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Healthcare scenario in India

Healthcare is one of the fastest growing industries in worldwide and our country in the present scenario. The size of the Indian hospital industry is presently estimated at 115 billion USD (against world industry USD 3.20 trillion). This industry is going at an annual rate of 13 percent. The private sector accounts for nearly 76 percent of the healthcare market while the public sector accounts for the rest. The Indian hospital industry has the potential to become a global hub for healthcare services. An increasing number of global players are focusing on the Indian market.

Complexities in the running of the hospital management have made it one of the challenging and sought-after courses. Similarly, with growing population and disease burden there is need of professionals who can plan and manage different kind of public health programs in both public and private sectors. According to a recent US survey, health administration/management is among the top ten millennium professions. India with the second largest population and a high incidence of diseases load. There is greater emphasis on quality healthcare and patient satisfaction. This has brought tremendous need for persons with professional qualification in healthcare. At present, the rising incidences of lifestyle diseases, the rising demand for affordable healthcare, the emergence of technologies like telemedicine, and the increased role of government in healthcare investment space are the major driving factors in Indian healthcare industry.

Some of the new initiatives are:

NITI Aayog. Government of India has established NITI Aayog, national institution for transforming India to replace Planning Commission on January 1, 2015. It will seek to provide a critical and strategic input into the developmental processes.

Niti Aayog will emerge as a think tank that will provide governments at central and state levels with relevant strategic and technical advice, across the spectrum of key elements of policy. NITI Aayog will monitor and evaluate the implementation of programmes and focus on technology, up gradation and capacity building.

Ayushman Bharat Scheme-PMJAY. This scheme has been launched by the government on September 23, 2018 to provide free access to healthcare for 40 percent people in the country. People can access their primary care services from a family doctor also. The services are medical care services such as pre and post hospitalization, day care services and new born child services. Dedicated ID card will be given to the eligible family and PMJAY e-card will be given at the time of hospitalization. Families identified by the govt. through deprivation and eligibility criteria based on socioeconomic status in both urban and rural areas, are identified as beneficiaries of the scheme. Each such identified family will be covered for `500,000 per year.

KAYAKALP-Swatch Bharat Abhiyaan. Launched on October 2, 2014 by Prime Minister focussing on promoting cleanliness in public space. Cleanliness and hygiene in hospital are critical to preventing infections and provide patients with a positive and encourages moulding behaviour related to clean environment. Its objectives include incentives and reorganization of the healthcare facility and to inculcate the culture of ongoing assessment of performance related to hygiene, cleanliness and sanitisation. Cash awards the best performed health facility. Assessment is based on the six parameters i.e. hospital cleanliness, sanitization and hygiene, infection control, biomedical waste management support services, and hygiene promotion. Facility should score more than 70 percent. This effort will increase the healthy living standard of people.

Mission Inderdhanush. A health mission launched by Union Health Minister on December 25, 2014 and inaugurated by Prime Minister Narendra Modi. This scheme includes 90 percent full immunisation coverage by the year 2020. Its goal is to ensure full immunization with all available vaccines for children up to 2 years and pregnant women. It is also known as Rainbow Vaccine depicting seven colours of the rainbow, targets to immunise all children against seven vaccine preventable diseases that are diphtheria, pertussis, tuberculosis, polio, hepatitis-B, measles, and tetanus.

Vaccine against Rota virus has been launched in phased manner in 2016 beginning with four states initially, which was later on expanded to seven states and by 2018 in all the 28 states/9 UTs. Rota virus vaccine is of two types: Rota Teq and Rota Rix, which is under UIP programme.

Initiative in COVID-19. The pandemic had thrown a new direction in development in regards to human resource, hospital infrastructures specially ICU services, equipments, investigative facilities specially establishment of molecular lab, availability of drugs, preventives measures etc. Vaccine preparation is at full swing. This involves coordinating the COVAX facility, a global risk sharing mechanism for pooled procurement and equitable distribution of eventual COVID-19 vaccines. Probably the health sector has been given top priority and will be an indication to increase the heath budget in future very near to 6 percent of GDP as proposed by WHO.

Aarogya Setu. It is a unique open source, COVID-19 contact tracing, syndromic mapping, available in 12 languages. It is a self-assessment digital service , available as a mobile application. Presented by the National Informatics Centre under the Ministry of Electronics and Information technology (Meity). Similarly, on the same pattern the government of UP and Uttarakhand have also developed an application for healthcare providers known as Chititsa Setu. Its objective includes to provide official training content, spread awareness, ensure safety of healthcare workers, sanitisation, and police personnel who are actively involved to protect citizens, breaking the chain of Covid-19 infection.

e-Health. The e-Health initiative aims at providing effective and economical healthcare services to all citizens. The SEHAT (Social Endeavour for Health and Telemedicine) has been launched by government to empower rural citizens by providing access to information, knowledge, skills, and other services in various sectors through the intervention of digital technologies.

Challenges in 2020 and beyond
Healthcare is facing many challenges healthcare delivery system. The fast evolving government regulations, technological innovations, and patients expectations create a new environment in which running a medical practice is not just about treating patients any more. So here are few challenges into 2020 and beyond by healthcare industry they are: Inequality in urban and rural forms, inadequate infrastructure, not enough funds for healthcare, healthcare financing, less emphasis on preventive care. No support for medical research, cyber security, increased patient demand and challenges to meet the threats arising in future from COVID-19 like situations.

The article is co-authored by Prof. (Dr) Hem Chandra, Vice Chancellor, HNB Medical University, Dehradun.

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