Health Mission-Going Digital

GS-2 GOVERNANCE-Issues relating to development and management of Social Sector/Services relating to Health.

Introduction

     The Independence Day address of the Prime Minister launching the National Digital Health Mission (NDHM)(‘Going Digital’) during an unprecedented novel coronavirus pandemic crisis.

      India’s competitive advantage lies in its large pool of well-trained medical professionals

      India is also cost competitive compared to its peers in Asia and Western countries.(cost of surgery in India is about 1/10th of that in the US or Western Europe.)

      Even though India ranks 145 among 195 countries in terms of quality and accessibility of healthcare.

Indian healthcare delivery system is categorised into two-

  • Public healthcare system:focuses on providing basic healthcare facilities in the form of primary healthcare centres (PHCs) in rural areas.
  • Private sector: provides majority of secondary, tertiary, and quaternary care institutions with major concentration in metros and tier I and tier II cities.

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Objectives:

  • Establishing,managing and exchanging core digital health data.
  • Promoting the adoption of open standards.
  • Creating personal health records(easily accessible to citizens and service providers on consent)
  • Promoting health data analytic and medical research.
  • Enhancing Efficiency and effectiveness of governance.
  • Ensuring quality.
  • Leveraging the information systems.
PROSCONS
Treatment and Viewing of Healthcare System(tragic loss of lives, the exponential increase in cases, economic morass and social disruptions have emerged by the pandemic)Can be highly misused by the private healthcare sector, diagnostic labs, pharmaceutical and insurance sectors.
Adequate measure for Emergence of Reports on Healthcare’s Problem.Mistakes might cause more damage than good to the health of the people.
Lack of interest between stakeholders of the Healthcare System will be decreased.Self-reported morbidities from successive National Sample Surveys suggest a large proportion of ailments go unrecognised and undetected.
Provide ‘healthcare for all’not be possible without enhancing public health provision from bottom-to-top approach, access to affordable and quality healthcare in rural areas.

Challenges:

  • Dealing with ethical issues, breach of privacy, and dealing with social stigma.
  • Aadhaar and Health Management Information Systems (HMIS) raises doubts on ensuring the quality of registration and maintenance of records.

Current Status in Health Sector:

  1. India lags behind its BRICS peers on the road.
  2. Total health expenditure (both private and public1%) in India is just 3.6% of the country’s GDP.(Canada 8% and Australia 6.3% of its GDP)
  3. According to the World Health Organisation, India finishes second from the bottom amongst the 10 countries on percentage in GDP spending.
  4. OECD data available for 2017-India reportedly has only 0.53 beds available per 1,000 people as against 0.87 in Bangladesh, 2.11 in Chile, 1.38 in Mexico, 4.34 in China and 8.05 in Russia.

Way Forward:

  • Provide healthcare without sufficient health budget sanctions and revamping of existing public healthcare infrastructure.
  • Healthcare System:
    • society must reframe its outlook and notions about healthcare workers.
    • Faith in the doctor and trust in the hospital/healthcare system.
    • Governments need to make laws more effective,less virulent and more constructive as regulation by legislation.
    • Social media needs a dedicated group of health evangelists to fact check, correct and inform the public.
  • Public health professionals: Government and private HIPs to upgrade their hardware and connectivity systems, training of present staff, the entry of data afresh apart from other indirect costs.

Conclusion:

         Healthcare has become one of India’s largest sector, both in terms of revenue and employment.

Public health practitioners at the grass-root level would continue to wonder if digitisation is the immediate problem facing the health sector or the best way to go about addressing data gaps.

They may be blamed for trying to delay the inevitable; the inexorable march to digitization. Perhaps they need to discover that data is the only cure, for all our ills.

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