Even though access to health care has improved over the years, India faces persistent obstacles to health equity. In this context, examine the barriers to achieving health equity in India and suggest measures to overcome these challenges.

Why?

With a large and diversified population, India faces persistent obstacles to health equity, including notable differences in health-care outcomes and access. Even though access to health care has improved over the years, there is still much work to be done in rural India.

Approach:

• Introduce your answer by defining health equity as the principle ensuring equal health potential achievement for all, regardless of circumstances.
• In the main body, discuss barriers to health equity like geographical disparities, socio-economic inequities, inadequate infrastructure, lack of health literacy, gender disparities, etc. Next suggest measures including increased healthcare investment, enhanced rural infrastructure, addressing social determinants, improving health literacy, digital health adoption, etc.
• Conclude by emphasizing health equity as essential for India’s prosperity and to achieve a healthier future for all.

Answer:

Health equity represents a fundamental principle of fairness and justice in healthcare, guaranteeing every individual the opportunity to attain their maximum health potential, regardless of their background or circumstances. This concept acknowledges that health is influenced not just by genetic factors but significantly by social, economic, and environmental determinants. It aims to provide more than mere access to medical care.

Barriers to Achieving Health Equity in India:

• Geographical Disparities: Rural-urban health divide is stark in India, with rural areas having significantly less access to healthcare facilities.
  • As per the National Health Profile 2019, there are only about 27.1% of hospitals located in rural India, where nearly 66% of India’s population resides.
• Socio-economic Inequities: Economic constraints and social determinants such as caste and gender profoundly impact health outcomes.
  • NFHS-5 reveals that Scheduled Castes and Scheduled Tribes have higher child mortality rates and lower immunisation coverage compared to other social groups.
• Inadequate Healthcare Infrastructure: There’s a critical shortage of healthcare professionals and facilities, especially in rural areas.
  • WHO recommends a minimum doctor-population ratio of 1:1000, whereas India has only 0.8 doctors per 1,000 people.
• Lack of Health Literacy: Limited awareness about health issues and preventive measures can hinder equitable health access.
  • Low awareness levels about the importance of maternal health, nutrition, and immunisation programs contribute to adverse health outcomes, especially in underprivileged sections.
• Gender-based Disparities: Women and girls face unique health challenges, often exacerbated by socio-economic status.
  • NFHS-5 data indicates that 59% of women in the lowest wealth quintile suffer from anaemia, nearly double the rate in the highest quintile.
• Environmental and Public Health Emergencies: Events like pandemics and climate change disproportionately affect the most vulnerable.
  • The COVID-19 pandemic has disproportionately affected marginalised groups.

Measures Needed to Overcome These Challenges:

• Increasing Investment in Healthcare: Higher allocation of resources towards healthcare infrastructure, workforce training, and preventive care.
  • Incremental increase in healthcare spending to reach the WHO-recommended target of at least 6% of GDP.
• Strengthening Rural Healthcare Infrastructure: Enhance accessibility and quality of healthcare in rural areas by increasing the number of healthcare facilities and professionals.
  • Expansion of the National Rural Health Mission (NRHM).
• Addressing Social Determinants of Health: Initiatives to improve education, housing, and employment opportunities, targeting the root causes of health inequities.
  • Integration of health equity goals in policies across sectors.
• Empowering Women and Marginalised Groups: Special focus on programs that address the health needs of women and socially disadvantaged groups.
  • Anaemia Mukt Bharat to reduce anaemia prevalence among women and children.
• Enhancing Health Literacy: Public education campaigns to raise awareness about preventive healthcare, nutrition, and hygiene practices.
  • Inclusion of health education in school curriculums and community outreach programs.
• Leveraging Digital Health Solutions: Adoption of telemedicine and digital health technologies to bridge the gap in healthcare access.
  • Expansion of the e-Sanjeevani telemedicine service.
• Fostering Public-Private Partnerships: Collaborations between government, private sector, and civil society to enhance healthcare delivery and innovation.
  • Ayushman Bharat’s partnership model with private hospitals to extend health coverage.

By addressing the challenges in achieving health equity, India can pave the way towards a more equitable and healthy future for all its citizens. Health equity is not just a moral imperative but a practical necessity to ensure the well-being and prosperity of the nation.

‘+1’ Value Addition:

• The National Health Policy, 2017 articulates “the attainment of the highest possible level of good health and well-being, and universal access to good quality health care services without anyone having to face financial hardship as a consequence” as its goal.
• India’s Constitution lacks a direct right to health but Directive Principles (Articles 39(e), 42, 47) support worker health, humane conditions, and public health improvement.
• According to ICMR, infectious diseases, such as tuberculosis, are 1.5 times more common in slums than in non-slum areas.