18 March 2025 : Daily Answer Writing
Q1) The persistent health equity challenges in India pose a critical barrier in achieving Universal Health Coverage. In this context discuss the role of the public and private sectors in ensuring adequate health access and outcomes across rural and urban areas. (15 marks, 250 words)
ANSWER
India faces persistent health equity challenges in the form of rural-urban inequality, lack of proper healthcare infrastructure, high out of pocket expenses, poor doctor to patient ratio, low public spending on health (2% of GDP), social
determinants (caste, gender, etc.).
With India suffering with poor public-health infrastructure, and evolving private-healthcare setup, these both sectors play a complementary role in
ensuring health access in rural and urban areas.
ROLE OF PUBLIC SECTOR IN ENSURING ADEQUATE HEALTH ACCESS
- Accessibility: Public sector in health ensures that everyone gets access to healthcare facilties through not-for-profit healthcare centres, government run hospitals, wellness centres and goevrnment doctors in every location around the nation.
- Affordability: Public sector ensures affordability of healthcare through various programmes like Ayushman Bharat, PM-JAY, Mission Indradhanush, etc.
- Availability: Public sector ensures that healthcare facilities and infrastructure is readily available to all including remote and inaccessible areas.
- Awareness: The education and campaigning by the public sector involving ASHA, panchayats, Anganwaadis, ensure that educational, nutritional and health-related information is transmitted to all sectors and sections of the society. For example, ASHA workers campaign for pregnant and lactating mothers.
- Policy Implementation: Public sector ensures that policy devised by the government reaches the grassroot levels and ensures implementation. For example, the role of the public sector in National Health Policy, 2017.
ROLE OF PRIVATE SECTOR IN ENSURING ADEQUATE HEALTH ACCESS
- Expertise: The private sector brings in the requisite expertise, research and experience required for working in the healthcare system, especially tertiary healthcare. For example, almost 80% of doctors in India work in the private sector.
- Technological Advancement: The private sector through FDI and funding provides access to new and evolving technologies in healthcare. For example, DBS was brought in by Apollo to India to treat neurological disorders.
- Efficiency: Private sector providers are usually efficient in their service delivery while catering to the quality.
- Tertiary Healthcare: The private sector supplements the public healthcare system by providing additional healthcare facilities, particularly in urban areas. This is the most important aspect in tertiary healthcare which is almost dominated by the private sector.
- Innovation: The private sector drives innovation in medical technology, pharmaceuticals, and healthcare delivery models. For example, development of vaccines, new drugs, etc.
- Filling the Gaps: In NHP, 2017, the role of the private sector is emphasized in filling up the gap created due to low public expenditure in health (2.1% of GDP). In several government programmes, the private sector is expected to participate in order to fill the gap created due to lack of public infrastructure or public healthcare experts. For example, in JSY, the private dispensaries are also allowed to participate in labour and delivery of women.
To achieve the goal of Universal Healthcare in India, the way forward is development and strengthening of PPP in healthcare, where while the public sector focusses on improving the four A’s (Affordable, Accessible, Available and Awareness), the private sector can complement by filling in the gaps created due to inadequacy of funds. In this manner, a sustainable healthcare system can be developed in India.
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