Syllabus: GS2/Issues Related To Health
Context
- Despite efforts to improve healthcare access, India’s public health system remains underfunded and poorly coordinated, leading to inefficiencies in disease prevention, healthcare delivery, and medical education.
About the Public Health System of India
- India’s public health system is structured to provide universal healthcare access, focusing on preventive, promotive, and curative services.
- It operates through national health programs, state-level initiatives, and local healthcare delivery mechanisms.
- It is crucial in India due to the double burden of communicable and non-communicable diseases, as well as significant health disparities.
- Public Health Foundation of India (PHFI) is a leading public health institution in India that works on training, research, and policy development in the field.
| Health & 7th Schedule of Indian Constitution – State List: Public health is primarily categorized under primary care and health education, limiting broader policymaking. – Concurrent List: Drug safety, pollution control, family planning, and food safety fall under shared legislative control between State and Union governments. – Union List: Critical issues like quarantine measures, international health regulations, and Census data are centrally governed. |
Key Challenges in India’s Public Health System
- Policy Paralysis and Governance Issues: Public health responsibilities are scattered across multiple government levels, like the Ministry of Health, Ministry of Water Resources, Food Safety Departments, and local bodies, causing poor coordination and accountability gaps.
- Immunization and disease control are managed separately by departments of public health and preventive medicine, while food safety, sanitation, and water management remain under Distinct Commissionerates.
- The Indian Council of Medical Research (ICMR) fights diseases linked to tobacco, while Indian Council of Agricultural Research (ICAR) advances tobacco production, reflecting a lack of policy coherence.
- The absence of a unified national health strategy results in inconsistent healthcare policies across states.
- Weak Training and Education Standards: Public health education in India is often limited to medical training, ignoring social, environmental, and behavioral health factors.
- The Master of Public Health (MPH) programs lack standardized curricula, affecting the quality of public health professionals.
- Underfunding and Infrastructure Gaps: India’s healthcare spending remains below global benchmarks, limiting investments in primary care and preventive health services.
- The growth of private healthcare has overshadowed public sector development, widening healthcare access disparities.
Key Components of India’s Public Health System
- Ayushman Bharat: India’s flagship universal health coverage program, providing financial protection for secondary and tertiary care.
- National Health Mission (NHM): It focuses on maternal and child health, communicable disease control, and strengthening primary healthcare.
- It includes Health and Wellness Centers (HWCs) to improve preventive healthcare services.
- Health and Wellness Centers (HWCs): Strengthen preventive healthcare and expand primary health services.
- National Health Policy (2017): It outlines India’s vision for strengthening healthcare infrastructure, disease prevention, and universal health coverage.
- It emphasizes primary healthcare expansion, digital health integration, and financial protection for vulnerable populations.
- It recommended raising public health spending to 2.5% of GDP by 2025, and recent budget allocations indicate progress toward this goal.
- Public Health Surveillance (Vision 2035): It aims to enhance data-driven disease monitoring and response strategies.
- It promotes real-time health data collection and predictive analytics for epidemic preparedness.
- Health Systems Strengthening: India has adopted Indian Public Health Standards (IPHS) to ensure quality healthcare delivery.
- Initiatives include hospital management societies, skill development programs, and quality assurance mechanisms.
- Public Health Governance and Policy Frameworks:
- Public health responsibilities are divided across central, state, and local governments, leading to overlapping regulations and weak coordination.
- MoHFW oversees national health policies, disease control programs, and medical education.
Way Forward
- Strengthening Public Health Governance: Establishing a centralized health policy framework to improve coordination between state and national health agencies.
- Expanding public health education beyond medical training to include social sciences, environmental health, and policy analysis.
- Enhance interdepartmental coordination to unify efforts in disease prevention, sanitation, pollution control, and food safety.
- Investing in Healthcare Infrastructure: Increasing budget allocations for primary healthcare, focusing on preventive care and disease surveillance.
- Enhancing training programs for public health professionals, ensuring standardized curricula and skill development.
- Promoting Community-Based Health Initiatives: Encouraging local governance participation in healthcare planning and implementation.
- Strengthening public awareness campaigns to improve health literacy and preventive care adoption.
Conclusion
- India’s public health system requires urgent policy reforms, improved training programs, and increased funding to address systemic inefficiencies.
- By strengthening governance, investing in infrastructure, and expanding education, India can build a resilient and equitable healthcare system for future generations.
| Daily Mains Practice Question [Q] How do policy gaps and inadequate training contribute to the challenges in India’s public health system, and what reforms are necessary to create a more efficient, equitable, and sustainable healthcare infrastructure? |
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