Release Of India Health Report


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This report provides a broad direction for India’s health sector in the coming years. In doing so, it describes India’s
achievements with regard to the three key goals of health policy—improved health status, financial risk protection,
and equity. It does so by identifying some of the factors and the state of policy instruments that have facilitated
these achievements in the areas of access, quality and efficiency. Hence, it looks at public health interventions,
regulations, financing, and the organisation of healthcare. The role of both public and private institutions in the pro-
vision of such services is studied in this overall context. The focus, therefore, is to analyse the status of health
in India, and this is done by bringing together data and analyses from government documents, health economics
and policy literature and a host of other sources.
Organised in nine chapters, the report begins by making a case for investing in health as a sound economic decision.
Ajay Mahal and Victoria Fan (Chapter 1) make the point that investing in health should be a priority, even when
resources are otherwise limited, owing to the high returns from such investment. As such, they highlight the need
to enhance protection against the financial risk inherent in an unhealthy population. They argue their case at four
levels: (a) health is a major factor in influencing aggregate economic outcomes; (b) instances of ill health can expose
entire households to financial risk and, in many cases, im poverishment; (c) health status itself is an indicator of
human well-being; and (d) in a society undergoing great economic and social transition, such as India, improvements
in health carry an added importance (and correspondingly constitute a greater challenge).
As the mere provision of health infrastructure does not necessarily ensure universal accessibility, in Chapter 2,
Laveesh Bhandari and Aali Sinha examine the multiple facets governing the access to, and utilisation of, health-
care services: awareness levels; locational or financial constraints; efficiency of public and private healthcare
providers; issues of quality and reliability of service and treatment; analysis of hospitalisation and out-of-pocket
expenditure, etc. They conclude that despite heavy public intervention, the health burden carried by Indians con-
tinues to be significant. They underline the importance of effectively addressing the constraining issues through
effective systemic changes.
In Chapter 3, Sumita Kale studies the new issues in disease management in India today, many of which are linked to growing prosperity in the country.
One set of issues she examines is the rising incidence of diseases like ischemic heart, diabetes, cancer, HIV/AIDs, where health education and regular
screening can play a significant preventive role. She also highlights the need to match society’s rising affluence with an environment where mental and physical disorders
and disabilities are included in the mainstream discussion on health management.
In Chapter 4, Laveesh Bhandari and Ankur Gupta discuss the status of the four major inputs fundamental to
a good health profile in India: well-trained, adequate and well-motivated healthcare providers; a well spread and
acces sible healthcare infrastructure; a good water supply and sanitation system which also facilitates hygienic prac-
tices; and a population that is well supplied nutritionally and practices a hygienic lifestyle. Bhandari and Gupta
highlight a single key problem underlying all these inputs: the lack of a public health focus. Seeing the multiplicity of
government units involved in the various aspects of health administration, they recommend a centralised authority
that is able to synchronise and coordinate various policy measures in line with the received evidence on improving
health outcomes.
Medical ethics encompasses a vast range of issues, and in

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Release Of India Health Report

  1. 1. CII-INDICUS RELEASE OF INDIA HEALTH REPORT   THURSDAY, 2ND SEPTEMBER 2010 Venue: Hotel The Lalit, Barakhamba Avenue, Connaught Place, New Delhi – 011
  2. 8. India Health Report-2010: A Perspective <ul><li>Health as India’s ‘Double Burden’ </li></ul><ul><li>-> Public Health / Curative Health </li></ul><ul><li>-> Poverty / Affluence </li></ul><ul><li>-> Newborn / Elderly </li></ul><ul><li>-> Rural / Urban </li></ul>India Health Report 2010 by Indicus Analytics
  3. 9. Research Methodology <ul><li>Bringing together the data on current health issues from government and other highly respected sources </li></ul><ul><li>Reviewing literature from medicine, health policy and health economic journals </li></ul>India Health Report 2010 by Indicus Analytics
  4. 10. What lies inside? <ul><li>The Case for Improving Health in India </li></ul><ul><li>Access to Healthcare </li></ul><ul><li>Emerging Issues in Health </li></ul><ul><li>Inputs for Health </li></ul><ul><li>Ethics and Side Payments </li></ul><ul><li>Access to Medicines in India: Issues, Challenges and Policy Options </li></ul><ul><li>The Evolving Role of the Government: Regulations and Programmes </li></ul><ul><li>Health Financing in India </li></ul><ul><li>Health Reform: A Historical Perspective and the Future </li></ul>India Health Report 2010 by Indicus Analytics
  5. 11. The Case for Improving Health in India <ul><li>Health status is an indicator of human well-being </li></ul><ul><li>Health is a major factor influencing aggregate economic outcomes </li></ul><ul><li>Poor health exposes households to financial risk, many case impoverishment. </li></ul><ul><li>Improvements in health have significant impacts on the socio-economic welfare of the economy. </li></ul>India Health Report 2010 by Indicus Analytics
  6. 12. Millennium Development Goals for India-2015 <ul><li>Reduce Child Mortality by two-thirds </li></ul><ul><li>Improve Maternal Health – Reduce maternal mortality ratio by three quarters </li></ul><ul><li>Combat HIV/ AIDS, Malaria, and other diseases </li></ul><ul><li>Halve the proportion of the population without sustainable access to safe drinking water and basic sanitation. </li></ul>India Health Report 2010 by Indicus Analytics
  7. 13. Emerging Issues in Health <ul><li>India has witnessed a significant rise in Non-Communicable Diseases in last two decades. </li></ul><ul><li>Ischematic Heart Diseases, Diabetes, Cancer, HIV/AIDS Mental and Physical Disability – Diseases and conditions need to be addressed with immediacy </li></ul>India Health Report 2010 by Indicus Analytics
  8. 14. Access to Healthcare <ul><li>Right combination of quality and price needs to be available for a service to be truly accessible and desirable. </li></ul><ul><li>Marginalized groups reveal a much lower utilization of health services. </li></ul><ul><li>Poorest people are worst affected from lack of access of healthcare </li></ul>India Health Report 2010 by Indicus Analytics
  9. 15. Access to Healthcare ..continued <ul><li>Average Indian remains underserved by the present Healthcare system. </li></ul><ul><li>Physical proximity to facilities and the cost of the treatment are the important determinants of access. </li></ul><ul><li>Bulk of ailments occurring in the poorest quintiles are treated in private facilities. </li></ul><ul><li>‘ Unqualified’ practitioners form the bulk of private practitioners in India, and are most prevalent in rural areas. </li></ul><ul><li>Public Health services are not always free. Often they are poorly equipped. </li></ul>India Health Report 2010 by Indicus Analytics
  10. 16. Inputs for Health <ul><li>India suffers from serious shortages in Health manpower. Physician to Population ratio is 0.6 per 1000 persons in India vis-à-vis WHO bench mark of 1:1000 </li></ul><ul><li>Hospital bed density in India (0.7) lags miserably behind current world average of 26 (Beds per 1000 population) </li></ul><ul><li>Only 28 percent of Indians have access to improved sanitation </li></ul><ul><li>Nutrition has a direct impact on health. 36 and 39 percent of Children under 3 are underweight in Urban and Rural India </li></ul>India Health Report 2010 by Indicus Analytics
  11. 17. <ul><li>Shortfall in Manpower in health sector </li></ul><ul><li>Vacancies in sanctioned posts for specialists </li></ul>India Health Report 2010 by Indicus Analytics
  12. 18. Focus Areas for the Main Inputs for Health <ul><li>Creation, Training, Allocation, Motivation and Monitoring are five key focus areas for human Resources in Health </li></ul><ul><li>Capacity building and improving the quality of existing healthcare services. </li></ul><ul><li>Creation of sufficient infrastructure is must so that households in India have adequate access to water supply and sanitation </li></ul><ul><li>Overall improvements in nutrition can be achieved if focus is on improving Poverty, Awareness campaigns. </li></ul><ul><li>Overall a centralized entity is required to synchronize and coordinate various policies measures to improve overall health in India. </li></ul>India Health Report 2010 by Indicus Analytics
  13. 19. State-wise Distribution of Private Hospitals and Beds (% to total; 2002) India Health Report 2010 by Indicus Analytics
  14. 20. Access to Medicines in India <ul><li>Drug spending: Inadequate and inefficient </li></ul><ul><li>Drug Price Control: Ineffective and Inadequate- Price controls must ensure all sections of society can afford medicines. </li></ul>Barriers to expanding access to Medicines India Health Report 2010 by Indicus Analytics
  15. 21. Accessing Medicines <ul><li>Medicine Supply systems are unreliable </li></ul><ul><li>Procurements and logistics presents a serious problem for the supply chain management of Medicines. </li></ul><ul><li>Pharmaceuticals markets in India </li></ul><ul><li>Requires competition to ensure price controls happen in the case of essential drugs and medicines. </li></ul><ul><li>Drug Product Patents </li></ul><ul><li>The Indian Patent Regime must encourage Indian manufacturers to develop indigenous drugs to battle the growing burden of diseases. </li></ul><ul><li>Drug spending </li></ul><ul><li>Inadequate and inefficient </li></ul><ul><li>Drug Price Control </li></ul><ul><li>Ineffective and Inadequate- Price controls must ensure all sections of society can afford medicines </li></ul>India Health Report 2010 by Indicus Analytics
  16. 22. Evolving Role of Government <ul><li>India needs a good regulatory structure governing healthcare provision so as to address the many gaps in regulatory oversight and implementation. </li></ul><ul><li>The Health Ministry website lists 42 centrally-sponsored programmes and schemes for which expenditure was allocated. </li></ul><ul><li>Mid-term appraisal of NRHM has found significant improvement in health indicators even in the short period that the Mission has been in operation. </li></ul>India Health Report 2010 by Indicus Analytics
  17. 23. Government Programmes <ul><li>NRHM is an integrated bottom-up approach towards the achievement of this objective </li></ul><ul><li>Removed the system of parallel schemes, missions and programmes. </li></ul><ul><li>Aims at generating systemic improvements with checks and balances, community involvement, and monitoring and planning. </li></ul><ul><li>The proposed NUHM is a significant step in the evolution of the government’s role in direct healthcare provision </li></ul><ul><li>As suggested by initial documents, it seeks to expand NRHM into urban areas. </li></ul><ul><li>Recognises the existence of the ‘diversity of the available facilities in the cities’ and therefore rightly points towards ‘flexible city specific models led by the urban local bodies’. </li></ul>India Health Report 2010 by Indicus Analytics
  18. 24. Summarizing <ul><li>India lags behind other countries in health indices </li></ul><ul><li>Health outcomes considerably poor for those at </li></ul><ul><li>lower strata </li></ul><ul><li>Indians extremely vulnerable to financial risks </li></ul><ul><li>India’s slow progress towards MDGs </li></ul><ul><li>Public health care delivery mechanisms insufficient in capacity and poor in quality and delivery </li></ul><ul><li>Private sector facing its own set of problems </li></ul><ul><li>Key issues - Inadequate access, mixed quality of health services and a generally inefficient use of resources </li></ul><ul><li>NRHM and NUHM – key government programmes </li></ul><ul><li>Indian health care needs more focus and attention of the policymakers </li></ul>India Health Report 2010 by Indicus Analytics
  19. 25. Authors of India Health Report <ul><li>Dr. Ajay Mahal is Associate Professor, Harvard School of Public Health </li></ul><ul><li>Professor Bibek Debroy, Research Professor, Centre for Policy Research </li></ul><ul><li>Dr. Laveesh Bhandari, Director, Indicus Analytics </li></ul><ul><li>Dr. Veena Nabar, Ex-Chief Coordinator for the Government of India High Power Committee on Cooperatives </li></ul><ul><li>Dr. Sumita Kale, Chief Economist, Indicus Analytics </li></ul><ul><li>Dr. Devendra B Gupta, Senior Consultant, National Council of Applied Economic Research </li></ul><ul><li>Dr. Sakthivel Selvaraj is a Health Economist and faculty member at the Public Health Foundation of India </li></ul>India Health Report 2010 by Indicus Analytics
  20. 26. About Indicus <ul><li>Indicus Analytics is a specialized economics research firm </li></ul><ul><li>Indicus among India's highly credible economic research organizations </li></ul><ul><li>We assist business enterprises, industry associations, government and institutions in the development of policy scape serving strategic needs. </li></ul><ul><li>Indicus Analytics specialises in </li></ul><ul><li>Econometric Modeling </li></ul><ul><li>Monitoring & Evaluation </li></ul><ul><li>Macro-economics </li></ul><ul><li>Microeconomic Evaluations </li></ul><ul><li>Policy Analysis </li></ul>
  21. 27. <ul><li>Thank you </li></ul>Contact details Indicus Analytics Nehru House 2nd Floor, 4, Bahadur Shah Zafar Marg New Delhi 110002   India Health Report 2010 by Indicus Analytics