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Mains Test Series

Issues relating to the development and management of social sector

Q. India’s health care system is not designed to cater to the rising challenges of Non-communicable diseases. Comment (250 words)

Non-communicable diseases tend to be long-duration diseases resulting from a combination of genetic, physiological, environmental and behavioural factors.

In India, 66% of the total deaths were due to non-communicable diseases in 2019 according to the WHO report, “Invisible Numbers – the true scale of Noncommunicable Diseases.”

Challenges India’s health care system:

  1. Structural Problems:
    1. Focus on Communicable diseases: India’s health architecture is designed in a way to focus on communicable diseases more. A significant portion of the health budget goes to communicable diseases.
    2. Reactive Health Support: The Indian Health system provides reactive health care instead of rehabilitative and proactive healthcare.
    3. Aging Population: The Indian Healthcare system is insufficient to deliver Palliative care.
  2. Economic Problems:
    1. The problem of Affordability: For instance, cures for cancer and cardiovascular diseases, drugs, etc., are highly expensive.
    2. High out-of-pocket expenditure: Most health services are provided by private facilities, and 65% of medical expenses in India are paid outof-pocket by the patients.
    3. Low Insurance coverage.
  3. General Deficiencies:
    1. Lack of infrastructure: India’s health care system is struggling with deficient infrastructure in the form of a lack of well-equipped medical institutes.
  4. Load on the system:
    1. High Patient Load: For example, according to a study, India contributes to nearly one-sixth of the global diabetes burden of 422 million.
    2. Shortage of efficient and trained manned power: For example, the doctor-to-patient ratio remains abysmally low at merely 0.7 doctors per thousand people compared to the WHO standard of 2.5 doctors per 1000 people.
  5. Malnutrition:
    1. Bad lifestyle and heavy use of fatty acids, sugar and high salt diets.
    2. Heavy reliance on Carbohydrates in diets and India’s PDS system.

Solutions to the rising challenges:

  1. Preventive care: Built upon robust early screening facilities for Noncommunicable diseases such as oral, breast, and cervical cancers. For this, the government has come up with Ayushman Bharat health and wellness centres.
  2. Strengthening of tertiary care cancer facilities scheme to support the setting up state cancer Institutes and Tertiary care centres in different countries.
  3. Access to essential NCD medicines: For example, More Jan Aushadhi stores needed to be set up by the Department of Pharmaceuticals to provide generic drugs at affordable prices.
  4. A digital collection of Data for Non-communicable diseases for better policy.
  5. Better Lifestyle:
    1. Inclusion of AYUSH system into the health system like Yoga to prevent Cardiovascular diseases and diabetes.
    2. Focus on physical activity and mental health: Multiple interrelated risk factors such as raised blood pressure, glucose, lipids, and obesity are preventable just by ensuring adequate physical activity.
  6. Better Nutrition
    1. Nutritional support: By addressing the challenges of Malnutrition, the incidence of diseases like diabetes, heart disease and hypertension can be prevented.
    2. Better FSSAI standards and regulations to restrict high-fat, sugar and salt diets.
  7. Awareness generation Campaigns: Grassroots level delivery of locally relevant & contextual messages for health promotion & primordial prevention of Non-communicable diseases, for example, through ASHA workers.
  8. Disease-specific Campaigns:
    1. Higher taxation of Tobacco, Liquor, Fatty foods, etc.
    2. More Research for cancer treatment, genetics and rare diseases.
    3. More access to insulin.


Non-communicable diseases need higher priority in financial allocation and health system strengthening initiatives with a strong emphasis on primary care. India must improve its health infrastructure through the PM Atmanirbhar Swasth Bharat Programme.

The National Health Policies 2017 highlights the health for all’ approach to providing assured healthcare at an affordable cost, whereas healthcare policy should focus on proactive healthcare, not reactive healthcare.

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