Overcoming Structural Problems

National Health Policy envisaged a strong partnership with private providers but have not reached maturity levels.

- Prof Usha Manjunath

The rise on the health sector front is at best a mixed bag in India. Even as India continues to straggle on many indicators of morbidity, mortality, and malnutrition, the health sector is progressing rapidly. We carry a disproportionate burden of the world’s illnesses, the country accounts for 20% of the global burden of diseases with 17.5% world’s population.

Structural challenges continue to abound the system and gains such as polio eradication, improved infant mortality rates and other key indicators seem not so significant at this juncture. Add to this the rapidly increasing prevalence of non-communicable diseases and need for tertiary care. India has not done very well on public spending on healthcare which has been around 1% of GDP for so many years even though the National Health Policy has promised to increase it to nearly 3%. Growth of public health services with NRHM and the recent NHM is meritorious. However, compared to 2005 which had one Government hospital bed for every 2,336 persons there were one bed for every 1,833 person.

However, state wise incongruity are too high to be happy with averages. For instance, a small state like Goa has one government bed for every 614 but Bihar has one for every 8,789 people. Rural Health Statistics 2015 indicates that at least six large states had nearly 40% shortfall of community health centres with Bihar having the highest shortfall at 91% and many of those states also are falling short significantly in terms of number of PHCs, the backbone of public health!