bound manner.