Health Status and Health Care Services in India (HCA 302)

Health Status and Health Care Services in India
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At the beginning of the century, health care systems in India lagged behind those of other peer countries. However, progress made in recent times has been varied. The Indian government has been at the forefront in providing improved healthcare to its citizens through the adoption of favorable laws and interventions. The private sector has also played a crucial role in improving access to healthcare services for the whole population. This paper seeks to discuss the progress made by the Indian health services in improving its healthcare services. It will explore the ease of access that Indians have in the health care services. The paper will further focus on such issues as the population and its health status, how the healthcare system is financed as well as the healthcare services that are available. In concluding, the paper will outline the status of the healthcare service in India and how it relates to other developed countries and especially the United States.
The paper is divided into four parts. The first part focuses on the population and the health status in India. This section will focus on such factors as infant and general mortality rates. It will also focus on what are the causes of the deaths, as well as the demographic characteristics of the population. The second section discusses the availability of healthcare services in India. This section more specifically outlines the factors limiting access, the utilization of health services as well as a general description of the healthcare services. The third section focuses on expenditures and more specifically outlining the total expenditures and the role of the government in financing healthcare for its people. The fourth part will discuss how the macro-environmental factors such as politics, technology, cultures, as well as socio-economic issues, affect the health-care systems in India. The paper will conclude by commenting on some problems and opportunities that are available in management of the healthcare system in India, as well as comparisons between it and the United States of America concerning healthcare issues.
Population and Health Status
Demographic Characteristics of population
India has the second largest population in the world following china. The population of India stands at 1.21 billion people, which constitutes about one sixth of the population of the world (World Health Organization, 2013). Projections by the WHO place India as being the most populous country by 2024 and may attain a population of 1.6 billion persons by the year 2050. The report continues on to state that the young population below the age of 25 stands at 50% of the population and 65% of the population is below the age of 35. India's dependency ratio is projected by the WHO to stand at just over 0.4 by 2030 with the average age of an Indian standing at 29 years. There are huge disparities in literacy levels in India, which stands at 62.8% for the total population with 75.2% of males being literate and 50.8% of women (Census of India 2011). Every major religion is represented in India, and there are four major language families represented in the country (Rao et al. 2014).
Mortality, Infant Mortality Data, Causes of Death
Data on mortality forms the core of any planning or formulation of health strategies. Over the last few years, the infant mortality rate (IMR) of India has experienced major decline. India's IMR stands at 4.5% that is 42 fatalities for every 1000 live births (Institute for Healthcare and Informatics2012). Mohanty et al. (2014) argue that combined factors such as low awareness among health workers and the lack of knowledge on reproductive rights among potential mothers contribute the India's infant mortality rate. Additionally, maternal anemia and malnutrition are also responsible for infant deaths in the country. The life expectancy rate of India stands at 65.8 years as of 2013 (UN Human Development Report 2013).
Causes of Death
In overall, non-communicable diseases are the leading cause of death in India, accounting for 42% of all recorded deaths (Institute of Healthcare and Informatics 2012). The report points out that nutritional, prenatal, communicable diseases and maternal conditions account for another 38% while injuries and ill-defined causes that are take up 10% of all deaths. The report continues on that in rural areas; more deaths are reported due to communicable, prenatal, maternal and nutritional conditions. It explains that the urban areas, on the other hand, have lower deaths due to communicable diseases but have a higher proportion due to non-communicable diseases at 56 %. The report concedes that deaths related to injuries are constant in both rural and urban areas, but specific causes vary. In general, according to the health report, cardiovascular diseases are the leading cause of death in India accounting for 19% of total deaths. Respiratory diseases and specifically the chronic obstructive pulmonary disease (COPD) and asthma constitute 9%, while diarrhea diseases accounting for 9% of all deaths, prenatal conditions at 6.3%. Infections of the respiratory tract, which include acute pneumonia account for 6.2% of total deaths with tuberculosis accounting for 6%, malignant at 5.7%, senility at 5.0%, unintentional injuries at 4.9% and other undefined conditions accounting for 4.8% (Institute for Healthcare and Informatics 2012).
Quality of Life
India ranks 70.50 on the quality of life index (WHO 2013). The report provides data listing the purchasing power in India, which stands at 57.88 while the safety index is at 54.36. On the healthcare index, India ranked at 63.71 in the world and 28.27 on the consumer price index and on the pollution index, India ranks at 74.97 globally. Available data from the report on the time it takes citizens to commute from one point to another, India ranks at 47.41 while on the comparison of property prices to income ratio; the country is ranked at 10.34.
In the last decade, the health care system in India has progressed well. Efforts to reform the public healthcare system got a big lift with the institution of the Millennium Development Goals (MDGs). The government set targets to stop the spread of HIV/AIDS, Malaria and a variety of other ailments and to have started eradicating them by the year 2015 (Institute for Healthcare and Informatics 2012). The report states that long awaited healthcare reforms were realized by the creation and adoption of the Eleventh Five-Year plan. The plan enabled public sector initiatives to change and made such initiatives have a great intensity. In the private healthcare system in India, increased medical facilities grew and more people achieved insurance coverage. Additionally, the report explains that in the last decade, several partnerships among the private and public healthcare institutions have been achieved. The partnerships have improved access and quality of healthcare to the people of India. The partnerships mainly occur in hospitals and diagnostic services (Institute for Healthcare and Informatics).
Despite the progress achieved in India's healthcare system, several challenges persist. For instance, several healthcare indicators continue to lag and threaten to make India fall short of achieving its millennium development goals for reduction of infant mortality rate by the year 2015. Another problem has been that the spending on healthcare has not been growing at the same consistency as the gross domestic product of the country. According to data of the World Health Organization (2013), the spending of India on healthcare has actually reduced from 4.4 percent in the year 2000 to 4.0 percent in 2010 implying that the expenditure of India on healthcare has grown at a much slower rate than its GDP. Spending money by the public on healthcare is also high in India, this is despite the fact that the country has increased its spending on the provision of healthcare services, this points out that public spending has struggled to keep up with the rise in the demand of healthcare. Despite the problems, India has continued to improve provision of healthcare services to its people through increasing spending on healthcare services as well as improving public access to the healthcare services.
Availability of Healthcare Services
The change and improvement of India's healthcare system over the past decade has been remarkable, initiatives by the Indian government, public-private sector partnerships have contributed to the progress realized. Several indicators can be used to gauge the level of access that the citizens in India enjoy, physical accessibility to the healthcare facilities is one such indicator, another indicator is the affordability of the complete treatment therapy to the patient. The third indicator is the capacity for the existent resources to treat a patient while the fourth indicator looks at the quality and functionality that the available resources aid in providing care.
If any one of the indicators becomes difficult to achieve by a patient, such a patient is unlikely to receive the required healthcare services. The government of India has instituted some key initiatives that have been vital in improving access to healthcare by the Indian public, and example is the initiative the government undertook to eradicate polio out of India, which in all regards has made India into a polio free country (Rao et al. 2014). He explains that the government initiatives have been pursued with high levels of attention, monitoring and planning as well as provision of adequate resources. Alongside the government, the private sector has also played an important role in improving access to healthcare in India. Private hospitals have increased to about 7, 500 with the number of private medical practitioners standing at 300,000 (Rao et al. 2014). He continues on to point out that the private sector has improved access and availability of quality medicines through setting up of chemists and indeed, over 105, 000 chemists today are spread out over 120 cities providing medicines to the public.
Issues related to access
Several issues influence the availability and quality of medical care that can be used by the population in India (Mohanty et al. 2014). Several factors influence access of the medical services in India. Each of the four factors will be discussed below and how the factors affect or limit access of the people of India to medical care. The factors discussed include the physical reach, the availability or capacity of the available healthcare structures, the quality of the services offered as well as the affordability of the available healthcare plans. It is important to note that even if one of the indicators is missing, the patient will be unlikely to receive quality healthcare in a manner that it appropriate as well as efficient. It becomes essential, therefore, to discuss all the four dimensions in outlining the state of access to the healthcare access.
Physical Reach
Physical reach is defined as the ability to access a medical healthcare institution within five kilometers of the place of work or a place of residence (Mohanty et al. 2014). Physical reach defines the accessibility of the patient to a healthcare facility and more importantly the availability of outpatient and inpatient departments for hospitalization in the healthcare institutions. The institutions in this case may be the private or the public sectors. Mohanty et al. explain that in the rural areas of India, physical reach to healthcare facilities is a challenge due to the problems in transportation while in urban locations; physical reach is less of a challenge due to the improved transportation system.
Availability and Capacity
This component of the healthcare system defines the availability of resources in the healthcare system to provide patients with treatment (Mohanty et al. 2014). The resources in this case include the doctors, nurses, availability of in-patient bed, consumables as well as diagnostic services. The availability will be governed by the minimum specifications that are defined by the government of India and other international organizations including the WHO. Mohanty explains that many patients in India use the private medical care for both the in-patient and the outpatient treatments; this is because private hospitals have better quality of healthcare. However, studies carried out on the healthcare system found out that the patients are willing to revert to the public healthcare system if quality doctors and better options of treatment become available (Institute for Healthcare and Informatics 2012).
Affordability
Affordability refers to the ability of a patient suffering a particular ailment being able to afford the complete treatment or therapy required to combat the ailment or disease. Various factors influence the affordability of healthcare to the citizens of India (Mohanty et al. 2012). They explain that income disparities, as well as poverty and the location of rural or urban settlements, wil...