Health System & Coverage

This discussion note is on health system and coverage.

Health System & Coverage
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A Health system is defined as a group of people, programs, institutions, & organisations that provide healthcare through their combined efforts. A fair and just health system accounts for trained health workers, suited infrastructure, proper medication, adequate funding, reliable and accessible data, and a sustainable environment to breed an equitable and affordable health system. To strengthen the public health system, we should also look forward to the accessibility, availability, and quality of public healthcare. The health system requires diagnostic services, affordable medicines and treatments, accessibility to physical infrastructure, and an adequate human resource acceptable to the masses (KPMG, 2015).

Between 1946 and 2015, India made significant improvements. For instance, life expectancy at birth increased by approximately 10 years; infant mortality rate (IMR) became more than halved; total fertility rate (TFR) dropped to near replacement level, and maternal mortality ratio (MMR) declined by more than 60 per cent (The World Bank, 2019). Data provided by National Sample Survey, 71st round (2011-12) that expenditure on free medicines for inpatients has reduced from 31% to 8.99% and for outpatients from 17.98% to 5.34 % within two decades. Looking at the health coverage, Indian accounts to 60% of the global vaccine production contributing a large portion to child vaccination. Still the coverage for Children aged 12-23 months fully immunized for the available (BCG, Measles and three doses of Pentavalent vaccine) covered under UIP is only 62% (SDG Index, NITI Aayog, 2018). Apart from that, India has an insufficient number of doctors, nurses, and a lack of health infrastructure, i.e. PHCs, CHCs, and hospitals functional at all locations. The public funding for health is meagre; however, the private expenditure and out of pocket expenditure are rising very high.

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