India's health sector not performing well: Niti Aayog

A report by Niti Aayog raises concern for India's health system, saying it needs improvement. It also charts a clear roadmap for its complete transformation.

Niti Aayog report

Published : Nov 18, 2019, 11:36 PM IST

New Delhi: India's health system is under-performing and lagging behind many comparable countries in key performance indicators, a NITI Aayog report said.

The report - Health Systems for a New India: Building Blocks - Potential Pathways to Reforms - released here on Monday said: "Severe fragmentation, compounded by market failures and governance challenges, is the key driver of India's underperforming health system."

The report charts a clear roadmap for the complete transformation of India's health system. It focuses on breaking silos in the health space and removing fragmentation between various initiatives, ensuring greater convergence between ministries as well as the Centre and the states, as already initiated under the Ayushman Bharat scheme.

Read: Smriti Irani, Bill Gates launch Bharatiya Poshan Krishi Kosh

The report identified five focus areas of future health system -- deliver on unfinished public health agenda, change health financing away from out of pocket so spend into large insurers, integrate service delivery vertically and horizontally, empower citizens to become better buyers of health, and harness the power of digital health.

The report noted that health financing is fragmented at all three levels -- revenue sources, health insurance (financial risk pooling), and strategic purchasing (how funds are used to set incentives for service providers to maximise efficiency, responsiveness and quality in the health service provider market).

There are high levels of fragmentation in the sources of revenues, with most health expenditure (about 62 per cent) coming directly from households.

Currently, the government (Union and the states put together) spends roughly 1.13 per cent of GDP on health, which is grossly inadequate compared to similar spending by other countries.

As a result, 62 per cent of healthcare spending is financed by households through out-of-pocket expenditure at the point of care.

Also Read: NITI Aayog mulls healthcare system for middle class

New Delhi: India's health system is under-performing and lagging behind many comparable countries in key performance indicators, a NITI Aayog report said.

Read: Smriti Irani, Bill Gates launch Bharatiya Poshan Krishi Kosh

There are high levels of fragmentation in the sources of revenues, with most health expenditure (about 62 per cent) coming directly from households.

Currently, the government (Union and the states put together) spends roughly 1.13 per cent of GDP on health, which is grossly inadequate compared to similar spending by other countries.

As a result, 62 per cent of healthcare spending is financed by households through out-of-pocket expenditure at the point of care.

Also Read: NITI Aayog mulls healthcare system for middle class

Intro:New Delhi: Admitting that India spends roughly 1.13 percent of GDP on health sector, Niti Aayog on Monday released Health System for a New India: Building Blocks-Potential Pathways to Reform, a 15 years vision for an inclusive development of country's health sector.

Body:The 285 page report was released by Niti Aayog vice chairman Dr Rajiv Kumar in he presence of Bill Gates, co-chairman of Bill and Melinda Gates foundation in New Delhi.

The report identified five focus area of future health system, deliver on unfinished public health agenda, change health financing away from out of pocket so spend into large insurers, integrate service delivery vertically and horizontally, empower citizens to become better buyers of health, harness the power of digital health.

In the report, the think tank (Niti Aayog) has admitted that currently the government (Union and states put together) spends roughly 1.13 percent of GDP on health, which is grossly inadequate compared to similar spending by other countries.

"As a result, 62 percent of healthcare spending is financed by households through out of pocket expenditure at the point of care," the report said.

The report has also found that India also suffers from inadequate and fragmented delivery of healthcare services.

"Over 98 percent of healthcare facilities in India are those which employee 10 persons or less. A consequences of the fragmented provider space is that the health record of patients lie buried in manual system or in some cases disparate IT systems with little standardisation with almost no possibility of inter-operatibility, thereby limiting the availability of information that could potentially guide the decision on health policy," said the report.

While highlighting transformation in India's health system in the 21st century, the report said that India's health system is still a work in progress and there remains a large unfinished agenda.

"There are significant interstate and intrastate differentials in health outcomes with socia-economically disadvantaged groups being particularly vulnerableto gaps in access as well as quality of healthcare available to them," the report said.

Through this report, Niti Aayog also tried to involve renowned global experts and their collaborators in India to take a look at the current state of affairs prevalent in the health system.

Admitting that health sector fragmentation, market failures, and governance challenges are the key drivers of an underperforming healthcare system in India, the report said that improving health sector performance will save lives, protect households from poverty, improve the patient interface with the health sector and accelerate economic growth.

The report said that with the implementation of six vital suggestions (As mentioned below) India has a unique opportunity to transform its healthcare system over the next decades or so...

(FGX IN

1. Further develop and deliver on the unfinished agenda pertaining to population and public health.

2. Change health system financing structure away from the predominant undesirable out of pocket spending.

3. Reduce fragmentation of riskpools and health service provision.

4. Empower patients to become better purchaser.

5. Harness the power of digital health.

6. Implement PM-JAY with an eye on its potential to influence the overall healthcare transformation in India, beyond its current explicit mandate.

GFX OUT)

Identifying that Risk pooling-the health system's insurance function-is critical for improving access to health service, the report further said that country's robust macroeconomic performance and vibrant growth of its private sector provide an excellent opportunity for introducing the necessary changes in the health sector.

Conclusion:Talking about vision, the report said that India needs to transform its currently fragmented healthcare delivery system into a more organised, accountable and affordable system aligned with public objectives.

"While there is negative consensus on the broad shortcomings of the service delivery system, a positive consensus on the what and how of reforming organisation and provision remains elusive," the report pointed out.

At the same time, the report also highlighted on promoting whole system governance.

"Establish a multi-stakeholder coordination and oversight governance structure in each state with representatives from government, private sector and civil society. There should be capacity building for performance management and evidence based policy making and implementation monitoring with a focus at the state level," the report suggested.

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India's health sector not performing well: Niti Aayog

A report by Niti Aayog raises concern for India's health system, saying it needs improvement. It also charts a clear roadmap for its complete transformation.

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