Health Equity and India’s Struggle: The Crisis of Affordability Intensifies

Photo Credits: Mayur Kakade (Getty Images)

India has a rough road to health equity, where it remains far behind the basic amenities of hospital beds, abysmal doctor-patient ratio amongst many others. The system is kept bounded within systemic barriers despite significant policy advancements. Ayushman Bharat, despite being the world’s largest health insurance scheme; millions continue to be caught in a loop of exclusion. This brings our attention to struggles of balancing equity with a sense of perpetual inequality alongside. 

The Barriers in Healthcare Fundings: The Statistics Says it All

Ayushman Bharat, was launched in 2018, aiming to cover Rs. 5 lakhs per family per year. To add, the scheme also aimed to transform 1,50,000 Health and Wellness Centers (HWCs) into existing Sub Centers and Primary Health Centers. The statistics reveal around 24000 hospital partnerships have approved $2.4 billion for patient admissions. This goes well for lowering out-of-pocket (OOP) for many people out there. The healthcare budget witnessed a 137% increase largely due to emergency funding for COVID-19 that enhanced infrastructure and vaccination efforts. However, public health expenditure remains at a mere 1.4% of GDP, staying below the intended goal of 2.5%, leaving millions dependent on the private healthcare system. 

The Stark Rural-Urban Divide: The Neglect of Health

Rural India remains home to 70% of the population, which faces a significant shortage of doctors, with only 0.8 doctors available for every 1,000 individuals. Furthermore, many of these clinics have a low doctor-patient ratio. For instance, Bihar spends a mere Rs. 93 per person on public health, while Himachal Pradesh allocates Rs. 630. On the other hand, there lies a concern with the slums situated in urban places. Around 17% of city dwellers report experiencing tuberculosis, which is 1.5 times higher than non-slum areas. This is usually attributed to worsening cases of overcrowding and inadequate sanitation.

The Road Ahead – The Future of Healthcare

The question of affordability arises. Experts advocate a multi-tiered approach to go along with balancing equity. The first speaks of expanding Ayushman Bharat’s Health and Wellness Centers to rural and remote areas. The second talks about training healthcare workers to address cultural biases and ensure dignity in care – to adopt a sense of ‘sensitization’. The third approach is integration of health initiatives with the programs of poverty alleviation, education and sanitation.  

India’s pursuit of health equity goes beyond the hikes – it requires to shatter the established social and economic hierarchies and prioritizing the marginalized voices of rural. While progress is underway, the future hinges on systemic inclusivity and a sense of accountability.