While mostly working in a silo driven environment, COVID-19 pandemic experiences brought together challenges and immense learning, not just for healthcare and its allied industries, but for all. Core to the realisation was that delivery in healthcare goes beyond traditional providers of care and encompasses individuals, Industries and Government. The pandemic clearly demonstrated this, evidenced by many unconventional partnerships that came forward to fill in the gaps and make the healthcare delivery systems work efficiently.
A system that is harmonised delivers the services seamlessly, where different stakeholders are focussed and accountable on their goal of delivery of quality healthcare services. Shifting from episodic interventions to a continuum of care and prevention can be brought into effect when health is identified as an indicator of sustained growth and development of a nation.
The system needs to be reconfigured if these commitments are to provide optimum benefits to the people. The most effective way is to improve primary and public healthcare facilities and focus on preventive health. Secondary and tertiary healthcare needs of the population can be achieved on a mass scale by joining hands with private healthcare and regionalising it with a hub-and-spoke model. Transparency and accountability rests equally for public and private, be it in the cost of care or efficiency and quality.
Partnership models could be leveraged in strengthening the secondary and tertiary care levels of the healthcare value chain by bringing together the operational and managerial efficiencies of the private sector. This will aid in better utilization of the already existing public sector infrastructure and result in improved utilization of assets and services.
Though network of delivery settings is in place, each tend to work in isolation, leading to inefficiencies in cost and an imbalance in the patient inflow addressed by these healthcare facilities. There is a need to streamline the value chain of the delivery system to provide a comprehensive delivery system.
Availability of skilled medical, nursing, paramedical and allied workforce is another roadblock of the healthcare delivery chain in India. Skilled and competent workforce is the most profound pillar of quality healthcare service, and the pandemic highlighted a worldwide shortage of the same. The workforce was ill-equipped to address the need that arose at the time of the pandemic, thereby signifying an urgent need to strengthen and expand the existential numbers. Augmenting and building the capacity of existing workforce can offset a significant amount of the disease burden at the primary level and result in better health outcomes. Augmenting, upskilling and empowering ASHA workers, who have a massive outreach to the population will be huge enabler in addressing the gaps on an immediate basis.
Medical care in India has been based on the intervention model and this does not address continuum care. There is a need to realize the importance of continuum care and systems should be adapted to make it more robust. Effective treatment over the continuum of care requires attention to many moving parts. Not only does the medical care need to be coordinated between a variety of providers, but the financing and record-keeping must also be efficient and accessible. The advent of electronic health record managed care (quality of care) and payer networks have helped the logistics involved in supporting continuum care.
Approximately 619 tonnes of biomedical waste per day was generated by 3,22,425 healthcare facilities during the fiscal year 2018-2019. Two major challenges faced are; first, the quantum of the waste that is produced and second, improper disposal of biomedical waste. As healthcare moves towards new advancements, the issues around biomedical waste management also peaks. The risk of contamination increases if the waste is not managed and disposed off safely, therefore strong biomedical waste management systems are required to be adopted for elimination of hazards and spread of infections.
India has a unique knowledge and position in traditional medicine of Ayurveda, which is another advantage that needs to be adequately marketed to the world. From yoga ashrams to spas and wellness centres offering holistic therapies, India offers a multitude of sites and locations to retreat, recharge, and rejuvenate. The strong branding of AYUSH by the Government is drawing patients to India from across the world. Several private players are setting up wellness centres equipped with traditional healthcare remedies.
It is acknowledged Indian healthcare provides high-end, cutting-edge technology medical services in state-of-the-art facilities at one tenth of the cost, compared to the West. India has been seeing many patients from countries in Africa, Eastern Europe, and Middle East as well. Indian healthcare sector is poised to serve the healthcare needs of the nation and the world effectively so long as we work in a collaborative trust-based ecosystem with clear accountable intentions.
The article was first published in the March 2023 edition of CII Policy Watch, Focus: Healthcare.