Healthcare in India is the responsibility of constituent states and territories of India India is a federal union of states comprising twenty-eight states and seven union territories. The states and territories are further subdivided into districts and so on. The Constitution Constitution of India is the supreme law of India. It lays down the framework defining fundamental political principles, establishing the structure, procedures, powers and duties, of the government and spells out the fundamental rights, directive principles and duties of citizens. Passed by the Constituent Assembly on 26 November 1949, it came charges every state India is a federal union of states comprising twenty-eight states and seven union territories. The states and territories are further subdivided into districts and so on with "raising of the level of nutrition Nutrition is the provision, to cells and organisms, of the materials necessary (in the form of food) to support life. Many common health problems can be prevented or alleviated with a healthy diet and the standard of living Standard of living is generally measured by standards such as real income per person and poverty rate. Other measures such as access and quality of health care, income growth inequality and educational standards are also used. Examples are access to certain goods (such as number of refrigerators per 1000 people), or measures of health such as life of its people and the improvement of public health Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals." It is concerned with threats to the overall health of a community based on population health analysis. The as among its primary duties". The National Health Policy was endorsed by the Parliament of India The Parliament of India is the federal and supreme legislative body of India. It consists of the office of President of India and two houses, the lower house, known as the Lok Sabha and the upper house, known as the Rajya Sabha.. It is located in New Delhi at Sansad Bhavan on Sansad Marg. Any bill can become an act only after it is passed by both in 1983 and updated in 2002.[1]
The art of Health Care in India can be traced back nearly 3500 years. From the early days of Indian history the Ayurvedic tradition of medicine has been practiced. During the rule of Emperor Ashoka Maurya (third century B.C.E.), schools of learning in the healing arts were created. Many valuable herbs and medicinal combinations were created. Even today many of these continue to be used. During his rein there is evidence that Emperor Ashoka was the first leader in world history to attempt to give health care to all of his citizens, thus it was the India of antiquity which was the first state to give it's citizens national health care.
In recent times India has eradicated mass famines however the country still suffers from high levels of malnutrition and disease especially in rural areas. Water supply and sanitation in India Water supply and sanitation in India continue to be inadequate, despite longstanding efforts by the various levels of government and communities at improving coverage. The situation is particularly inadequate for sanitation, since only one of three Indians has access to improved sanitation facilities . While the share of those with access to an is also a major issue in the country and many Indians in rural areas lack access to proper sanitation facilities and safe drinking water. However, at the same time, India's health care system also includes entities that meet or exceed international quality standards. The medical tourism business in India has been growing in recent years and as such India is a popular destination for medical tourists who receive effective medical treatment at lower costs than in developed countries.
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Healthcare Infrastructure
The Indian healthcare industry is seen to be growing at a rapid pace and is expected to become a US$280 billion industry by 2020 [2]. The Indian healthcare market was estimated at US$35 billion in 2007 and is expected to reach over US$70 billion by 2012 and US$145 billion by 2017 [3]. According to the Investment Commission of India the healthcare sector has experienced phenomenal growth of 12 percent per annum in the last 4 years [4]. Rising income levels and a growing elderly population are all factors that are driving this growth. In addition, changing demographics, disease profiles and the shift from chronic to lifestyle diseases in the country has led to increased spending on healthcare delivery [5].
Even so, the vast majority of the country suffers from a poor standard of healthcare infrastructure which has not kept up with the growing economy. Despite having centers of excellence in healthcare delivery, these facilities are limited and are inadequate in meeting the current healthcare demands. Nearly one million Indians die every year due to inadequate healthcare facilities and 700 million people have no access to specialist care and 80% of specialists live in urban areas. [6]
In order to meet manpower shortages and reach world standards India would require investments of up to $20 billion over the next 5 years [7]. Forty percent of the primary health centers in India are understaffed. According to WHO statistics there are over 250 medical colleges in the modern system of medicine and over 400 in the Indian system of medicine and homeopathy (ISM&H). India produces over 250,000 doctors annually in the modern system of medicine and a similar number of ISM&H practitioners, nurses and para professionals [8]. Better policy regulations and the establishment of public private partnerships are possible solutions to the problem of manpower shortage.
India faces a huge need gap in terms of availability of number of hospital beds per 1000 population. With a world average of 3.96 hospital beds per 1000 population India stands just a little over 0.7 hospital beds per 1000 population.[9]. Moreover, India faces a shortage of doctors, nurses and paramedics that are needed to propel the growing healthcare industry. India is now looking at establishing academic medical centers (AMCs) for the delivery of higher quality care with leading examples of The Manipal Group & All India Institute of Medical Sciences (AIIMS) already in place.
As incomes rise and the number of available financing options in terms of health insurance policies increase, consumers become more and more engaged in making informed decisions about their health and are well aware of the costs associated with those decisions. In order to remain competitive, healthcare providers are now not only looking at improving operational efficiency but are also looking at ways of enhancing patient experience overall.[10]
Central government role
Critics say that the national policy lacks specific measures to achieve broad stated goals. Particular problems include the failure to integrate health services with wider economic and social development, the lack of nutritional support and sanitation Sanitation is the hygienic means of promoting health through prevention of human contact with the hazards of wastes. Hazards can be either physical, microbiological, biological or chemical agents of disease. Wastes that can cause health problems are human and animal feces, solid wastes, domestic wastewater , industrial wastes, and agricultural, and the poor participatory involvement at the local level.
Central government efforts at influencing public health have focused on the five-year plans The economy of India is based in part on planning through its five-year plans, developed, executed and monitored by the Planning Commission. With the Prime Minister as the ex officio Chairman, the commission has a nominated Deputy Chairman, who has rank of a Cabinet minister. Montek Singh Ahluwalia is currently the Deputy Chairman of the, on coordinated planning with the states, and on sponsoring major health programs. Government expenditures are jointly shared by the central and state India is a federal union of states comprising twenty-eight states and seven union territories. The states and territories are further subdivided into districts and so on governments. Goals and strategies are set through central-state government consultations of the Central Council of Health and Family Welfare. Central government efforts are administered by the Ministry of Health and Family Welfare, which provides both administrative and technical services and manages medical education. States provide public services and health education Health education is the profession of educating people about health. Areas within this profession encompass environmental health, physical health, social health, emotional health, intellectual health, and spiritual health. It can be defined as the principle by which individuals and groups of people learn to behave in a manner conducive to the.
The 1983 National Health Policy is committed to providing health services to all by 2000. In 1983 health care expenditures varied greatly among the states and union territories, from Rs The Indian rupee (sign: ; code: INR) is the official currency of India. The issuance of the currency is controlled by the Reserve Bank of India 13 per capita in Bihar Bihar (Hindi: बिहार, Urdu: بہار, pronounced [bɪˈhaːr] ) is a state in eastern India. It is the 12th largest state in terms of geographical size at 38,202 sq mi (99,200 km²) and 3rd largest by population. Close to 85% of the population lives in villages. Almost 58% of Biharis are below the age of 25. which is the highest to Rs 60 per capita in Himachal Pradesh Himachal Pradesh (Hindi: हिमाचल प्रदेश pronounced [hɪmaːtʃəl prəd̪eːʃ] ) is a state in Northern India. It is spread over 21,495 sq mi (55,673 km²), and is bordered by the Indian states of Jammu and Kashmir on the north, Punjab on the west and south-west, Haryana and Uttar Pradesh on the south, Uttarakhand on the, and Indian per capita expenditure was low when compared with other Asian Asia is the world's largest and most populous continent, located primarily in the eastern and northern hemispheres. It covers 8.6% of the Earth's total surface area and with approximately 4 billion people, it hosts 60% of the world's current human population. During the 20th century Asia's population nearly quadrupled countries outside of South Asia South Asia, also known as Southern Asia, is the southern region of the Asian continent, which comprises the sub-Himalayan countries and, for some authorities , also includes the adjoining countries on the west and the east. Topographically, it is dominated by the Indian Plate, which rises above sea level as the Indian subcontinent south of the. Although government health care spending progressively grew throughout the 1980s, such spending as a percentage of the gross national product A variety of measures of national income and output are used in economics to estimate total economic activity in a country or region, including gross domestic product , gross national product (GNP), and net national income (NNI). All are specially concerned with counting the total amount of goods and services produced within some "boundary& (GNP) remained fairly constant. In the meantime, health care spending as a share of total government spending decreased. During the same period, private-sector spending on health care was about 1.5 times as much as government spending.
Expenditure
In the mid-1990s, health spending amounted to 6% of GDP The gross domestic product or gross domestic income (GDI) is a measure of a country's overall official economic output. It is the market value of all final goods and services officially made within the borders of a country in a year. It is often positively correlated with the standard of living, though its use as a stand-in for measuring the, one of the highest levels among developing nations. The established per capita spending is around Rs 320 per year with the major input from private households (75%). State governments contribute 15.2%, the central government 5.2%, third-party insurance and employers 3.3%, and municipal government and foreign donors about 1.3, according to a 1995 World Bank World Bank is a term used to describe an international financial institution that provides leveraged loans to developing countries for capital programs. The World Bank has a stated goal of reducing poverty study. Of these proportions, 58.7% goes toward primary health care It was a new approach to health care that came into existence following this international conference in Alma Ata in 1978 organized by the World Health Organisation and the UNICEF (curative, preventive, and promotive) and 38.8% is spent on secondary and tertiary inpatient care. The rest goes for nonservice costs.
The fifth and sixth five-year plans (FY 1974-78 and FY 1980-84, respectively) included programs to assist delivery of preventive medicine Preventive medicine or preventive care refers to measures taken to prevent diseases, rather than curing them or treating their symptoms. The term contrasts in method with curative and palliative medicine, and in scope with public health methods (which work at the level of population health rather than individual health) and improve the health status of the rural population. Supplemental nutrition programs and increasing the supply of safe drinking water Drinking water or potable water is water of sufficiently high quality that it can be consumed or used without risk of immediate or long term harm. In most developed countries, the water supplied to households, commerce and industry is all of drinking water standard, even though only a very small proportion is actually consumed or used in food were high priorities. The sixth plan aimed at training more community health workers and increasing efforts to control communicable diseases An infectious disease is a clinically evident illness resulting from the presence of pathogenic microbial agents, including pathogenic viruses, pathogenic bacteria, fungi, protozoa, multicellular parasites, and aberrant proteins known as prions. These pathogens are able to cause disease in animals and/or plants. Infectious pathologies are also. There were also efforts to improve regional imbalances in the distribution of health care resources.
The Seventh Five-Year Plan (FY 1985-89) budgeted Rs 33.9 billion for health, an amount roughly double the outlay of the sixth plan. Health spending as a portion of total plan outlays, however, had declined over the years since the first plan in 1951, from a high of 3.3% of the total plan spending in FY 1951-55 to 1.9% of the total for the seventh plan. Mid-way through the Eighth Five-Year Plan (FY 1992-96), however, health and family welfare was budgeted at Rs 20 billion, or 4.3% of the total plan spending for FY 1994, with an additional Rs 3.6 billion in the nonplan budget.
Primary services
Health care facilities and personnel increased substantially between the early 1950s and early 1980s, but because of fast population growth The demographics of India are remarkably diverse. India is the second-largest populated country in the world with over 1.18 billion people and consists of more than one-sixth of the world's population. It contributes 17.31% of the world's population and projected that India will be the largest populated country by 2025 surpassing China, and by 2050, the number of licensed medical practitioners per 10,000 individuals had fallen by the late 1980s to three per 10,000 from the 1981 level of four per 10,000. In 1991 there were approximately ten hospital beds per 10,000 individuals. However for comparison, the in China for comparison there are 1.4 doctors per 1000 people.
Primary health centers are the cornerstone of the rural health care system. By 1991, India had about 22,400 primary health centers, 11,200 hospitals A hospital, in the modern sense of the word, is an institution for health care providing patient treatment by specialized staff and equipment, and often, but not always providing for longer-term patient stays. Its historical meaning, until relatively recent times, was "a place of hospitality", for example the Chelsea Royal Hospital,, and 27,400 clinics A clinic is a small private or public health facility that is devoted to the care of outpatients, often in a community, in contrast to larger hospitals, which also treat inpatients. Some grow to be institutions as large as major hospitals, whilst retaining the name clinic. These are often associated with a hospital or medical school. These facilities are part of a tiered health care system that funnels more difficult cases into urban hospitals while attempting to provide routine medical care to the vast majority in the countryside. Primary health centers and subcenters rely on trained paramedics A paramedic is a medical professional, usually working as part of the emergency medical services provision in a given area. Their primary role is to provide pre-hospital advanced medical and trauma care, followed, where appropriate, by transfer to definitive care. Although most paramedics are field based in ambulances or response cars, some may to meet most of their needs. The main problems affecting the success of primary health centers are the predominance of clinical and curative concerns over the intended emphasis on preventive work and the reluctance of staff to work in rural areas. In addition, the integration of health services with family planning Family planning is the planning of when to have children, and the use of birth control and other techniques to implement such plans. Other techniques commonly used include sexuality education, prevention and management of sexually transmitted infections, pre-conception counseling and management, and infertility management programs often causes the local population to perceive the primary health centers as hostile to their traditional preference for large families. Therefore, primary health centers often play an adversarial role in local efforts to implement national health policies.
According to data provided in 1989 by the Ministry of Health and Family Welfare, the total number of civilian hospitals for all states and union territories combined was 10,157. In 1991 there was a total of 811,000 hospital and health care facilities beds. The geographical distribution of hospitals varied according to local socio-economic conditions. In India's most populous state, Uttar Pradesh Uttar Pradesh (Hindi: उत्तर प्रदेश, Urdu: اتر پردیش, pronounced [ˈʊtːər prəˈdeːʃ] , "Northern Province"), [often referred to as U.P.] is a state located in the northern part of India. With a population of over 190 million people, it is India's most populous state, as well as the world's most populous, with a 1991 population of more than 139 million, there were 735 hospitals as of 1990. In Kerala Kerala (Malayalam: കേരളം, pronounced [Kēraḷam]) is a state in South West India. It was created on 1 November 1956, with the passing of the States Reorganisation Act bringing together the areas where Malayalam was the dominant language, with a 1991 population of 29 million occupying an area only one-seventh the size of Uttar Pradesh, there were 2,053 hospitals.
Although central government has set a goal of health care for all by 2000, hospitals are distributed unevenly. Private studies of India's total number of hospitals in the early 1990s were more conservative than official Indian data, estimating that in 1992 there were 7,300 hospitals. Of this total, nearly 4,000 were owned and managed by central, state, or local governments. Another 2,000, owned and managed by charitable trusts, received partial support from the government, and the remaining 1,300 hospitals, many of which were relatively small facilities, were owned and managed by the private sector. The use of state-of-the-art medical equipment was primarily limited to urban centers in the early 1990s. A network of regional cancer diagnostic and treatment facilities was being established in the early 1990s in major hospitals that were part of government medical colleges. By 1992 twenty-two such centers were in operation. Most of the 1,300 private hospitals lacked sophisticated medical facilities, although in 1992 approximately 12% possessed state-of-the-art equipment for diagnosis and treatment of all major diseases, including cancer. The fast pace of development of the private medical sector and the burgeoning middle class in the 1990s have led to the emergence of the new concept in India of establishing hospitals and health care facilities on a for-profit basis.
By the late 1980s, there were approximately 128 medical colleges - roughly three times more than in 1950. These medical colleges in 1987 accepted a combined annual class of 14,166 students. Data for 1987 show that there were 320,000 registered medical practitioners and 219,300 registered nurses. Various studies have shown that in both urban and rural areas people preferred to pay and seek the more sophisticated services provided by private physicians rather than use free treatment at public health centers.
Indigenous or traditional medical practitioners continue to practice throughout the country. The two main forms of traditional medicine practised are the ayurvedic Ayurveda Ayurvedic medicine is a system of traditional medicine native to the Indian subcontinent and practiced in other parts of the world as a form of alternative medicine. In Sanskrit, the word ayurveda consists of the words āyus, meaning "longevity", and veda, meaning "related to knowledge" or "science". Evolving system, which deals with mental and spiritual as well as physical well-being The term quality of life is used to evaluate the general well-being of individuals and societies. The term is used in a wide range of contexts, including the fields of international development, healthcare, and political science. Quality of life should not be confused with the concept of standard of living, which is based primarily on income, and the unani Unani Medicine or Yunani Medicine means "Greek", also called "Unani-tibb" is a form of traditional medicine widely practiced in India and Indian subcontinent. It refers to a tradition of Graeco-Arabic medicine , which is based on the teachings of Greek physician Hippocrates, and Roman physician Galen, and developed in to an (or Galenic Aelius Galenus or Claudius Galenus or Claudii Galeni Pergameni , better known as Galen of Pergamon (modern-day Bergama, Turkey), was a prominent Greek physician, surgeon and philosopher. Arguably the most accomplished of all medical researchers of antiquity, Galen contributed greatly to the understanding of numerous scientific disciplines) herbal medical Herbalism is a traditional medicinal or folk medicine practice based on the use of plants and plant extracts. Herbalism is also known as botanical medicine, medical herbalism, herbal medicine, herbology, and phytotherapy. The scope of herbal medicine is sometimes extended to include fungal and bee products, as well as minerals, shells and certain practice. A vaidya is a practitioner of the ayurvedic Ayurveda Ayurvedic medicine is a system of traditional medicine native to the Indian subcontinent and practiced in other parts of the world as a form of alternative medicine. In Sanskrit, the word ayurveda consists of the words āyus, meaning "longevity", and veda, meaning "related to knowledge" or "science". Evolving tradition, and a hakim Hakim or Al-Hakim is a given name for a male. In the Arabic language, Hakim means wise is a practitioner of the unani or Greek tradition. These professions are frequently hereditary. A variety of institutions offer training in indigenous medical practice. Only in the late 1970s did official health policy refer to any form of integration between European-trained medical personnel and indigenous medical practitioners. In the early 1990s, there were ninety-eight ayurvedic colleges and seventeen unani colleges operating in both the governmental and non-governmental sectors.
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ue, 09 Mar 2010 19:57:14 GM
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