Doctor is not in-GS-2 (Crux of Indian Express Editorial)

The outbreak of dengue and chikungunya across India has again directed our attention to the state of the Indian health system.

To fix India’s healthcare scenario, what is most needed is “systems thinking”.

As per the World Health Organisation (WHO), an effective and efficient health system consists of six key building blocks

  1. service delivery,
  2. medicines,
  3. information,
  4. health workforce,
  5. financing and
  6. governance.
  • We all know that save for India’s ingenuity in producing cheap generic medicines, the country’s record via-a-vis the other five blocks is dubious at best.
  • Therefore, if we are actually serious about improving the health outcomes of India’s citizens, we must look at strengthening the country’s health system in its entirety, with an equal focus on disease prevention, health promotion, and disease diagnosis and treatment.

Roadmap to Follow:

  • Disease surveillance and data collection systems,
  • better medical research,
  • health workforce training and staff-retention programmes,
  • public provision of quality healthcare and nutrition services,
  • equal access to safe and efficacious medicines,
  • increased public financing for healthcare and nutrition, and
  • effective public and financial management of our national healthcare and
  • nutrition service delivery programmes.

All it needs is a strong political will, a long-term view of planning and management, and attention to detailed implementation.

Demographic Dividend:

  • Health and nutrition are inextricably linked to each other.
  • Research has shown that good health and nutrition during the early childhood period lead to proper physical and cognitive development amongst children, which is directly related to improved productivity and earning potential when these children become adults.
  • Therefore, our failure to improve the health and nutrition outcomes of our children is a major disservice to the future growth and progress of India.

A quick analysis

  • The 2016-17 budget allocations to the National Health Mission (NHM) and Integrated Child Development Services Scheme (ICDS Scheme), compared to the 2013-14 allocations, shows an approximate increase of six per cent and a decrease of 14 per cent, respectively.


  • For far too long, India has followed a vertical approach in its health sector, which translated into disease-specific national programmes being set up.
  • While many of these programmes have their own value, and have proved their efficacy over the last several years, there is an urgent need to adopt an approach that strengthens health systems to deal with problems such as the annual outbreak of diseases like dengue and chikungunya, as well as to prepare for the upcoming onslaught of non-communicable diseases such as cancer and diabetes.
  • India needs more public investment to strengthen its health system in line with WHO guidance, the paltry increase in the NHM allocation and the steep reduction in the ICDS budgets are ill-conceived

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