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| - Last Updated on April 12, 2024 by Neelam Singh
Quick Take
According to a social media post, healthcare in India is non-existent. However, after going through current statistics regarding the status of healthcare in India, we found out otherwise. Therefore, we term this as mostly false.
The Claim
As per an X (formerly Twitter) user, “Healthcare in India is non-existent.”
Fact Check
What is the current status of healthcare in India?
The current status of healthcare in India is a mix of progress and persistent challenges. There have been significant improvements in healthcare infrastructure, access to services, and advancements in medical technology. However, many Indians still face barriers, particularly in rural areas where healthcare facilities are scarce.
India has made significant strides in health, both in terms of outcomes and infrastructure. In 2017, an ambitious health policy was formulated, complemented by various programs initiated by both the Central and State governments. These programs include the National Health Mission (NHM), which integrates rural and urban health missions, Ayushman Bharat (world’s largest publicly funded health insurance program) aimed at providing health insurance to 40% of the population and strengthening primary healthcare through Health and Wellness Centers (HWCs), as well as initiatives like the Pradhan Mantri Swasthya Suraksha Yojana (PMSSY), Universal Immunization Programme, National Tuberculosis Elimination Programme, and National Vector Borne Disease Control Programme, among others. These interventions, focusing on family health and both communicable and non-communicable diseases, have contributed to progress in various areas.
According to recent statistics from the National Health Profile 2022, India has made strides in key health indicators such as life expectancy, infant mortality rate, and maternal mortality ratio. Life expectancy at birth has increased to 69.7 years for males and 71.2 years for females. Additionally, the Maternal Mortality Ratio (MMR) has decreased to 97 per 100,000 live births for the period 2018-2020, down from 178 per 100,000 live births recorded during 2010-2012. Similarly, the Infant Mortality Rate (IMR) stands at 28 infant deaths per thousand live births for the year 2020, marking a significant decline from 74 infant deaths per thousand live births in 1994.
What are the existing gaps in Indian healthcare?
In India, there are significant gaps in healthcare resources and accessibility. According to WHO guidelines, the ideal doctor-to-patient ratio should be 1:1000. However, in India, this ratio is much lower, with approximately 0.7 doctors per 1000 people (in 2020, including only MBBS graduates). Similarly, the nurse-to-patient ratio falls short of WHO recommendations, with only about 1.7 nurses and midwives per 1000 people, compared to the recommended ratio of 3 nurses per 1000 people.
Furthermore, there is a shortage of other healthcare professionals like dentists, pharmacists, and specialists. Additionally, the number of healthcare facilities, including hospitals, clinics, and primary health centres, is insufficient to meet the needs of India’s vast population.
We also need to focus on the disproportionate distribution of healthcare between urban and rural areas, where the rural population is substantially underserved. The quality of healthcare in rural areas is significantly poorer compared to urban setups, with rural healthcare facilities being under-resourced.
Ensuring patient safety nationwide poses a significant challenge, particularly in the absence of a consistent regulatory framework across the country. The introduction of NABH in 2006 marked a noteworthy milestone, providing a global standard framework for patient safety. However, over the past nine years, only 300 hospitals have managed to obtain NABH accreditation, a mere fraction considering the nation’s over 50,000 hospitals and nursing homes. With no current incentives for hospital accreditation despite substantial efforts required, there is a pressing need for the government to take urgent action. Measures should be implemented to link all government and private insurance scheme empanelment with NABH accreditation, encouraging widespread adoption of patient safety standards.
Are there disparities between the government hospitals and private hospitals?
Yes. While Indian healthcare system is continuously striving to achieve its full potential, there exists a prominent gap between the quality of healthcare services in the government sector and private sector hospitals. The state of medical care in many government hospitals is nothing short of a nightmare for the not-so-affluent class of the society. There is a desperate need for quality healthcare for the underprivileged and the underserved sections due to the huge disease burden and the eventual financial burden on our country’s GDP.
Government healthcare centres like the Mohalla Clinics or the Primary healthcare centres even in metro cities lack basic amenities such as safe drinking water, clean washrooms and most importantly the availability of a healthcare professional and common medicines. This forces the economically challenged populations to flock towards unregulated and unsafe healthcare practices delivered by quacks.
Lack of accountability, quality and facilities like ー beds, common medicines, doctors and nurses, oxygen cylinders and ventilators, labour room, clean washrooms, diagnostic tools ー due to scarcity of funds and authority’s intent lead to poor health outcomes in the marginalised sections of our society.
Does this mean healthcare in India is non-existent?
No, this is a rhetorical comment and holds no significance. Coming at such a time when the Lok-Sabha elections are just around the corner it indicates a personal bias against the current government. During our research, we discovered that despite existing gaps in the current healthcare system, our Central and State governments have been making serious and sincere efforts to address the disproportionate access to healthcare in both urban and rural areas.
What notable milestones define the recent successes of India’s healthcare sector?
In recent years, the Indian healthcare sector has witnessed remarkable achievements in both communicable and non-communicable disease control. India’s Universal Immunization Programme is one of the largest vaccination programmes in the world. In the realm of communicable diseases, milestones such as the eradication of Smallpox (1980), Guinea worm (2000), and Polio (2014) stand as testament to India’s dedication to public health. Furthermore, the elimination of Leprosy (2005) and Yaws (2006), alongside the containment of diseases like Avian Influenza, H1N1, and Plague, underscore the nation’s proactive approach. Notably, targeted efforts have effectively brought Cholera under control, while the burden of diseases like Malaria, trachoma, filarial, and Kala-Azar has seen substantial reduction. Initiatives to combat tuberculosis have also gained momentum.
Amidst these successes, India has also tackled the formidable challenge of COVID-19 with resilience and determination. Swift response measures, including nationwide lockdowns, testing and contact tracing strategies, and the rollout of vaccination campaigns, have been pivotal in curbing the spread of the virus. As of 4th March 2023, India has administered 2.2 billion doses of COVID-19 vaccines (including first, second and precautionary booster doses), marking a significant milestone in the global fight against the pandemic.
On the front of non-communicable diseases, integration of AYUSH with the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke (NPCDCS) in select districts has amalgamated traditional and contemporary medicine approaches, with Yoga playing an integral role. Additionally, pilot interventions have commenced for the prevention and control of Rheumatic Fever/Rheumatic Heart Disease in collaboration with Rashtriya Bal Swasthya Karyakram (RBSK). The establishment and operation of the National Organ and Tissue Transplant Organization (NOTTO) at Safdarjung Hospital, New Delhi, represent significant strides in organ transplantation. Standard Treatment Guidelines across various clinical specialties, along with minimum standards for clinical establishments and revised Indian Public Health Standards for government healthcare facilities, have bolstered healthcare delivery. Furthermore, the initiation of the National Injury Surveillance, Trauma Registry, and Capacity Building Centre at Dr. RML Hospital, New Delhi, and the launch of the National Program for Palliative Care (NPPC) highlight India’s multifaceted efforts towards holistic healthcare advancement.
The out-of-pocket expenditure for healthcare has seen a significant decline from 74% in 2001 to just 20% at present (2023 study). The rate of institutional deliveries in India rose from 70.6 percent in 2008-09 to 95.5 percent in 2021-22, which has a significant impact on the lowering of infant mortality.
The booming medical tourism in India paints a positive picture. The healthcare tourism sector in India is experiencing rapid growth. In 2022, the value of India’s healthcare tourism industry was estimated at US$9 billion. Each year, approximately 2 million patients from 78 countries visit India for medical, wellness, and IVF treatments, contributing around $6 billion to the industry. This figure is projected to reach $13 billion by 2026, supported by the government’s Heal in India initiative. A 2019 report by the Federation of Indian Chambers of Commerce and Industry and Ernst & Young highlighted that most medical tourists visiting India come from Southeast Asia, the Middle East, Africa, and the SAARC region. Additionally, India also attracts a significant number of medical tourists from Australia, Canada, China, Russia, the United Kingdom, and the United States. Notably, Chennai has emerged as the healthcare capital of India.
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