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Can India’s Public Healthcare System Fight The COVID-19 menace?

With a rising number of positive cases in India, Indian PM Narendra Modi announced a 21-day nationwide lockdown on March 24. The leader made firm restrictions requiring people to stay indoor. The lockdown was targeted at controlling the spread of the disease. Even the Indian Finance Minister Nirmala Sitharaman announced approximately USD $23 billion for help to ensure food security, insurance coverage and direct cash transfers to the poor.

Well, India has just 8 percent of the population that includes people over the age of 60. So it may not see deadly effects like other countries such as Italy, where about 23 percent of the population is over 65. Although the number of elderly people amount to 100 million, it is also worrisome for an under-resourced healthcare system of a country like India. 

While the entire world is struggling to get the vaccine, the healthcare system is well aware of the fact that they have to be ready to deal with a flurry of COVID-19 patients in future. The latest National Health Profile 2019, released in October 2019, depicts that the Indian Government has been spending less than 1.3% of the GDP on healthcare which is one of the lowest in the world. 

Rural area is the primary challenge

Right now the spread of pandemic is limited to urban areas. But once if the rural area gets affected, it will be very difficult for the public healthcare system to control the situation. Two third of the country’s population lives in rural areas. Everyone is aware that the healthcare facilities in villages are almost ineffective and broken.

There are several problems starting with the availability of medical professionals, inadequate supply of medicines and medical equipment. Above all, there is a lack of basic amenities such as drinking water, washrooms and electricity. 

Indian Government is doing its best to bring the frontline health worker along with private healthcare centers as they have played a vital role in eradicating past outbreaks such as Zika, Ebola and Nipah virus. In a situation like pandemics, frontline health workers and private healthcare centers can stop people from approaching the traditional treatment and direct them for the right treatment. 

Fear of Insufficient Testing

The primary concern for India is the number of tests being conducted. According to the news reports South Korea and Italy had tested 295,647 and 148,657 people, respectively, as of March 18. As of March 17, South Korea had carried out more than 5,500 tests per million people, and Italy more than 2,500 per million. With an average of just over 10 tests per million people, India is vastly behind.

Even in an interview to The Wire, Dr Ramanan Laxminarayan,  director of the Washington-based Center for Disease Dynamics, Economics and Policy mentioned that “India could be the next coronavirus hotspot guessing that India has more than 10,000 undetected cases.”

Though India is increasing the pace of its testing aggressively as it has ordered millions of test kits and asked WHO for more. The testing price for COVID-19 is fixed to avoid exploitation at INR4500/- 

In order to handle the situation, the government has started investing more money into private healthcare. Hopefully this action may flatten the curve of extensively spreading virus. 

While the step of lockdown and social distancing is dedicatedly followed by the Indian population, Indian Government also took some valuable precautionary steps such as shutting down schools, colleges and other public places.

As it happened, the authorities and medical experts paced up the screening process of the travellers (domestic or international) at railway stations, airports and other public places. 

Difference in State Healthcare in India

Public healthcare system is mainly managed by the state government. Every state is allotted a budget for healthcare expenditure. In a situation of a pandemic like COVID-19, making arrangements for new beds, ventilators, number of beds and ICUs and other infrastructural arrangements becomes difficult for the public healthcare system. They need the support of the private sector for the basic services. 

All these facilities in rural and urban areas vary across each state. For example, Kerala shares a large amount of public expenditure on public health and better facilities.

In January 2019, a guideline was issued for private sectors to invest in building hospitals in Tier -2 and Tier-3 cities by the Health Ministry under Pradhan Mantri Jan Arogya Yojana (PM-JAY). 

News:

According to the guidelines, the state governments was asked to do three things for the private investors in healthcare: (i) earmark and provide land within specific times (ii) facilitate administrative clearances and (iii) provide 40% viability gap funding (VGA) – advance payment from the exchequer (taxpayers’ money) for support in building the private facilities and provide gap funding up to 50% of tax on various costs, including capital cost, granting the status of industry to hospitals for ensuring that VGF is provided.

Then after a year in January 2020, the government introduced Public-Private Participation (PPP) under Niti Aayog. In this, government-run public hospitals were predicted to be handed over to private players. But this model is no more a part of policy conversations.

Ayushman Bharat for Deprived families

India’s healthcare also needs preparation to deal with this situation in terms of health insurance coverage. In the absence of financial security, families often adjust their health expenditure either by uncovering their savings, borrowing, selling properties or other assets or sacrificing on their treatment. Therefore, to overcome these challenges, NHA decided to cover COVID-19 treatment under Ayushman Bharat for the poor. 

For those who are unaware, Ayushman Bharat is an insurance scheme for below poverty line people in India. The scheme ensures that the poor population of India also gets the medical facilities without having to pay for it. Similar steps are being taken by Indian Government in order to fight coronavirus such as launching the Aarogya Setu mobile application. 

What is Aarogya Setu App?

To contain the spread of Novel Coronavirus, the Indian Government has launched Aarogya Setu App to trace, track, treat and test COVD-19 infection. All you need to know about Aarogya Setu App:

  • “Aarogya Setu” means a bridge of health in Sanskrit.
  • It tells users if they can catch Coronavirus. Through GPS and Bluetooth, it determines if a person is near or has been in contact with a Coronavirus-infected person. 
  • It also tells hygiene practices to be followed during the pandemic. 

Therefore, the next few days are very critical as these hard times demand an intense approach. This is the best opportunity for the Indian Government to transform this weak healthcare system and bring in coordination between public and private medical facilities to fight any such challenges in future with ease.

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