Tuesday December 10, 2019

India’s Health System Underperforming: Niti Aayog

Health sector in India is underperforming due to fragmentation, says a report by Niti Aayog

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Indian health
India's health sector is lagging behind other countries. Pixabay

A report by the Niti Aayog has admitted that India’s health system is underperforming and lagging behind many comparable countries in key performance indicators.

NITI Aayog on Monday released a report titled ‘Health Systems for a New India: Building Blocks — Potential Pathways to Reforms’.

“Severe fragmentation, compounded by market failures and governance challenges, is the key driver of India’s underperforming health system,” the report said, pointing to the fragmentation of health services as a major challenge.

Niti Aayog said the report charts a clear roadmap for the complete transformation of India’s health system. It focuses on breaking silos in the health space and removing fragmentation between various initiatives, ensuring greater convergence between ministries as well as the Centre and the states, as already initiated under the Ayushman Bharat scheme.

The report identified five focus areas of future health system — deliver on unfinished public health agenda, change health financing away from out of pocket so spend into large insurers, integrate service delivery vertically and horizontally, empower citizens to become better buyers of health, and harness the power of digital health.

Health system
Severe fragmentation, compounded by market failures and governance challenges, is the key driver of India’s underperforming health system. Pixabay

“At the systems level, overcoming the challenges of fragmentation across healthcare financing and service delivery will help us optimise both quality and access. India now needs to build on its many opportunities to achieve further progress on the health of its citizens and respond to the growing aspirations and needs of a new India,” said Rajiv Kumar, Vice Chairman, NITI Aayog.

The report noted that health financing is fragmented at all three levels — revenue sources, health insurance (financial risk pooling), and strategic purchasing (how funds are used to set incentives for service providers to maximise efficiency, responsiveness and quality in the health service provider market).

There are high levels of fragmentation in the sources of revenues, with most health expenditure (about 62 per cent) coming directly from households.

Currently the government (Union and the states put together) spends roughly 1.13 per cent of GDP on health, which is grossly inadequate compared to similar spending by other countries.

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As a result, 62 per cent of healthcare spending is financed by households through out-of-pocket expenditure at the point of care.

Lauding the significant improvements made in India’s health sector, Bill Gates, co-chairman of Bill and Melinda Gates Foundation, said that primary healthcare is extremely important for all. India is in a very hopeful situation, he said, and is set to be an example for other countries. (IANS)

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Fragmentation Reason Behind Low Performance of Indian Healthcare

Fragmentation is the reason behind Indian healthcare's poor performance

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Indian healthcare
The reason behind the poor performance of the Indian healthcare is fragmentation. Pixabay

The vicious cycle of severe fragmentation is the reason for low performance of Indian healthcare, in comparison to other countries in Asia and elsewhere, a top official has said.

In his address at the inaugural function of the 24th edition of IIHMR University’s annual event ‘Pradanya’ with the theme “Future of Healthcare: Globalization, Innovations and You”, Special Secretary, NITI Aayog, Yaduvendra Mathur said: “The time has come to unify and transform the healthcare system to achieve optimum outcomes in terms of public health and Sustainable Development Goals.”

“India’s healthcare system lags much behind other nations. India figures at number 145 in global healthcare, compared to 92 for China, 71 for Sri Lanka, 138 for Indonesia and 111 for Egypt. The Out of Pocket (OOP) expenditure for India is high at 63 per cent, compared to just 36 per cent for China and 37 per cent for Indonesia.

“Such sub-par performance of Indian healthcare is due to its deeply fragmented nature. This fragmentation needs to be addressed through better risk profiling/insurance of patients, strategic purchase of medicines and medical supplies by government and care givers, better organization of healthcare delivery, and creating a digital health landscape.

Poor healthcare
India’s healthcare system lags much behind other nations. Pixabay

“Ayushman Bharat and initiatives like National Medical Commission Act and National Digital Health Blueprint have created a strong foundation for such integration,” he added.

The future health system of India needs five focus areas: Deliver on the unfinished public health agenda, shift health financing away from out-of-pocket spend to larger insurers, integrate service delivery horizontally and vertically, empower citizens to become better buyers of health, and harness the power of digital health, Mathur suggested.

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In his address, IIHMR University Chairman, Dr S.D. Gupta said: “Future healthcare is intrinsically linked with globalisation and technological innovations. We need to visualise what the scenario is going to be in India in the next 30 to 40 years.”

The three-day programme, which started Monday, saw over 35 health experts from India and abroad attending the technical sessions and panel discussions. (IANS)