A recent study has called for a radical transformation in the health system architecture of India if the country is to achieve the government’s vision to ensure health for all. The document, written by Professor Vikram Patel (Public Health Foundation of India and the London School of Hygiene and Tropical Medicine) and colleagues, documents progress of India on the main health indicators over the past decade, but its many deficiencies as well; identifies structural problems with the health system, and reaffirms the recommendations of previous expert groups on the need for a radical new vision for the system of health care in India. Read:? health in India – is the Government, Narendra Modi will bring achche din
The most worrying indicator system deficiencies health care in India is the observation that health care costs are driving millions into poverty. The authors argue not only for more resources, but for a national integrated health system, built around a public system of strong primary care with a supporting role clearly defined for the private sector as indigenous, that (i) the acute addresses as well as chronic care necessarily health; (Ii) offers the option of care that is rational, accessible and of good quality, (iii) is out of cash at the time of the provision of services, and (iv) is governed by a strong regulatory framework to ensure accountability of counts.
The document records the considerable efforts made in the health sector, with national and local governments to invest in programs to control specific diseases and the National Health Mission focusing on maternal and child health.
Despite this, a number of structural weaknesses have led to a situation in which the performance of the health system in India is unable to cope with the huge demands placed on it by the growing population from the country.
According to the document, India follows the neighbors behind the region, especially in health indicators such as infant mortality of children under five years, with India recording a 27 percent all neonatal deaths and 21 percent of child deaths in the world. Deficiency of chronic malnutrition that manifests itself as stunting continues to affect a third of children under five. On the load it is large and rapidly increasing burden of noncommunicable and chronic diseases.
According to Vikram Patel, “The health timebomb ticks on due to the growing burden of noncommunicable diseases. Suicide is now the leading cause of death among young Indians, and Indian is likely to suffer from a heart attack at least ten years earlier than in developed countries, yet the health system has barely responded to these urgent health crisis. ”
In addition, says Patel, no, ‘generalized inequalities in health outcomes that are evident in the large differences in morbidity and mortality across socioeconomic status, caste, class, gender and geographic location. “
The document states that a major cause of this large and unevenly distributed burden of disease in India can be attributed to the social determinants beyond the provision of conventional health care sector, such as urbanization, lack of access to water and sanitation, food insecurity, environmental degradation, and the system of generalized castes.
According to the authors, the current health system in India has to correct its course urgently through seven key challenges. the first is to give priority to primary care and strengthening massively weak primary health system in the country. second is the challenge of skilled human resources, where a general shortage further complicated by the uneven distribution of skilled workers. third, India needs to make better and regulate its large private sector. fourth, sadly low public spending on health has paralyzed the public sector and created major obstacles in quality and access and most of this spending was out of pocket leading to catastrophic health care costs for millions of people.
Fifth is the issue of information systems fragmented and uncoordinated health metrics data health in India are collected by multiple agencies and surveillance systems, but are often incomplete and inadequate. Sixth, curb the irrational use and containing the rising costs of drugs and technology. And finally, to address the issue of weak governance and accountability.
The study was published in The Lancet.
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