UPSC MainsPUBLIC-ADMINISTRATION-PAPER-II202020 Marks
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Q12.

Examine the National Health Policy in the context of the current pandemic situation. Identify the problems and suggest improvements.

How to Approach

This question requires a critical assessment of the National Health Policy (NHP) 2017 in light of the COVID-19 pandemic. The answer should begin by briefly outlining the NHP 2017’s key principles and objectives. Then, it should analyze how the pandemic exposed the policy’s shortcomings, focusing on areas like infrastructure, financing, human resources, and access to healthcare. Finally, the answer should propose concrete improvements, considering lessons learned from the pandemic. A structured approach – Introduction, Policy Overview, Pandemic’s Impact, Problems Identified, and Improvements Suggested – will be effective.

Model Answer

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Introduction

The National Health Policy (NHP) 2017 aimed to achieve universal access to quality health services without anyone incurring financial hardship. It envisioned a health system that is accessible, affordable, and accountable. The policy emphasized strengthening primary healthcare, reducing disease burden, and improving infrastructure. However, the COVID-19 pandemic exposed significant vulnerabilities within India’s healthcare system, prompting a re-evaluation of the NHP 2017’s effectiveness and relevance. The pandemic acted as a stress test, revealing gaps in preparedness, resource allocation, and overall health system resilience, necessitating a critical examination of the policy’s framework and implementation.

National Health Policy 2017: A Brief Overview

The NHP 2017 rests on the principles of equity, affordability, accessibility, and quality. Its key objectives include:

  • Achieving a health assurance level of ‘Good Health’ for the population.
  • Reducing morbidity and mortality due to communicable and non-communicable diseases.
  • Strengthening the National Rural Health Mission (NRHM) and the National Urban Health Mission (NUHM).
  • Increasing the health expenditure to 2.5% of GDP.
  • Promoting inter-sectoral coordination for health.

Impact of the Pandemic on the Healthcare System

The COVID-19 pandemic severely strained India’s healthcare infrastructure. Key impacts included:

  • Overwhelmed Hospitals: A surge in cases led to shortages of beds, oxygen, ventilators, and essential medicines.
  • Strain on Healthcare Workers: Doctors, nurses, and other healthcare professionals faced immense pressure, leading to burnout and mental health issues.
  • Disruption of Essential Health Services: Routine immunizations, maternal and child health services, and treatment for non-COVID illnesses were disrupted.
  • Health Inequities: Vulnerable populations, including those in rural areas and marginalized communities, faced disproportionately higher risks.
  • Economic Impact: The pandemic led to significant economic losses, impacting household incomes and access to healthcare.

Problems Identified in the Context of the Pandemic

1. Inadequate Infrastructure

The pandemic highlighted the critical shortage of healthcare infrastructure, particularly in rural areas. There was a lack of sufficient hospital beds, ICU facilities, oxygen supply, and diagnostic capabilities. The public health infrastructure, already under-resourced, was unable to cope with the sudden surge in demand.

2. Insufficient Funding

Despite the NHP 2017’s goal of increasing health expenditure to 2.5% of GDP, actual spending remained significantly lower. According to the National Health Account (NHA) estimates (as of 2019-20, knowledge cutoff), public health expenditure was around 1.3% of GDP. This underfunding hampered the ability to strengthen the healthcare system and respond effectively to the pandemic.

3. Human Resource Shortages

India faces a severe shortage of healthcare professionals, including doctors, nurses, and paramedics. The pandemic exacerbated this problem, as healthcare workers were overwhelmed and many fell ill. The doctor-patient ratio remains far below the WHO recommended standard of 1:1000.

4. Weak Primary Healthcare System

The NHP 2017 emphasized strengthening primary healthcare, but progress has been slow. A robust primary healthcare system is crucial for early detection, prevention, and management of diseases, reducing the burden on hospitals. The pandemic revealed the weaknesses in primary healthcare delivery, particularly in terms of surveillance, testing, and contact tracing.

5. Supply Chain Disruptions

The pandemic exposed vulnerabilities in the supply chain for essential medicines, medical equipment, and oxygen. Disruptions in manufacturing, transportation, and distribution led to shortages and price hikes.

Suggested Improvements

  • Increase Health Expenditure: The government should prioritize increasing public health expenditure to at least 2.5% of GDP, as envisioned in the NHP 2017.
  • Strengthen Healthcare Infrastructure: Invest in expanding and upgrading healthcare infrastructure, particularly in rural areas. This includes building new hospitals, increasing bed capacity, and ensuring adequate oxygen supply.
  • Address Human Resource Shortages: Increase the number of medical colleges and nursing schools, and incentivize healthcare professionals to work in rural areas.
  • Strengthen Primary Healthcare: Invest in strengthening primary healthcare centers, equipping them with essential medicines, diagnostic facilities, and trained personnel.
  • Improve Supply Chain Management: Develop a resilient and diversified supply chain for essential medicines and medical equipment.
  • Enhance Surveillance and Preparedness: Strengthen disease surveillance systems and develop robust pandemic preparedness plans.
  • Promote Digital Health: Leverage digital technologies, such as telemedicine and electronic health records, to improve access to healthcare and enhance efficiency.
  • Inter-sectoral Coordination: Improve coordination between the health sector and other sectors, such as education, water and sanitation, and agriculture, to address the social determinants of health.

Conclusion

The COVID-19 pandemic served as a stark reminder of the vulnerabilities within India’s healthcare system. While the National Health Policy 2017 laid a foundation for improvement, its implementation has been hampered by inadequate funding, infrastructure gaps, and human resource shortages. Addressing these challenges requires a concerted effort to increase health expenditure, strengthen infrastructure, address human resource gaps, and prioritize primary healthcare. A proactive and resilient healthcare system is essential for protecting public health and ensuring a healthy future for all Indians.

Answer Length

This is a comprehensive model answer for learning purposes and may exceed the word limit. In the exam, always adhere to the prescribed word count.

Additional Resources

Key Definitions

Universal Health Coverage (UHC)
Universal Health Coverage means that all people have access to the health services they need, when and where they need them, without facing financial hardship.
Health System Resilience
The ability of a health system to absorb shocks, adapt to changing conditions, and continue to provide essential services during and after a crisis.

Key Statistics

India’s public health expenditure was 1.3% of GDP in 2019-20.

Source: National Health Account (NHA), Ministry of Health and Family Welfare (as of knowledge cutoff)

India has a doctor-patient ratio of approximately 1:1457 (as of 2019), significantly lower than the WHO recommended standard of 1:1000.

Source: National Health Profile 2019 (as of knowledge cutoff)

Examples

Kerala’s Public Health Model

Kerala’s success in managing the COVID-19 pandemic was attributed to its strong public health infrastructure, proactive surveillance, and community involvement. This demonstrates the importance of investing in public health systems.

Frequently Asked Questions

What is the role of Ayushman Bharat in achieving universal health coverage?

Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PMJAY) aims to provide health insurance coverage to vulnerable families, reducing out-of-pocket expenditure and improving access to healthcare.

Topics Covered

Social IssuesEconomyHealthcarePublic HealthPandemics