Health Equity
Kartavya Desk Staff
Syllabus: Health
Source: DH
Context: Health equity remains a critical goal for achieving Universal Health Coverage (UHC) in India. Despite government initiatives systemic inequalities persist across gender, religion, and regions, widening the gap in access to quality healthcare services.
What is Health Equity?
Health equity ensures that everyone has a fair opportunity to achieve their highest health potential, addressing avoidable disparities caused by social, economic, and environmental factors.
Various Parameters of Health Equity
• Access to Healthcare: Equitable distribution of hospitals, health workers, and medicines in rural and urban areas.
• Financial Protection: Reducing out-of-pocket healthcare expenditures and ensuring insurance coverage.
• Gender Parity: Equal healthcare access for women, men, and non-binary individuals.
• Social Determinants: Addressing poverty, education, housing, and clean water to improve health outcomes.
• Quality of Care: Ensuring timely, affordable, and standardized healthcare services for all.
Present Inequity in Health in India:
• Gender Inequality: Anaemia among Women: 59% in the lowest wealth quintile (NFHS-5, 2019-21). Maternal mortality remains higher in rural areas due to lack of care.
• Anaemia among Women: 59% in the lowest wealth quintile (NFHS-5, 2019-21).
• Maternal mortality remains higher in rural areas due to lack of care.
• Religious Inequality: Muslims have higher infant mortality rates (43 per 1,000 live births) than the national average (Census 2011).
• Muslims have higher infant mortality rates (43 per 1,000 live births) than the national average (Census 2011).
• Regional Disparity: Urban areas have 75% of healthcare professionals, but only 27% of India’s population resides there (WHO). Rural CHCs face 83% shortages of specialists, worsening access to care.
• Urban areas have 75% of healthcare professionals, but only 27% of India’s population resides there (WHO).
• Rural CHCs face 83% shortages of specialists, worsening access to care.
• Caste and Tribal Marginalization: Child Mortality: Higher among Scheduled Tribes and Scheduled Castes. Immunization rates lower for marginalized groups compared to upper castes (NFHS-5).
• Child Mortality: Higher among Scheduled Tribes and Scheduled Castes.
• Immunization rates lower for marginalized groups compared to upper castes (NFHS-5).
• Economic Disparity: Out-of-pocket expenses: 39.4% of total health expenditure (NHA, 2021-22). Over 50 million people are pushed into poverty annually due to healthcare costs.
• Out-of-pocket expenses: 39.4% of total health expenditure (NHA, 2021-22).
• Over 50 million people are pushed into poverty annually due to healthcare costs.
Government initiatives:
• Ayushman Bharat – PMJAY: Provides ₹5 lakh annual health cover for low-income families.
• National Health Mission (NHM): Focuses on strengthening primary and urban healthcare systems.
• Pradhan Mantri Ayushman Bharat Digital Mission: Promotes digital healthcare access and efficiency.
• Free Medicine Schemes: Tamil Nadu’s robust drug procurement system ensures free medicines.
• Focus on Primary Healthcare: Kerala’s model emphasizes strong primary health infrastructure.
Challenges for health equity:
• Inadequate Public Funding: Government healthcare spending stands at only 1.84% of GDP.
• Shortage of Healthcare Workers: Severe deficit of doctors and specialists, particularly in rural areas.
• Over-Reliance on Private Sector: High private healthcare costs exacerbate inequities.
• Socioeconomic Barriers: Poverty, gender discrimination, and illiteracy hinder healthcare access.
• Regional Imbalance: States with low healthcare infrastructure struggle with accessibility and quality of care.
Way ahead to achieve health equity:
• Increased Public Health Spending: Raise budgetary allocation to 2.5% of GDP for improved infrastructure and resources.
• Strengthen Primary Healthcare: Focus on PHCs and CHCs with adequate staffing and facilities in rural areas.
• Expand Insurance Coverage: Integrate informal sector workers into schemes like PMJAY.
• Leverage Technology: Use digital health platforms for telemedicine and health awareness.
• Address Social Determinants: Tackle poverty, education gaps, clean water access, and nutrition to improve overall health outcomes.
Conclusion:
Achieving health equity requires political commitment, increased investment, and inclusive policies that address systemic disparities. As Nelson Mandela said, “Health cannot be a question of income; it is a fundamental human right.”
Insta Links:
• Inclusive-health-care
Consider the following statements: (UPSC-2023)
Statement-I: India’s public sector health care system largely focuses on curative care with limited preventive, promotive and rehabilitative care.
Statement-II: Under India’s decentralized approach to health care delivery, the States are primarily responsible for organizing health services.
Which one of the following is correct in respect of the above statements?
a. Both Statement-I and Statement-II are correct and Statement II is the correct explanation for Statement-I
b. Both Statement-I and Statement-II are correct and Statement II is not the correct explanation for Statement-I
c. Statement-I is correct but Statement II is incorrect
d. Statement-I is incorrect but Statement-II is correct
Answer: b)