Despite a certain amount of progress in the past decade or so, the report points out glaring gaps in healthcare infrastructure in the country — “low resource allocation, low emphasis on primary health care, poor utilisation of human resources,” as Professor K Srinath Reddy, one of the co-authors said.
Yet another report on India’s troubled health care system pointed out the country’s poor performance across health indicators, despite economic advantages. A report in the medical journal The Lancet — Assuring Health Coverage for all in India — by leading health researchers in the country put India as the worst performing country among the BRICS nations (Brazil, Russia, India, China and South Africa) and well behind its more impoverished neighbours such as Nepal and Bangladesh when it came to health.<!– Dna_Article_Middle_300x250_BTF –>Despite a certain amount of progress in the past decade or so, the report points out glaring gaps in healthcare infrastructure in the country — “low resource allocation, low emphasis on primary health care, poor utilisation of human resources,” as Professor K Srinath Reddy, one of the co-authors said.The report also talks about high out-of-pocket expenditure that drives millions to impoverishment and a disproportionate disease burden. As the report says, India has 20 percent of the global disease burden, marginally better than 21 percent in 2005 while expenditure has dropped from 4.5 percent of the GDP in 2004-05 to 4 percent in 2015.Speaking to dna, Professor Reddy said that idea behind this most recent analysis of data was to make a case for better investment in health care better financial allocation and governance and improved utilisation of all resources.There are certain positives; increase in life expectancy at birth, lowering of infant mortality rate and the maternal mortality ratio, containing the spread of HIV, being declared free of polio and maternal and neonatal tetanus by the WHO. However, “India accounts for 27 per cent of all the neonatal deaths and 21 per cent of all the child deaths (younger than 5 years) in the world. Diarrhoea, pneumonia, preterm birth complications, birth asphyxia, and neonatal sepsis account for 68 per cent of all deaths in children younger than 5 years in the country,” reads the study.The report calls for radical measures as the only way to assure the universal health targets that the country’s own draft National Health Policy endorses, by 2022. Suj measures start with building infrastructure for primary health care. This policy, according to Reddy, provides a sound roadmap and strategic components for the way forward. However, it’s been in cold storage for almost a year as the NITI Ayog differed from it.Earlier this year, media reports said that the Niti Ayog preferred more privatisation of health care as opposed to public spending.Expenditure on health care becomes the bone of contention. Though this government, as the report details, has launched several schemes to better healthcare across regions, ages, sexes caste and classes, it also slashed the annual health budget. Says Reddy that the argument is that resources are not used properly and often allocated money is returned. However, he advocates for more front end expenditure on human resources, drugs, technology, infrastructure.A day before The Lancet study, the Indian Health Report: Nutrition, too pointed out that India’s health indicators and its economic strength were not directly proportional. Stunting affects 38.7 percent of under five children pointing to widespread malnutrition. Both reports, importantly, highlighted that causes also lay in a range of socio-economic determinants, and “widespread inequities in health outcomes that are apparent in the large morbidity and mortality differentials across socio economic status, caste, class, sex, and geographic location”. “We’re doing poorly across the board according to aggregate indicators,” explained Reddy, however, results differed states from state, along caste and class lines. “We have to push to do better not only on aggregate indicators but also address these inequities and provide universal health access.