This document discusses the key challenges facing India's healthcare system and potential solutions. The main challenges are the large burden of infectious and chronic diseases, high maternal and child mortality rates, lack of universal access to healthcare, shortage of resources, and inadequate healthcare financing. Proposed solutions include strengthening public health programs, improving access to healthcare in rural areas, providing incentives for medical professionals to work in underserved areas, leveraging public-private partnerships, and increasing public financing of healthcare.

1. Healthcare challenges and
solutions in India
Kripa Krishnan
Mera Medicare
www.meramedicare.com

2. Indian Health Care system structure
Regulatory
markers
GOVERNMENT STATE
NATIONAL
MINISTRY OF
HEALTH
STATE
MINISTRY
Health
policies
Disease
control
Healthcare
delivery
Financing
Training of
personnel
Health
services
Family
welfare
Health
research
Traditional
medical
systems
Medical
education
Health
services +
family
welfare

3. CHALLENGES
 Mitigating burden of disease
Infectious
Chronic degenerative
 Maternal mortality, under-5 mortality, malnutrition
 Healthcare finance
 Lack of universal access to health care + Health inequality
 Lack of healthcare related resources

4. WHY DO SUCH CHALLENGES
EXIST?

5. Burden of disease
 Infectious diseases
Poor implantation of public health programs
Lack of environmental sanitation, safe drinking water,
information and awareness regarding importance of hygiene
and nutrition
Poor living conditions
 Chronic degenerative diseases
Lack of access to diagnostics (e.g. pap smear tests)
Poor diagnosis
Lack of specialists such as gynecologists

6. Burden of disease
Prevalence of non-communicable diseases
Lack of awareness of diseases such as diabetes and hypertension.
63 million diabetic patients in India
 Focus is more on communicable diseases such as tuberculosis and
Polio.
Rise of psychological disorders
 Lack of awareness and understanding

7. Maternal mortality, under-5 mortality, malnutrition
 Explosive population growth (High birth rates)
 Gender inequality
 Childbirth at home instead of hospital
 Poor education
 Poor nutrition
 Lack of breastfeeding
 Vulnerable to weakness and infection
 Poor immunity
 According to UNICEF, 1.7 million under the age of 5 die
 98000 affected with uncontrolled diarrhea

8. Healthcare Finance
 High cost of curative medical services
 Expensive health insurance
 Poor vaccination coverage
 Inappropriate and irrational use of high tech diagnostics
 The poor are more price sensitive to health care and are more likely
to report financial cost as a barrier for foregoing care when suffering
from illness

9. Lack of healthcare related resources
 Migration of qualified professionals
 Workforce concentrated in urban areas
 Underinvestment in health care related infrastructure in certain areas
 Limited opening hours
 Limited availability of drugs
 Poor physical environments
 Poor provider training and knowledge
 Poor governance of health care sector
 Adequate regulation of public and private sector has been difficult to
achieve
 Implementation of laws and codes is problematic

10. Lack of universal access + Health equity
 Health services not easily accessible to rural populations
Economics of scale achievable only in urban areas but the
majority of vulnerable groups exist where services are scarce
thereby affecting equity
Physical distance to facilities is an issue
 Health insurance only covers about a fifth of the entire population
Unorganized private sector accounts for almost 80% of outpatient
healthcare
 Dearth of qualified medical professionals in rural areas
Inappropriate drug use
 Emergence of anti-microbial drug resistance, drug toxicity, adverse drug reactions

11. SOLUTIONS FOR THESE
CHALLENGES

12. Solutions to burden of disease (infectious)
 Decentralized planning in districts
 Effective service delivery in communities
 Install adequate health facilities such as diagnostics in every
community and make check-ups compulsory and free of
costs/subsidized cost
 Sustained programs to change household behaviors and spread
awareness
 Creation of centers of excellence for health + nutrition policy
research

13. Solutions to burden of disease (Chronic)
 Prevention and management of the associated risk factors
 Avoid onset of disease
 Limit severity
 Improve vaccination coverage
Develop (a) Newer vaccines and (b) Newer modes of
delivery

14. Solutions to Maternal mortality, under-5 mortality,
malnutrition
 Needs a system that can meet the demands over a billion
people
Professional leadership
Trained cadre of personnel
 Coordinated approach
Patient and physician education
Antibiotic policy
Hospital infection control team
Regional and international antibiotic resistance surveillance

15. Solutions for Healthcare finance
 Data driven approach + analytic system driven by systems analysis
and software development
 Public-private partnerships directed at data capture, analysis, and
implementation
Accountability, transparency, and better leadership
 Development of the decision making process relating to achieving
health equity

16. Solutions to lack of universal access and inequality
 Formation of an integrated national/state public health system
Functional public health infrastructure that is shared between
central and state governments
 Efficient allocation of resources between different levels of services
and between different geographical regions
National, state, and local
Increase public financing
 Improve physical access to preventive and curative health services
especially in India’s rural population (e.g. hospital beds)
Improve infrastructure (better transport, roads, and
communication networks)

17. Solutions for Lack of healthcare related
resources
 Education of physicians and nurses in public sector
 Incentives and policies to (a) attract and (b) retain personnel
 Make it mandatory for professionals to do 3 years of rural service

18. References
 http://sajprevcardiology.com/vol8/vol8_4/ruralhealthcaresystem.htm
 http://www.kpmg.com/in/en/industry/pages/healthcare.aspx
 http://www.google.com/search?q=cache:Q1Fct0ah_K0J:https://hcmg.wharton.upen
n.edu/files/%3Fwhdmsaction%3Dpublic:main.file%26fileID%3D7831%2Bchallenges+in+h
ealthcare+india+ISB&client=safari&rls=en&oe=UTF-8&gfe_rd=cr&hl=en&ct=clnk