ARE THE GHOSTS OF THE PAST, HAUNTING THE FUTURE OF HEALTHCARE IN INDIA?

Healthcare has always been an integral part of our lives. India, the country of ‘AYURVEDIC’ practices has seen its glorious tradition of public health service from 5500–1300 BCE when the likes of Sushruta and Saints performed care-giving as practice. Ever since then, the objective of delivering healthcare to ‘everyone’ has indeed presented a spectrum of contrasting landscapes. Fast forward to the present, the healthcare sector has made prolific advancements, but its leaders and care providers are still appalled by the same challenge every now and then. The situation of the present healthcare delivery system is an eye opener and, make no mistake, it will be a ticking time bomb, unless it is systemically fixed.

Truth be told, several attempts have been made to enhance healthcare delivery in India since 1983, when the first National Health Policy of India (NHP) was formulated. With central and state governments trying their best to put forward the most ‘suitable’ policies to provide healthcare for all, very little has been done to make space for the integration of advancements of the future. 

In fact, when the seismic effects of technology in healthcare commenced the change to strengthen the existing care delivery system in India, the outdated infrastructure and policies limited this partnership between healthcare & technology, in the first few phases while leaving us in doubt about its excellence.

Although, there are several challenges in the path of the advancement of digital healthcare in India, let us add a little more light on basic infrastructure and healthcare policies. 

India has a three-tier structure that comprises primary, secondary and tertiary care. This structure further segregates the primary care via sub-centres, primary health centre (PHC), and community health centre (CHC) and sometimes, even Anganwadis. The secondary care is largely delivered through district and sub-district hospitals while on the other hand, tertiary care is extended at state and central level institutions, super/multi specialty hospitals. While this system looks ‘perfect’ to facilitate healthcare coverage even at the extreme corners of the country, the ground realities are different than we anticipate!


Even after creating huge buildings and infrastructures across the country, the existing public healthcare system is still relatively inaccessible, inefficient and primitive for its stakeholders. This makes the public healthcare system, undesirable for a large part of the communities, even though many still avail it for its “free-of-cost” approach.

According to a study —

“Despite private healthcare being four times more expensive, 72% of rural and 79% of urban residents would not trust a public healthcare facility.”

On one hand, the statistics present patient experience and care outcome concerns, and on the other, it questions us if this has always been the case. The answer is No. In its initial days, Public healthcare in India was preferred by everyone and has assisted care professionals to deliver care to the patients. However, the times have changed, and so have the patient’s expectations; delivery methods and even treatments, but public healthcare infrastructure, policies and care-givers in India remain stuck in the old times, enjoying past glory without preparing for the future.

The blame for the underdevelopment of the healthcare delivery system in India also lies on the shoulders of ‘ancient’ healthcare policies & norms that we still follow. Moreover, these “dinosaur-era” policies remain to be one of the most significant factors why establishing digital healthcare delivery is so hard in India.

The Role Healthcare Policies in Healthcare Delivery

Since its establishment in 1983, the National Healthcare Policy was hardly revised till 2002. As for the latest National Health Policy (NHP) 2017 highlights, it presented the ‘Health for All’ approach to provide assured healthcare for all at an affordable cost. With schemes like Ayushman Bharat Digital Mission (ABDM) and Pradhan Mantri Jan Arogya Yojana (PM-JAY) we are possibly even pacing up towards the vision of better healthcare practices, but as stakeholders are we ready for it? 

Earlier in 2021, when the Ministry of Health announced the National Digital Health Mission, to digitise the existing healthcare structure, the policymakers certainly overestimated its results. The adoption of such remarkable policies has been much slow because we overlooked the ground-level reality check. The current state of the system lacks skilled professionals, it has low technology literacy and even the basic infrastructure to sustain these changes have corroded with time.  

The truth is Digital health and the existing healthcare design is still at a crossroad. These are the times, when we as a civilization are facing a mounting healthcare crisis extensively exposed by COVID combined with Natural Disasters, Heavy Rains combined with an ever-increasing burden of disease with ever increasing population, resulting in low care quality.

These aged policies are hampering the adoption of digital health solutions in India. Interestingly, on the other hand, the time tested way of delivering “non-digital care” has also been affected by these policies. For example : 

  • The norms of establishing healthcare facilities required a certain minimum land acquisition which increased the project cost by multiple times. 
  • The process of hiring medical staff is tedious, requires “caste certificates” and numerous rounds of approvals.

This has had a knock-out effect on the development of any sort of health solutions, as many of the modern day solutions require a fresh look at things from beyond the purview of the ancient policies. 

As a result, the potential benefits of digital health are not being realised in India, and the country’s healthcare system is still struggling to keep up with the demands of a rapidly growing population. It is essential that the government revises its policies in order to allow modern health solutions to flourish in India. Only then will the country be able to address its healthcare challenges sustainably and effectively.

From the Stakeholders Perspectives —

Ideally, digitization and modernization of the healthcare system must optimise the practice of doctors, enhance patient-doctor communication to improve patient outcomes. But, since the introduction of ABDM in 2021, the statistics showed a mixed response from the major stakeholders of healthcare. Wherein, the urban regions of the country showed significant adoption rates concerning Virtual Care Modules, but in the rural areas, nothing has changed. Infact, the ‘burden of digitization’ on the ‘Gramin’ healthcare system’ has created nothing but chaos! 

Often the challenges that care professionals go through are due to age-old infrastructure or outdated policies. And, it is evident that until we redesign the healthcare delivery systems according to care professionals and the beneficiaries, we ain’t moving anywhere. Below is a small example of a public health doctor, exposing lack of infrastructure and trained medical professionals which would help him execute his duty. 

Read the full answer here. 

On the other hand, when we have unnecessary policies on the infrastructure side, we totally lack policies, guidelines and regulations on the data security side. This has led to data theft, misuse of digital prescriptions, electronic health records, fraudulent practices and solicitation in the form of listing websites in the noble field of care delivery.

HArborSays:

Change is often not so easy but, when the existing policies and regulations lead to insufficient care experiences for the beneficiaries as well as the service providers, it is time we change them. We must modernise them. And, it must start with changing the age-old perspective toward healthcare delivery. An approach that remains more India-centric in healthcare tech while keeping all the major stakeholders on a single platform. 

Here at HArbor, we have already started our journey by simplifying care practices for medicos to assist them to deliver the best care outcomes possible.

Connect with us to know how HArbor platform can help your care facility!  

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