Healthcare

The crisis of COVID-19 vaccines in India is a consequence of government policies dating back decades. Private foundations led by the Bill and Melinda Gates Foundation have engineered a shift in research and manufacture of essential technologies such as vaccines to private biotech labs and factories. Companies such as the Serum Institute of India and Bharat Biotech can dictate terms and prices of vaccines developed with public support because the closure of public vaccine manufacturing units over a decade ago has left the government at the mercy of the private sector.

Awareness about risk factors is a prerequisite for the prevention of diabetes mellitus amongst diabetic patients. A questionnaire-based survey of diabetic patients adapted from “WHO-STEPS Surveillance” was performed during 2018 in Punjab, using descriptive statistics and multivariate logistic regression. The overall awareness level was found to be 83%, but perception and comprehension regarding risk factors and prevention strategies are still at a nascent stage. There is need for innovative awareness programmes and government campaigns on the consequences of lifestyle modification, sedentary lifestyle, and altering epidemiology of diabetes.

India’s health system is dominated by the private sector and as a result, out-of-pocket expenditure is very high. To provide financial risk protection and avoid catastrophic health consequences, policy emphasis is on the Ayushman Bharat programme which targets to cover 50 crore people. Such a large-scale insurance scheme needs huge infrastructural and administrative support. Unincorporated private healthcare providers comprise 99% of private health providers in India, the majority of them being small scale, employing less than 10 workers and having a strong urban bias. To better promote universal health coverage, policy emphasis on better monitoring, administering regulations, transparency in system, and ensuring quality in delivery of service is needed.

In the context of India where public expenditure on healthcare is low, the private sector plays an important role in delivering healthcare during childbirth. An analysis of the latest round of National Family Health Survey data to estimate the differential probability of caesarean sections in private medical facilities relative to government facilities, and focusing on unplanned C-sections, reveals that the probability of an unplanned C-section is 13.5–14 percentage points higher in the private sector. These results call for a critical assessment of the role of private sector in healthcare in the context of inadequate public provision, expanding private provision and weak governance structures.

The National Family Health Survey-3 and 4 data show that in the past 10 years, overweight/obesity among women in terms of Body Mass Index has increased quite sharply. In the Indian context, undernutrition and obesity are not separate problems. A large proportion of overweight/obese women are undernourished, with small stature, food transition towards more fats and increasingly sedentary lifestyles making them vulnerable towards being overweight/obese. More diversified diet reduces the risk of overweight/obesity. It is suggested that adequate and good quality diversified diets need to be ensured for comprehensive energy and nutrient adequacy. This requires an overhaul of India’s food programmes.