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    Health System in India: Rochak Naveen Singh Bains Mbbs 2 Prof Roll No. 75

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    The health system in India has several levels of government that share responsibility for health. It struggles with low spending, high out-of-pocket costs, and large inequities across economic classes and rural/urban and gender divides. While India produces many medical professionals and drugs, health indicators are poor - only 43.5% of children are fully immunized and 80% of health spending is paid directly by individuals. The system excludes the poor, who face greater debt and health issues due to lack of access and services. Overall, the political and economic context has led to a health system that fails to provide basic care as a right.

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    Health System in India: Rochak Naveen Singh Bains Mbbs 2 Prof Roll No. 75

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    fullugullu
    21 views16 pages
    The health system in India has several levels of government that share responsibility for health. It struggles with low spending, high out-of-pocket costs, and large inequities across economic classes and rural/urban and gender divides. While India produces many medical professionals and drugs, health indicators are poor - only 43.5% of children are fully immunized and 80% of health spending is paid directly by individuals. The system excludes the poor, who face greater debt and health issues due to lack of access and services. Overall, the political and economic context has led to a health system that fails to provide basic care as a right.

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    The health system in India has several levels of government that share responsibility for health. It struggles with low spending, high out-of-pocket costs, and large inequities across economic classes and rural/urban and gender divides. While India produces many medical professionals and drugs, health indicators are poor - only 43.5% of children are fully immunized and 80% of health spending is paid directly by individuals. The system excludes the poor, who face greater debt and health issues due to lack of access and services. Overall, the political and economic context has led to a health system that fails to provide basic care as a right.

    Copyright:

    Attribution Non-Commercial (BY-NC)
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    21 views16 pages

    Health System in India: Rochak Naveen Singh Bains Mbbs 2 Prof Roll No. 75

    Uploaded by

    fullugullu
    The health system in India has several levels of government that share responsibility for health. It struggles with low spending, high out-of-pocket costs, and large inequities across economic classes and rural/urban and gender divides. While India produces many medical professionals and drugs, health indicators are poor - only 43.5% of children are fully immunized and 80% of health spending is paid directly by individuals. The system excludes the poor, who face greater debt and health issues due to lack of access and services. Overall, the political and economic context has led to a health system that fails to provide basic care as a right.

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    Health System in India

    ROCHAK NAVEEN SINGH BAINS


    MBBS 2ND PROF
    ROLL NO. 75
    Introduction
    The political economy context
    The organisational structure and delivery mechanism
    Health financing mechanisms
    Coverage patterns
    Current status of health and health care
    The Political Economy Context
     A democratic federal system which is subdivided into
    28 States, 7 union territories and 593 districts
     In most of the states three local levels of government
    (Panchayati-raj)
     Per capita income US $440
     435 million Indians are estimated to live on less than US $ 1 a day
     36% of the total number of the worlds’ poor are in India
     Tax based health finance system with health insurance
     80% health care expenditure born by patients and their families
    as out-of -pocket payment (fee for service and drugs)
     Expenditure on health care is second major cause of
    indebtedness among rural poor
    Main Systems of Medicine
    Western allopathic
    Ayurveda
    Unani
    Homeopathy
    Government Health System
     Three levels of responsibilities-

     First-
     health is primarily a state responsibility
     Second-
    - the central government is responsible for developing and
    monitoring national standards and regulations
    - sponsoring various schemes for implementation by state
    governments
    - providing health services in union territories
     Third-
     both the centre and the states have a joint responsibility for
    programmes listed under the concurrent list.
    Administrative Structure
    1. Central Ministries of Health and Family
    Welfare –
    - Responsible for all health related
    programmes
    - Regulatory role for private sector
    2. State Ministries of Health and Family
    Welfare
    3. District Health Teams headed by Chief
    Medical and Health Officer
    Service Delivery Structure
    Sub Health Centres-
    staffed by a trained female health worker and/or a
    male health worker for a population of 5000 in the
    plains and a population of 3000 in hilly and tribal
    areas.
    Primary Health Centres-
    staffed by a medical officer and other paramedical
    staff for a population of 30,000 in the plains and a
    population of 20,000 in hilly, tribal and backward
    areas. A PHC centre supervises six to eight sub centres.
    Service Delivery Structure
    Community health centres-
    with 30-50 beds and basic specialities covering a
    population of 80,000 to 120,000. The CHC acts as a
    referral centre for four to six PHCs.
    District/General hospitals-
    at district level with multi speciality facilities (City
    dispensaries)
    Medical colleges and All India institute of
    Medical Sciences
    Health Financing Mechanisms..
    Revenue generation by tax
    Out of pocket payments or direct payments
    Private insurance
    Social insurance
    External Aid supported schemes
    Spending on Health
    Annually over 150,000 crores or US$34 billion, which is
    6% of GDP (Government spending on health Is only
    0.9% of GDP)
    Out of this only 15 % is publicly financed 4% from
    social insurance, 1% by private insurance remaining
    80% is out of pocket spending ( 85% of which goes in
    private sector)
    Only 15% of the population is in organised sector and
    has some sort of social security the rest is left to the
    mercy of the market
    Contradictions
    India has the largest numbers of medical colleges in
    the world
    It produces the largest numbers of doctors among
    developing countries
    It gets “medical Tourists” from developed countries
    This country is fourth largest producer of drugs by
    volume in the world
    But... the current situation….
     Only 43.5% children are fully immunised.
     79.1% of children from 6 months to 5 years of age are anaemic.
     56.1% ever married women aged 15-49 are anemic.
     Infant Mortality Rate is 58/1000 live births for the country with a
    low of 12 for Kerala and a high of 79 for Madhya Pradesh.
     Maternal Mortality Rate is 301 for the country with a low of 110
    for Kerala and a high of 517 for UP and Uttaranchal in the 2001-
    03 period.
     Two thirds of the population lack access to essential drugs.
     80% health care expenditure born by patients and their families
    as out-of -pocket payment (fee for service and drugs)
     Health inequalities across states, between urban and rural
    areas, and across the economic and gender divides have become
    worse
     Health, far from being accepted as a basic right of the people, is
    now being shaped into a saleable commodity
    Contd….
    poor are being excluded from health services
    Increased indebtedness among poor
    (Expenditure on health care is second
    major cause of Indebtedness among
    rural poor)
    Difference across the economic class spectrum and
    by gender in the untreated illness has significantly
    increased
    Cutbacks by poor on food and other consumptions
    resulting increased illnesses and increasing
    malnutrition
    Health Inequities
    The infant mortality Rate in the poorest 20% of the
    population is 2.5 times higher than that in the richest
    20% of the population
    A child in the ‘Low standard of living’ economic group
    is almost four times more likely to die in childhood
    than a child in a better of high standard living group
    A person from the poorest quintile of the population,
    despite more health problems, is six times less likely to
    access hospitalisation than a person from richest
    quintile.
    Health Inequities
    A girl is 1.5 times more likely to die before reaching her
    fifth birthday
    The ratio of doctors to population in rural areas is
    almost six times lower than that for urban areas.
    Per person, government spending on public health is
    seven times lower in rural areas compared to
    government spending urban areas
    TH
    A NK
    S
    THANKS

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