Overview
In India, health services are provided by the government through publicly
financed and managed curative and preventive health services from the
primary to the tertiary level. These services, accounting for about
18 percent of the overall health spending and 0.9 percent of the GDP,
are provided free of cost to the patients. A fee-levying private sector
that plays a dominant role in the provision of individual curative care
through ambulatory services coexists with public health care. It accounts
for about 82 percent of the overall health expenditure and 4.2 percent
of the GDP. Nationwide health care utilization rates show that private
health services are directed mainly at providing primary health care
and are financed from private resources, which place a disproportionate
burden on the poor.
The state, central, and local governments share health care responsibility,
although service delivery is a state responsibility. State and local
governments incur about three-quarters and the central government about
one-quarter of public spending on health. The responsibility for health
rests at three levels. Health is primarily a state responsibility, and
the central government is responsible for health services in union territories
without a legislature. It is also responsible for developing and monitoring
national standards and regulations, linking the states with funding
agencies, and sponsoring numerous schemes for implementation by state
governments. Goals and strategies for the public sector in health care
are established through a consultative process involving all levels
of government through the Central Council for Health and Family Welfare
(CCHFW).
The outcomes from meetings of the CCHFW have provided a thrust to various
sub-sectors within the health sector. Private and voluntary sectors
have emerged as important arms of the health sector. A huge campaign
to eradicate poliomyelitis through pulse polio immunization (PPI) was
initiated in 1995.
The traditional system of medicine also plays a significant role due
to escalating costs of health care. State health systems and projects
have been formulated to improve efficiency in the allocation and use
of health resources through policy and institutional development. Specific
efforts have been made to consolidate and strengthen the primary health
centre (PHC) infrastructure, under the minimum-needs program, by providing
enhanced assistance to regions with severe health problems, supporting
voluntary organizations, improving IEC activities, and the like. The
convergence of services to provide a holistic approach to population
control has also been promoted. In March 1995, a separate Department
of Indian System of Medicine and Homeopathy (ISM&H) was created
within the Ministry of Health and Family Welfare.
Today, India stands on the threshold of a new era in which millions
will be safe from many diseases. Diseases such as poliomyelitis, leprosy,
and neonatal tetanus will soon join smallpox and guineaworm as diseases
of the past.
Concurrently, the country is surrounded by the burden of both communicable
and non-communicable diseases. Some infectious diseases thought to have
been conquered have returned with a vengeance or have developed stubborn
resistance to drugs. These include viral hepatitis, tuberculosis, malaria,
and pneumonia. Furthermore, new and previously unknown diseases such
as HIV/AIDS, the ebola virus, and food- and water-borne diseases continue
to emerge.
Issues relating to access to basic health services including availability
of essential medicines and the challenge to achieve goals by 2000-2015:
- Achieve zero-level growth of HIV/AIDS
- Reduce mortality by 50 percent on account of TB, malaria, and other
vector- and water-borne diseases
- Increase utilization of public health facilities
 Global Trends & India's Position
The health care sector in India has been growing at a frenetic pace. India is becoming known as the global destination for a large number of health care requirements. In fact, India is promoting its health tourism globally. India offers world-class yet economical health care facilities.
In the last five years, the number of patients visiting India for medical treatment rose from 10,000 to about 150,000. With an annual growth rate of 30 percent, India is already inching closer to Singapore, an established medical care hub that attracts 150,000 medical tourists a year. Hospitals in India can conduct the latest medical procedures at very low costs.
During 2002, India's health care industry was contributed 5 percent to the GDP and employed approximately 4 million people. By 2012 this industry is projected to contribute 8.5 percent of the GDP. Health care spending in the country will double over the next 10 years. Private health care will form a large chunk of this spending, rising from US$14.8 billion to US$33.6 billion in 2012.
CII Initiatives
CII/WHO Study: Promote and Implement a Healthy Workplace in
the Industry
CII, in collaboration with the World Health Organization (WHO), is conducting
a study of healthy workplace settings promoted by WHO globally. This
study, a first of its kind in India, will be a road map for how the
industry can achieve sustainable organizational performance in accordance
with global standards.
The WHO/CII team has selected 15 industries for this research. The
objective of the study is to motivate and mobilize businesses to achieve
sustainable organizational performance in conjunction with the existing
profile of the industry's work pattern and related workplace activities.
The information will be interpreted for preparing standard operational
guidelines for the industry.
Baseline Survey on Health Services in the Corporate Sector
and Industry
A study is being conducted to build baseline data on health services
for the employees and the community of CII-member companies. In the
first phase of the study, 670 large-scale companies are being surveyed.
Reproductive and Child Health
Maternal, Child, and Disease-Related Nutrition in Rural India
In an effort to promote and improve nutritional practices for women
and children, CII and the Australia India Council (AIC) are implementing
a project for the Aditya Birla Group Providing expertise in the field,
building capacity in nutrition using a “train the trainer model”
(thereby strengthening Mother and Child Health Services), and correlating
good nutrition with disease form part of the program. The project will
be replicated and scaled up in Vedanta Industries' Balco Unit in
Chattisgarh and Hindustan Zinc Ltd. in Udaipur.
New Initiative
CII and PFI are conducting a one-year advocacy initiative on the issues
of population stabilization, reproductive health, and reproductive rights
in the states of Bihar and Jharkhand.
Declining Child Sex Ratio
National Advocacy Campaign against Prebirth Elimination of
Females
CII, the Population Foundation of India and Plan India have launched
a national advocacy campaign against female feticide in Gujarat, Maharashtra,
Uttaranchal, Uttar Pradesh, Delhi, Andhra Pradesh, Madhya Pradesh, and
Chattisgarh. A series of workshops is being conducted in the belief
that businesses are more than economic institutions and play an important
role in the welfare of their workforce.
New Initiative
A National Forum to Save the Girl Child is being launched, in collaboration
with UNFPA and Members of Parliament.
CII/USAID-EHP Project
Improving the Health of the Urban Poor is a pilot project to explore
new ways of supplementing and strengthening health service delivery
for the urban poor. The Government of India has designated USAID-EHP
as the nodal technical agency for urban health program directions.
Publications
- “Tuberculosis Control at Workplace: Doing the Right Thing,
at the Right Place, in the Right Way
- “Viral Hepatitis: Frequently Asked Questions
- “A Guide to Malaria Prevention with Special Emphasis on Insecticide-Treated
Mosquito Nets
- “Active Families are Healthy Families: A Guide to Physical
Fitness”
Current Issues in Healthcare
The health sector in India is faced with many issues . These range from
the need to bring the infant mortality rate to below 30 per 1,000 live
births to the need to reduce the maternal mortality rate to below 100
per 100,000 live births. Other issues include:
- Addressing unmet needs for basic reproductive and child health
services, supplies, and infrastructure
- Achieving universal immunization of children against all vaccine-preventable
diseases
- Achieving 80 percent institutional deliveries and 100 percent deliveries
by trained persons
- Convergence in implementation of related social sector programs
- Reducing the incidence of HIV/AIDS, malaria, and other communicable
diseases in accordance with the Millennium Development Goals (MDGs)
- Increasing the accessibility of integrated comprehensive primary
health care
- Community health/social insurance
- Population stabilization, gender and demographic balance
Opportunities for Collaboration
The health care sector in India offers abundant collaboration opportunities
for businesspeople, medical practitioners, and academicians. There are
opportunities for service providers to invest in curative and preventive
services and possibilities of investing in medical infrastructure and
medical tourism.
The Indian American population comprises a large percentage of doctors,
medical practitioners, and nurses. Dr. Naresh Trehan is an outstanding
example of an Indian American who has contributed to India's health
care sector in a big way. It was he who helped set up the Escorts Heart
Institute to provide state-of-the-art heart treatment right in the heart
of the country.
Medical practitioners and academicians can teach at various medical
colleges, visit India to transfer expertise in invasive interventions
and super-specialties and train upcoming surgeons, invite young surgeons
to America to become understudies, and expose them to state-of-the-art
medical facilities. There are also options for training nurses and technicians
in India.
Further, India needs alternative models of health financing and insurance.
Investing in technology—developing and using appropriate health
technology, health management information, disease surveillance, and
response systems—is a must to enable India to gain momentum in
health care.
Ongoing projects / activities available in India
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Strengthening specific health programs through partnerships,
especially IEC for health education and promotion |
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Social marketing and franchising in Reproductive and Child Health
Phase II |
For more information please send email to iac@cii-usa.org.
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