UPSC MainsGENERAL-STUDIES-PAPER-II202110 Marks150 Words
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Q6.

“Besides being a moral imperative of a Welfare State, primary health structure is a necessary precondition for sustainable development.” Analyze.

How to Approach

This question requires a multi-faceted answer linking public health to economic development. The approach should be to first define primary healthcare and welfare state principles. Then, analyze how a strong primary healthcare system acts as a precondition for sustainable development by impacting human capital, productivity, and reducing health-related economic burdens. Finally, discuss the moral imperative aspect and conclude with a balanced perspective. Structure the answer into Introduction, Body (impact on human capital, economic productivity, equity & inclusion), and Conclusion.

Model Answer

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Introduction

A Welfare State, as enshrined in the Directive Principles of State Policy (Article 38 of the Indian Constitution), aims to secure social and economic justice for all citizens. Central to this is the provision of basic necessities, with healthcare being paramount. Primary Health Care (PHC), defined as essential healthcare made accessible to the population through first contact, is the cornerstone of a robust healthcare system. Beyond a moral obligation, investing in a strong PHC structure is increasingly recognized as a fundamental prerequisite for achieving sustainable development goals, impacting not just health outcomes but also economic growth and social equity.

Impact on Human Capital

A well-functioning PHC system directly enhances human capital. Early detection and treatment of diseases, maternal and child health services, and immunization programs contribute to a healthier and more productive workforce. Improved nutrition, sanitation, and health education, all integral parts of PHC, lead to better cognitive development in children, increasing their future earning potential. The National Family Health Survey (NFHS-5, 2019-21) data shows a correlation between access to PHC and improved indicators like Infant Mortality Rate (IMR) and Total Fertility Rate (TFR).

Economic Productivity and Growth

Poor health significantly hampers economic productivity. Illness leads to absenteeism, reduced work capacity, and increased healthcare costs for individuals and the state. A strong PHC system reduces the burden of preventable diseases, leading to a healthier workforce and increased economic output. Investments in PHC have a high return on investment, as evidenced by studies showing that every dollar invested in health can yield a $4-$20 return in increased productivity. For example, the ASHA (Accredited Social Health Activist) program, a key component of India’s PHC, has demonstrably improved health access in rural areas, contributing to increased labor force participation.

Equity and Inclusion

PHC plays a crucial role in promoting equity and inclusion. It ensures that healthcare services reach the most vulnerable populations – the poor, marginalized communities, and those in remote areas – who often lack access to secondary and tertiary care. Schemes like the National Rural Health Mission (NRHM), launched in 2005, aimed to bridge the rural-urban gap in healthcare access. By addressing health disparities, PHC contributes to social justice and reduces inequalities, fostering a more inclusive and sustainable development process. The Ayushman Bharat – Health and Wellness Centres (HWCs) are further strengthening this focus on equitable access.

Reducing Health-Related Economic Burden

Effective PHC reduces the demand for expensive curative care by focusing on prevention and early intervention. This lowers healthcare expenditure for both individuals and the government, freeing up resources for other developmental priorities. The emphasis on health promotion and disease prevention reduces the incidence of chronic diseases, which are often costly to manage. Furthermore, a healthy population is less likely to fall into poverty due to catastrophic health expenses, contributing to economic stability.

Indicator Impact of Strong PHC
Infant Mortality Rate (IMR) Decreases significantly
Life Expectancy Increases
Productivity Increases due to reduced sick days
Healthcare Costs Reduced due to preventative care

Conclusion

In conclusion, primary health structure is not merely a moral obligation of a Welfare State, but a vital precondition for sustainable development. By investing in PHC, nations can build a healthier, more productive, and equitable society. Strengthening PHC requires sustained political commitment, adequate funding, a skilled healthcare workforce, and effective community participation. Moving forward, integrating technology, strengthening data collection, and addressing social determinants of health will be crucial for maximizing the impact of PHC on sustainable development.

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

Sustainable Development
Development that meets the needs of the present without compromising the ability of future generations to meet their own needs. (Brundtland Report, 1987)
Universal Health Coverage (UHC)
Ensuring that all people have access to the health services they need, when and where they need them, without facing financial hardship.

Key Statistics

India’s public health expenditure is around 1.3% of GDP (2021-22), significantly lower than the global average of 6%.

Source: National Health Profile 2022

According to WHO, approximately 100 million people are pushed into poverty each year due to out-of-pocket health expenses.

Source: World Health Organization (WHO)

Examples

Kerala’s Public Health Model

Kerala’s success in achieving high health indicators, comparable to developed nations, is attributed to its strong focus on public health infrastructure and community participation, particularly through local self-governance.

Frequently Asked Questions

What are the key challenges facing India’s primary healthcare system?

Key challenges include inadequate infrastructure, shortage of healthcare workers (especially in rural areas), uneven distribution of resources, lack of inter-sectoral coordination, and limited community participation.

Topics Covered

Social IssuesEconomyPublic HealthWelfare SchemesSustainable DevelopmentHealthcare Infrastructure