India as a country has gone through significant transformation over the past few decades given the economic, cultural & political milieu. Despite the progress, the country's public health system continues to be overburdened and over loaded. It is estimated that the total healthcare expenditure in India during last few years was only 3.9 per cent of GDP, as compared to 8.9 per cent for Brazil, 6.2 per cent for Russia and 5.2 per cent for China. Research suggests that 39 million people are forced into poverty each year because of medical expenditure and because of the rising costs many simply can’t afford any sort of healthcare at all.
According to National Family Health Survey III, the private medical sector remains the primary source of health care for 70 percent of households in urban areas and 63 percent of households in rural areas. The main reason attributed for this is the poor quality of health care of the public sector which was echoed by 57 percent of the respondents. Other deterrents in accessing public health care were the poor infrastructure which entailed long waiting hours, and inconvenient hours of functioning. As per the WHO recommended guidelines for the healthcare worker ratio of 2.5:1000 population India, has 1.65:1000. Total hospital bed density in the country (0.9:1000 population) is well below the global average (3.0) and WHO guideline of 3.56. This is severely affecting the health-related Millennium Development Goals.
The National Rural Health Mission (2005) has been catering to the rural population of the country. It encapsulates various national programmes such as the National Vector Borne Diseases, Revised National TB Control Programme, the Janani Suraksha Yojana, Adolescent Reproductive Sexual Health Programme among others. The challenge of the inequity in accessibility, affordability and quality of healthcare are still to be addressed. The country needs to develop a strategic approach to leverage the growth trajectory of healthcare to its advantage. Efforts of the government given the complexities of cultural differences, specific area and community requirements get delayed thereby becoming a daunting challenge during implementation.
The private sector along with civil society organizations have a significant role to play in ensuring equitable healthcare access in the country. Various research scholars have reiterated the relevance of multi-stakeholderism. Given the complexity of healthcare in the country, the role of collaboration has been established which is meant to be a pre-requisite for success.
A collaborated effort among government, private and civil society organization would bridge the current gaps given the joint strengths. The new healthcare systems must address the concerns of inadequate skilled medical doctors, effective and affordable medication, skilled managers and effective policies. It must focus energies on constructing effective community-private-partnerships that will help design and implement programmes focused on community needs.