The Indian healthcare system is a multi-layered system that consists of primary, secondary, and tertiary care, aimed to address the various health needs of the population. It plays an essential role in providing equitable access to healthcare, ameliorating health outcomes, as well as encouraging economic growth by increasing productivity.
Structure of the Indian Healthcare System
The structure of the Indian Healthcare System can be seen as follows:
Primary Healthcare
It is the foundational level of the healthcare system, whose primary purpose is to provide basic healthcare services to all. It focuses more on prevention, early diagnosis/detection, and treatment of basic and common ailments.
(A) Components:
(i) Promotion of health and education.
(ii) Immunisation programs.
(iii) Maternal and child health services.
(iv) Prevention and treatment of common diseases.
(v) Nutrition and sanitation awareness.
(B) Infrastructure:
(i) Sub-Centres (SCs): Taken care of by Auxiliary Nurse Midwives (ANMs), they manage rural and remote populations.
(ii) Primary Health Centres (PHCs): Primary point of contact for professional medical care, handling curative, preventive, and promotive healthcare.
Secondary Healthcare
It serves as a referral system for patients from primary care. It has specialists and provides more advanced and specific medical treatment.
(A) Components:
(i) District Hospitals and Community Health Centres (CHCs).
(ii) Specialised services like gastroenterology, gynaecology, nephrology and many more.
(iii) Emergency (trauma) care and minimally invasive or minor surgeries.
(B) Infrastructure:
(i) CHCs: They act like a bridge between PHCs and tertiary healthcare, providing specialist services.
(ii) District Hospitals: They are meant for comprehensive care and also manage larger populations.
Tertiary Healthcare
Tertiary healthcare refers to the highest level of medical care, delivering super-specialised services and advanced treatments.
(A) Components:
(i) Super-Speciality Hospitals: They provide advanced treatments for complicated diseases like cancer, organ transplants, and neurosurgery.
(ii) Teaching Hospitals: Associated and linked with medical colleges and research institutions.
(iii) Private Hospitals: A large and pivotal contributor in urban areas for specialised care and diagnosis of diseases.
(B) Infrastructure:
(i) All India Institute of Medical Sciences (AIIMS) and other premier institutions.
(ii) Corporate hospitals providing cutting-edge tech-loaded treatments and global standards of care.
Key Challenges in Indian Healthcare
There are several challenges in the Indian healthcare sector are as
(i) Unequal Access: Rural areas face a crunch of access to quality healthcare in contrast to urban centres.
(ii) Workforce Shortages: India faces a huge shortage of doctors, nurses, and healthcare workers, specifically in rural areas.
(iii) Infrastructure Gaps: Many healthcare facilities are devoid of basic amenities and modern/tech-assisted medical equipment.
(iv) High Out-of-Pocket Expenditure: A major chunk of healthcare expenses is borne by people themselves, leading to financial stress.
(v) Disease Burden: India faces a dual burden of contagious diseases (like tuberculosis) and non-contagious diseases (like diabetes and heart conditions).
Government Initiatives to Strengthen Healthcare
(i) Ayushman Bharat (Pradhan Mantri Jan Arogya Yojana): It ensures free health coverage to economically weaker sections for secondary and tertiary care.
(ii) National Health Mission (NHM): Its primary aim is to improve primary and secondary healthcare infrastructure, particularly in rural areas.
(iii) Jan Aushadhi Scheme: It provides economically viable generic medicines through dedicated medical stores.
(iv) Mission Indradhanush: It aims to accomplish full immunisation coverage for children and pregnant women.
(v) Digital Health Initiatives: It implements e-health records and telemedicine to ameliorate accessibility.
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Strategies for Improvement
(i) Strengthening Primary Care: It enhances budgetary allocation for PHCs and SCs, recruits trained healthcare professionals, and provides availability of essential medicines.
(ii) Public-Private Partnerships (PPPs): It collaborates with private players to upgrade infrastructure and lessen patient costs.
(iii) Focus on Preventive Healthcare: Encouragement to healthy lifestyle (exercise, healthy diet, etc), regular body checkups can mitigate the burden of diseases diagnosed at a later stage.
(iv) Medical Education Reforms: It expands medical colleges, introduces innovative training programs, and incentivises rural postings for doctors.
(v) Universal Health Coverage: Under this program, economically feasible and quality services are provided to all.
Conclusion
The Indian healthcare sector, being a multi-level system, plays an essential as well as critical role in addressing the health requirements of a diverse set of people in India and the world as well. However, issues like inequality in access, infrastructure deficit, and insufficient workforce demand urgent heed. Robust primary, secondary, and tertiary care, besides implementing effective and efficient government policies, will ensure equitable and quality healthcare to all Indians. A strengthened healthcare system is the fabric and foundation of a healthier and more prosperous nation.