In the last decade or so, except for GDP growth, in most development indicators, India has significantly lagged behind the rest of the world – particularly in health care. India’s share in global deaths, maternal and prenatal disorders, communicable disease, infant mortality and morbidity, and nutritional deficiencies, to name a few, is staggering.
Supply and demand-side factors that affect health care access, and principles for achieving equity in health care are-
The present evidence on the wide disparities in public spending across different States in India, skewed spending on urban population, and inadequate expenditure on preventive services – factors that lead to unequal distribution of health care provision.
One of the alarming statistics provided (based on another study) is that in rural Rajasthan, 40 percent of private providers did not have a medical degree, and 20 per cent had not completed secondary education.
So it helps to understand whether such selective (non-academic) entry metrics negatively affect the quality of health care supply by producing more number of less competent professionals.
Insufficient public financing, inefficient risk pooling, and heavy out-of-pocket expenditure affect equity in health care financing.
This Issue particularly affects the poorest of the population whose expenditure share on health care is increasing rapidly over the years.
Creating an intelligence system like in Thailand, that integrates data management and its application, would help monitor and assess health care system performance efficiently.
Partnership with research and academic institutions could help co-ordinate and disseminate knowledge through sharing of best practices, and lead to efficient and effective utilisation of resources.
Increasing accountability, transparency and leadership combined with political priority for health care equity can potentially help increased and efficient health coverage, especially for the poor.
Increasing health care consciousness through awareness and education can largely address the demand-side challenges that the country faces.
Another move that could significantly ensure effective implementation of health care plans is to instate a few external agencies (independent of the government) that can periodically assess the execution of the health care plans.