Setting up the Millennium Development Goals was the first step taken towards creating a better world, a better environment and a better life. But, over the time Millennium Development Goals turned out to be myopic and did not address the problem, holistically. For development in Healthcare, many other allied issues had to be address and a vertical, compartmentalized approach wasn’t enough. That is when SDGs came into the picture.
SDGs or Sustainable Development Goals were adopted in September 2015 at the United Nations Summit. While India has made significant progress in its state of Healthcare, we are still miles away from reaching an ‘acceptable point’ in terms of the quality of healthcare and its distribution at the ground level.
There were 17 Sustainable Development Goals that were adopted, of which Goal #3 zeroes in on the current state of healthcare. It states –
Ensure healthy lives and well-being for all at all ages.
Where Do We Lack?
The sheer size and scale of the country points means that the success of the global goals, to a large extent, depends on progress made in India. But, there are certain glaring lacunae in the current healthcare system in India, that need to be addressed on priority to achieve the SDGs.
- Low Spend On Healthcare As A Percentage of GDP
Before the MDGs the average spend on Healthcare as a percentage of GDP was a mere 0.9%. This directly pointed to the unforgiving high costs of medical care and medicines that were only affordable to the upper sections of the society. By the time SDGs came into the picture, this situation has slightly improved and the spend as of today is 1.15% of the GDP. As per the new National Health Policy, this figure is set to go up to 2.5% whereas, experts recommend a 5% spend as the ideal figure.
This inadequate spending manifests in all aspects of public health care. We still don’t possess the requisite infrastructure (hospitals,primary health care centers) capacity (number of well-qualified medical and para-medical personnel, dynamic and universal medical insurance coverage) technology (especially low-cost medical devices for use in rural areas) and the know-how (medical research, manufacturing of advanced devices) to provide for the population of the country.
- Inadequate Training Of Primary Healthcare Staff
The current state of healthcare is such that, practitioners follow a triangular approach while treating a patient. Doctors and nurses in the primary health centres lack the knowledge to treat a patient who is suffering from anything beyond a normal cough or cold. For symptoms that are even slightly advanced or ambiguous, the patients are referred to a specialist (secondary healthcare). The specialist – patient proportion is highly skewed, thereby, making consultation and treatment costs higher.
- Absence Of Pro-health Ecosystem
A pro-health ecosystem is the one that is multi-sectoral in nature. Development of the healthcare system is highly dependent on the simultaneous progress in alleviating poverty, hunger, promoting quality education, gender equality, and reducing inequalities. Clean air, clean water and clean soil are big contributors to the good health of a country’s citizens. Thus a holistic sustainable development is necessary for development in healthcare, which is grossly inadequate.
Setting Up Of NITI Aayog and The Launch Of NHP
Once the SDGs were set up the next obvious step was to create a national level body that will monitor and regulate every movement in the direction of SDGs at national and state level. That is when, National Institution for Transforming India, better known as the NITI Aayog was set up. NITI Aayog is a nodal body that monitors and works with the states in implementing SDGs.
The National Health Policy (NHP) was announced on 16th March 2017 as the next step towards working for the SDGs. There were many hits and misses, but the policy recognised that the SDGs were of pivotal importance.
While their recommendations and road ahead are commendable, the NHP surprisingly doesn’t talk about traditional determinants of health – reducing poverty, hunger, promoting quality education, gender equality, and reducing inequalities ( SDGs – 1,2,4-6,10)
Filling The Gap with Social Entrepreneurship
Where the government lacks, social entrepreneurs take the lead. We are calling out the following ventures for their work in healthcare.
Started by Swapnil Chaturvedi, aka, the ‘Poop Guy’ Samagra, builds toilets and provides improved sanitation services to the urban poor. The initiatives at Samagra target the Sustainable Development Goal #6 of providing Clean Water and Sanitation services, which hasn’t been addressed in the National Health Policy.
Samagra partners with municipal agencies and redesigns community toilet infrastructure to create a community center and a one-stop shop for slum residents. With their special LooRewards program, Samagra rewards slum residents for hygienic behaviour like washing hands and prompt payment upon using the toilets. Their work towards changing attitudes towards sanitation and hygiene is a great example of social impact.
Started by a techie, Sujay Santra, iKure delivers last mile health care services to the rural communities. Sujay believes that “If primary health care is inaccessible to the poor, why not take healthcare to them?” iKure follows an innovative impact model that is centered around providing sustainable livelihood to healthcare workers on one hand and employing technology on the other by remotely connecting doctors with patients.
Thus through iKure, Sujay has created a scalable business that is accelerating the reach of primary health care to the rural masses.
- Embrace Innovations
Embrace Innovations, a healthcare technology company based in Bengaluru, India, develops, manufactures, distributes, and sells Embrace Nest, a portable infant warmer for helping low birth-weight and premature babies. Given that 0.75 neonates die every year in India, the highest for any country in the world, Embrace Innovations focuses on improving infant and maternal health, a crucial aspect of healthcare in India.
After all the deliberations and discussions, the wheels are finally set in motion to make healthcare ecosystem in India, better, effective and affordable to people from every section of the society. That being said, Government can only create the required environment to achieve healthcare SDGs, but the way ahead towards the fulfillment of these goals is through social enterprises who can take these policies to the deepest level and ensure their maximum reach.
There are several promising startups in this space. We would love to hear about them and mention their work. If you know some, please suggest to the editorial team through comments below.