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How has Indian healthcare sector evolved in last 70 years?

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MP_healthcareHealthcare in India goes back to ancient times and has been documented in our scriptures like Vedas and Charak Samhita. Ayurveda or the “science of life” is believed to be imparted to the sages and rishis by the gods themselves. Well, this is mythology but the fact that Ayurveda has survived for ages might itself be considered as some sort of proof of the kind of medical knowledge our ancestors possessed.

Moving further along the timeline, there was an influx of physicians or hakims in India as it saw foreign invasions in the 10th century AD. Modern medicine was first brought in by the Portuguese but the first hospitals were built by the British and French. 19th century saw organised training in allopathy and other medical streams. Indian healthcare sector has come a long way.

The British rule that lasted for over a century saw the establishment of dispensaries at district level, but they were mostly for the treatment of army personnel. At the time of independence, there were just over 7,000 hospitals in the country and called for much more to be done, starting with the availability of healthcare to every citizen irrespective of their caste, religion or occupation.

Although the exploitation of India at every possible level was unimaginable, the Britishers arguably left a decent healthcare delivery framework when they left. Health was however not an immediate priority for a country that just came out of foreign oppression after almost 150 years. It was given a small separate budget and was made a State subject. Unfortunately, the States weren’t able to justify the system and it turned out to be a failure.

Eventually, by setting up a separate Health Survey and Planning Committee and introduction of Five Year Plans, healthcare saw some positive results when it came to eradication and control of epidemics.

Primary healthcare services were given attention. Primary centres were established in rural and urban areas. Central Government also began to focus on higher education, research and national health programmes. It also launched the CGHS (Central Government Health Scheme) for government sector employees.

The health infrastructure improved with these efforts and parameters like the number of doctors per 1,000 population, number of hospital beds per 10,000 population, number of medical colleges, number of hospitals and dispensaries, all improved slowly but gradually. The advent of private hospitals and big players also had a hand in developing healthcare and helped increase the life expectancy of the average Indian from 32 years in 1947 to 69.09 years in 2018.

Along with allopathy or modern medicine, the Indian government also accepted Homeopathy, Ayurveda, Naturopathy, Yoga, Unani and Siddha as valid alternate medicine approaches. In fact, the youth of today have started believing in such ancient practices and have adopted yoga and naturopathy as a form of preventive healthcare.

There is no doubt that we still have a long way to go before we can assure quality healthcare to all our citizens. We have been slowly but gradually moving in the direction.

The obvious impediments to see the desirable results are:

  • Our burgeoning population and its undue strain on our healthcare infrastructure
  • Lack of awareness among people, especially in rural areas about the importance of health
  • Main focus only of physical health when lifestyle and behavioral health issues have started to show much more negative effect
  • Lack of preventive care
  • Shortage of public hospitals with long waiting time often leading to untimely deaths
  • Expensive treatment in private hospitals in addition to the growing lack of trust among patients

On the positive side, Indian healthcare has surely come a long way post-independence. Even though the healthcare infrastructure calls for a major overhaul, India has been able to put itself on the world map when it comes to medical tourism. Alternative treatments like Ayurveda, yoga and naturopathy have also seen a boom especially in the last decade or so.

Increasing mobile and internet penetration has seen the growth of online pharmacies and online doctor consultation. Doctor and hospital reviews and online appointment booking systems have made it easier for patients to get desirable treatment. Behavioural and mental healthcare have also leveraged technology to disseminate information on topics that were considered a taboo for a very long time. With online information, first level screenings and counselling, primary care is easily provided to those who are somewhat aware of these increasing lifestyle issues.

As mentioned earlier, we still have a long way to go before we can confidently say that our healthcare system is strong enough and is accessible by each and every citizen, irrespective of their ability to afford the same. We have definitely come far and have made positive progress in the last 70 years and fortunately, things are looking only up from here.

Health, both physical and behavioral, is something that is of utmost importance to any nation if it wants to succeed. India has to constantly keep working in the direction. Government initiatives and schemes, public private partnerships (PPP) in health, private sector hospitals, increasing awareness about health insurance and even start-ups in the space that use technology to reach a wider set of audience, hold the key in creating a robust healthcare ecosystem that will benefit the maximum number of our citizens.

(Writer Shivani Khera is founding member and the Chief Marketing Officer at MeeHappy Wellness. The views expressed are a personal opinion.)

 

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