Even though we have lost 2020 to the pandemic, there is hope in 2021. The pandemic has impacted both lives and livelihood causing healthcare challenges, economic recession and humanitarian crisis. A lot has also evolved through the year, incredible advances in technology, digital health, governance, and humanity. From the “new normal” to a “new future”, nations are looking at restoring health, restarting economy and rebuilding resilient societies.
India has made significant advances in health system and outcomes in the past decades. Despite this, India faced a huge burden on healthcare, mainly a result of low public investment. Further high out-of-pocket costs are driving millions to poverty and debt. The pandemic has disrupted health services and likely to increase mortality indirectly. But all is not bad.
The new mortality estimate shows a substantial decline in the under-five mortality rate for India, from 126 in 1990 to 34 in 2019. There was decline in both infant mortality rate (89 in 1990 to 28 in 2019) and neonatal mortality rate (57 in 1990 to 22 in 2019). However, the recent data from the National Family Health Survey-5 (NFHS-5) released for 22 States/Union Territories, indicates extreme trends in nutrition and health indicators. Data shows worsening trends in nutrition indicators (childhood stunting, wasting and underweight), and promising trends for indicators of health outcomes and health delivery system in most states. There is a significant decline in both infant mortality rate and under-five mortality rate across states. Vaccination coverage, an important indicator of public health shows considerable improvement in immunization among children 12-23 months across states/UT’s.
To sustain the current progress in health indicators calls for accelerated coverage of child health and nutrition services both at community and facility level. India needs to step up its investment in healthcare services to sustain its economic growth as well as prepare for future public health emergencies. The remedy to overcome India’s healthcare afflictions calls for the amalgamation of data, technology and collaboration. Here is an opportunity to redesign the health system and building resilience equipped to handle future pandemics without disrupting routine health services.
Key takeaways for 2021
India’s healthcare has seen significant digital transformation and calls for a holistic digital health ecosystem to improve health outcomes. The National Digital Health Mission to be rolled out in January 2021 will look at enabling more effective delivery of healthcare services and moving towards health to all. It promises to significantly contribute to achieving the Sustainable Development Goals related to health. Digital health makes healthcare more accessible.
The government of India has chalked out a plan to deliver Covid-19 vaccine through a new digital platform 'CO-WIN’ beginning January 2021. The development of safe and effective vaccines is one thing, however, safety & efficacy, delivery dynamics, access & cost along with an effective communication strategy are equally important. Technology in healthcare plays a crucial role in resolving crisis and improve efficiency. The use of telemedicine- an enabler of healthcare access and affordability or artificial intelligence in pandemic detection, vaccine development, and facial recognition with masks etc. have greatly enhanced in the pandemic.
The Telemedicine Practice Guidelines issued jointly by the Ministry of Health & Family Welfare and NITI Aayog is timely and allows for remote consultation. India has surpassed in the use of AI in 2020 (70 percent) as compared to 2019 (62 percent), with 73 percent of healthcare and pharma companies adopting during the pandemic. AI can impact Indian healthcare by enabling access, enhance efficiency and enabling preliminary diagnosis.
Covid-19 has exposed the fragility of India’s healthcare system and the need to accelerate progress towards Universal Health Coverage (UHC). The recent launch of Reimagining India’s Health System- a Lancet Citizens’ Commission will layout the roadmap for achieving UHC in India. Health care is essential and fundamental to achieving sustainable development. The commission will work towards developing a citizen’s blueprint by 2022 for the implementation of UHC through a participatory and consultative process across India's healthcare landscape.
The pandemic has reversed the global health progress and nations have to work hard to bring it on track. The 10 ways to put global health issues on track in 2021 looks promising. India needs to strengthen its preparedness for pandemic and other emergencies, also tackling health inequalities, revitalize effort to tackle communicable diseases and prevent and treat non-communicable diseases etc.
Vision 2035: Public Health Surveillance in India, a vision document by NITI Aayog and University of Manitoba is futuristic and provides insights to strengthen it’s health systems and services. It envisages predictive and responsive health surveillance- inclusive of prioritized, emerging, and re-emerging communicable and non-communicable diseases.
The author of the article, Dr. Shoba Suri is a Senior Fellow with Health Initiative, Observer Research Foundation.