India witnesses radical changes in health infrastructure under Modi government

Jan hai to Jahaan Hai – an adage since ages, would have been just that – one for the ages, had it not been for the proactive and in many ways disruptive approach that PM Modi-led government has taken towards providing accessible, affordable, quality healthcare, for all citizens of India.

While both planned and unexpected medical expenditure was an additional burden for all under the previous administrations, it was the low-income households that suffered the major brunt. Thanks to programmes such as the flagship AB PM-JAY scheme that ensures universal health coverage to crores of poor families and the Ayushman Bharat Digital Mission that is revolutionising healthcare in India through digitisation of health records via Ayushman Bharat Health Accounts (ABHAs), medical needs are met, and unfathomable fears around expenses, mitigated.

The Government’s far-sighted approach towards healthcare is not an isolated strategy. Think back to Covid-19; India began implementing grave measures for the containment of the pandemic much earlier than the expected trajectory. Be it “do gaj doori” or mask mandates, or lockdowns, we were so well prepared that in April 2020, India had already set up a vaccine task force. Eventually, by administering over 220 crore vaccine doses, as well as exporting them to the world – Vaccine Maitri – We emerged as an exemplary roadmap for many other countries.

Not just during the pandemic, future-proofing India’s healthcare ecosystem, be it through the government’s bold decision of replacing the Medical Council of India with the National Medical Commission thus eliminating corruption, or the setting up of integrated public health labs across districts, or giving an impetus to education in medicine (such as the first ever AIIMS in the Northeast in Assam), over the last nine years, this government has followed an extremely comprehensive and visionary approach.

Of course, this extends to healthcare being made available digitally. Ayushman Bharat Digital Health Mission (ABDHM) which includes CoWIN and Aarogya Setu is a shining example of the power of tech in healthcare, or healthtech, becoming a viable tool for quality. ABDM facilitates evidence-based decision making for effective health interventions.

Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP) that makes quality generic medicines available at affordable prices through Pradhan Mantri Bhartiya Janaushadhi Kendras (PMBJKs) is another great example of how the ‘complete coverage’ approach informs every health policy. Today, around 9200 Jan Aushadhi Kendras are providing quality generic medicines at affordable prices to citizens. At the Jan Aushadhi Kendras OTC products can be purchased without a prescription and they sell close to 1800 drugs and 280 surgical instruments. The most significant draw though is that the prices of medicines are 50-90 per cent cheaper than similar branded medicines sold elsewhere in the market. The AMRIT pharmacies, similarly, sell more than over 5000 drugs, stents, implants, surgical disposables and other consumables at up to 60 per cent discounts. This covers major diseases such as oncology and cariology.

In alternative and holistic therapy, too PM Modi-led government has made tremendous strides. AYUSH centres that cater to overall Wellness Ayurveda, Yoga, Naturopathy, Unani, Siddha and Homeopathy are seeing a much-awaited resurgence and adoption, both in India and globally. The market size of Ayush industry has increased exponentially over the last few years. This has led to another viable and healthy offshoot, the ‘Ayurveda Aahara’ category aimed at wellness that begins with right intake.

As with everything else in nature, nurture begins with the mother. It is therefore, with utmost empathy that PM Modi-led government has approached healthcare as it relates to a mother, and child: Surakshit Matritva Aashwasan (SUMAN), for instance provides assured, quality healthcare at zero-cost and zero-tolerance for denial of services to those visiting a public health facility. Mission Indradhanush (MI) extends immunisation coverage to all children across the country; by fully vaccinating children up to 5 years and pregnant women, this is the government’s effort to reduce child mortality. Similarly, PM POSHAN scheme covers school children studying in classes first through eighth in government and government-aided schools.

Perhaps the best analogy is also the simplest: the Jan Aushadhi Kendras sell sanitary napkins at just Rs. 1 to accord safety, hygiene and dignity to women. The same can be said of the government’s overall approach to healthcare for all – it is safe, it is hygienic and most importantly, by way of direct as well as indirect indicators, it accords dignity all. Without exception.

Comparative analysis: Then and now
Budget allocation for Department of Health & Family Welfare has increased by 159%!

• 2013-14 (BE): Rs. 33,278 crore
• 2023-24 (BE): Rs. 86,175 crore

The per capita Government Health expenditure has been increased 82%!

• 2014-15: Rs. 1108
• 2018-19: Rs. 2014

Healthcare: 2.6 times increase in expenditure in last 9 years!

• 2015-16: Rs. 34.13 thousand crore
• 2023-24 (BE): Rs. 88.95 thousand crore

Number of AIIMS: 3X Increase!

• 2014: 7
• 2023: 23

Number of Medical Colleges: Increase of 71%!

• 2014: 387
• 2013: 660

Number of MBBS seats: Increase of 97%!

• 2014: 51,348
• 2023: 1,01,043

Number of PG seats: Increase of 110%!

• 2014: 31,185
• 2023: 65,335

Households with any member covered by health insurance

• NFHS-4 (2015-16): 28.7%
• NFHS-5 (2019-21): 41%

Neonatal Mortality Rate (NMR) reduced 23%!

• 2014: 26
• 2020: 20

Maternal Mortality Ratio (MMR) reduced 25%!

• 2014-16: 130 per lakh live births
• 2018-20: 97 per lakh live births

Under-5 Mortality Rate (U5MR) reduced 28%!

• 2014: 45 per 1000 live births
• 2020: 32 per 1000 live births

A family which used to spend nearly 62% of health expenditure on its own is now spending only 41%!
Share of Out-of-Pocket expenditure in Total Health Expenditure:

• 2014-15: 62.6%
• 2019-20: 47.1%

Share of Government Health Expenditure in Total Health Expenditure increased

• 2014-15: 29%
• 2019-20: 41.4%

Market size of AYUSH industry increased 535%!

• 2014-15: Rs. 23,532 crore
• 2020: Rs. 1.49 lakh crore

Organiser Weekly