Public Health Infrastructure

The following is a brief introduction to the topic:

It is the basis of public health. The public health infrastructure includes all aspects of healthcare, including workforce, information technology, transportation and policies. The importance of an effective public health system in India is not to be underestimated. The current challenges and opportunities for India’s public health infrastructure are discussed in this article, along with examples.

The current state of public health infrastructure in India

• Healthcare Facilities

  India’s health care facilities can be classified in three categories: primary, second, and third level.

  1. Primary Care

     It is the initial point of contact when individuals are seeking health care services. The term includes both Primary Health Centres, or PHCs. In India, according to the National Health Profile 2019 India has approximately 1,58,417 sub-centres (SCs) and 25,650 primary health centres (PHCs).

  2. Secondary Care

     Community Health Centres and District Hospitals are considered secondary care. In India, there are 763 District Hospitals (DHs) and 5,624 Community Health Centres (CHCs). They provide a higher level of medical treatment than primary care centers.

  3. Tertiary care

     Medical colleges, research institutes, and super-specialty hospital provide tertiary health services. Examples include the All India Institute of Medical Sciences, or AIIMS.

• Healthcare Workforce

  Doctors, nurses, paramedics and community health workers are all part of the workforce that is responsible for providing healthcare. India has a severe shortage of healthcare professionals. The ratio between doctors and patients is far lower than the WHO-recommended 1:1000. In order to fill this gap, the government has launched initiatives like National Health Mission, which aims at recruiting more healthcare staff, especially in rural regions.

• Healthcare Information Systems

  For monitoring and managing health, it is essential to have effective systems of health information. India has taken a step forward in this regard with the National Digital Health Mission and the Integrated Disease Surveillance Programme. These initiatives are aimed at collecting, analysing, and disseminating data on health to help improve policy and decision making.

• Public Health Policy

  India is home to a number of comprehensive public health policies, programs and initiatives that are aimed at solving various health problems. This includes the National Health Policy of 2017, Ayushman Bharat, and Swachh Bharat Abhiyan. The National Health Policy 2017 and the Ayushman Bharat Yojana are two key initiatives that aim to improve access, affordability, as well as quality of healthcare for citizens.

Public Health Infrastructure Challenges

• Resources Allocation

  Urban and rural resource allocation is a major challenge. Rural areas often lack the resources and healthcare personnel that urban centres have, resulting in disparities between healthcare.

• Financial Constraints

  India’s expenditure on public health is very low. In fact, it only accounts for 1.28%. Underfunding can hinder the implementation of different health programs as well as the maintenance of medical facilities.

• Qualitative Care

  Public healthcare is frequently compromised by overcrowding and inadequate infrastructure. Lack of training of staff also contributes to this. The result is a preference for the private sector, even though it costs more.

• Disease Burden

  India is burdened by both infectious and noncommunicable diseases, such as diabetes and cardiovascular disease. To address this, a multifaceted strategy is needed, which includes preventive measures and early diagnosis as well as efficient treatment.

• Health Literacy

  Poor health outcomes are caused by a lack of health literacy in the general population. To educate people on common health problems and the importance for timely medical intervention, public awareness campaigns are crucial.

There are always improvements to be made

• Public-Private Partnerships (PPP)

  Public-Private Partners can be used to bridge gaps in the infrastructure of healthcare. PPPs have shown positive results for improving healthcare in Karnataka, Maharashtra and other states.

• Telemedicine and Health Technology

  Adoption of telemedicine can be a solution to the accessibility issue, particularly in remote and rural areas. Telemedicine services like eSanjeevani have been gaining popularity and helping patients connect with experts.

• Capacity building and training

  It is vital to invest in training healthcare professionals and building their capacity. This will improve the overall quality of the care. Skill India is a program that aims to improve the healthcare worker’s skills.

• The Reform of Policy

  The overall infrastructure of the health system can be significantly improved by continuous policy reforms that aim to increase public health spending, improve healthcare delivery systems and strengthen healthcare governance.

• Community Participation

  Participating local communities in healthcare initiatives may lead to improved health outcomes. Accredited social health activists (ASHAs) and other community health workers play an important role in closing the gap between healthcare services and the local communities.

Some Successful Initiatives

• Ayushman Bharat Yojana

  Ayushman Bharat is an initiative that aims to provide health insurance coverage for families who are vulnerable. The initiative is divided into two parts: Health and Wellness Centres and PradhanMantri Jan Arogya Yojana. The HWCs aim to deliver comprehensive primary healthcare, while PM-JAY provides secondary and tertiary healthcare coverage of up to ₹5 lakhs per family per year.

• Swachh Bharat Abhiyan

  The campaign is focused on hygiene and sanitation, which are critical factors in public health. Swachh Bharat Abhiyan was established in 2014. Since then, it has contributed significantly to improving sanitation across India.

• National Health Mission

  In 2013, the NHM was created by merging both the National Rural Health Mission and National Urban Health Mission. The NHM aims at improving healthcare quality and access, especially for underserved communities. Various health programs were implemented under NHM. These included immunization programs, services for mothers and children, and programs to control disease.

• Mission Indradhanush

  The program is designed to protect children and women during pregnancy from vaccine-preventable illnesses. Mission Indradhanush vaccinated children and women pregnant since its inception, which has significantly improved the immunization rate of Thailand.

• POSHAN Abhiyaan

  Launched in 2018 POSHAN Abhiyaan aims combat the malnutrition rates among children, women who are pregnant, and mothers breastfeeding. This program is aimed at improving nutrition outcomes by combining intersectoral convergence with community-based intervention and technology.

The Frequently Asked Questions

• What are the benefits of public health infrastructure for society?

  It is vital to have a public health infrastructure as it provides the foundation for a nation’s healthcare system and allows the delivery of comprehensive health services. This is essential for the prevention of disease, promotion of health, and overall wellbeing.

• In India, how are health care facilities classified?

  Public health services in India are classified into three categories: primary, second, and third level. Primary health care comprises Sub-Centres, Primary Health Centres, and District Hospitals. Community Health Centres and District Hospitals are the two main types of secondary care. Tertiary healthcare includes medical schools and superspecialty hospitals.

• What are the challenges facing India’s health care infrastructure?

  India’s public healthcare infrastructure faces a number of challenges including unequal resource allocation and financial constraints. It also has a poor standard of care as well as hefty disease burdens.

• What initiatives are being taken to improve the public health infrastructure of India?

  Several initiatives in India aim to improve the public health infrastructure, including Ayushman Bharat Yajana, Swachh Bharat Abhiyan (National Health Mission), Mission Indradhanush and POSHAN Abhiyaan. The programs are aimed at improving healthcare accessibility, affordability, outcomes, and quality.

• What are the benefits of the Ayushman Bharat Yojana for the general public?

  Ayushman Bharat Yojana offers health insurance to families at risk through two parts: Health and Wellness Centres and Pradhan Mantri Jan Arogya Yojana. The HWCs offer comprehensive primary healthcare, while PM-JAY provides secondary and tertiary healthcare coverage of up to ₹5 lakhs per family per year.

• What is the importance of community health workers to India’s healthcare system

  Accredited Social Health Activists are community health workers who play a key role in India’s Healthcare System. ASHAs act as a conduit between the local communities and healthcare providers. These health workers are responsible for promoting good health, preventing disease, and providing access to healthcare, especially in remote and rural areas.

• What impact has Telemedicine had on India’s access to healthcare?

  Telemedicine in India has improved access to healthcare, particularly in remote and rural areas. Initiatives such as eSanjeevani allow patients to communicate with doctors without having to travel. This improves accessibility, and ensures timely care.

• What is National Health Mission?

  National Health Missions (NHMs) are comprehensive programs that aim to improve access and quality of healthcare, particularly in underserved areas. This program merges both the National Rural Health Mission(NRHM) as well as the National Urban Health Mission(NUHM), and it implements a variety of health programs including immunization campaigns, maternal and children health services and disease control.

• What is the POSHAN Abhiyaan focused on?

  The POSHAN abhiyaan aims at tackling malnutrition in children, women who are pregnant, and mothers breastfeeding. The POSHAN Abhiyaan focuses on improving nutrition outcomes by leveraging inter-sectoral collaboration, community-based intervention, and technology in monitoring and managing nutritional status.