India’s Health System: Present And Future

Urvashi Prasad

Introduction

IMPRI Impact and Policy Research Institute, New Delhi’s Center for the Study of Finance and Economics (CSFE) hosted the first rendition of Health Sector Management and Governance: An Indian Perspective, an online national summer school program hosted during June-July 2024. The course on Health Sector Management and Governance: An Indian Perspective is vital for achieving India’s vision of a healthy population by 2047 and addressing the sector’s professionalization challenges. It also emphasizes the importance of managing health systems and technologies to mitigate economic and security risks highlighted
by the pandemic.

On Day 2 of the program, Ms Urvashi Prasad, Director at the Office of Vice Chairman, NITI Aayog delivered a comprehensive talk outlining the current state and future trajectory of India’s health sector. India’s healthcare system is on the brink of a transformative era, characterized by rapid advancements in technology, a shift from curative to preventative healthcare, and a growing focus on gender-specific and elderly care.

The Shift from Curative to Preventative Healthcare

In her talk, Ms Urvashi Prasad emphasized a pivotal shift in India’s healthcare system from the traditional focus on curative care to a more proactive approach centered on preventative healthcare. Historically, India’s healthcare infrastructure, much like those in other parts of the world, has been reactionary. It primarily dealt with addressing health issues after they occurred, managing symptoms, and curing diseases post-diagnosis. However, as healthcare systems evolve globally, and the burden of lifestyle diseases (non-communicable diseases or NCDs) rises, India is beginning to rethink its approach. Ms Prasad articulated the need for this shift, explaining early detection and health management will become the cornerstone of India’s future healthcare landscape.

At the heart of this preventative care model is the utilization of modern technology, particularly wearable devices. Wearables, which were once simple gadgets tracking basic health metrics like heart rate, steps, and sleep patterns, are rapidly evolving. Ms Prasad outlined how the next generation of wearable technology will be much more advanced. Devices like smartwatches will not only track basic vitals but also conduct more sophisticated diagnostic functions, such as performing electrocardiograms (ECGs) on the go. These ECGs will be able to monitor heart rhythms in real time, alerting users to potential issues like arrhythmias or even predicting the likelihood of heart attacks through advanced algorithms.

The move toward predictive technology marks a significant leap in healthcare. By analyzing data collected over time, wearables could detect subtle changes in an individual’s health long before a traditional diagnostic test might be conducted. For example, a user might receive a warning that their heart rate variability is declining, which could signal an increased risk of cardiovascular disease. This kind of insight allows users to seek medical attention early, potentially preventing severe health episodes such as heart attacks, strokes, or other acute conditions.

Ms Prasad also underscored the importance of integrating mental health into the realm of preventative care. The rapid growth of mental health issues, such as depression and anxiety, is a concern that needs equal attention alongside physical health.

Just as with physical health, early detection of mental health conditions is crucial for effective intervention. Wearable devices will soon have the ability to monitor mental health markers detecting early signs of stress, anxiety, and depression. For instance, changes in sleep patterns, heart rate variability, or even physical activity levels can indicate shifts in mental health. With this data, individuals could receive notifications or suggestions to consult a healthcare professional, enabling early mental health interventions and reducing the long-term psychological burden on the healthcare system.

Additionally, Ms Prasad emphasized that preventative care goes beyond merely using wearables to detect conditions. It also involves creating an ecosystem where individuals are empowered to take charge of their health, supported by educational tools and digital platforms that can provide personalized health advice. Preventative healthcare requires not just technological advancements but also a shift in mindset from patients and healthcare providers alike. Prasad highlighted the need for awareness programs and initiatives that promote healthy lifestyles, early screenings, and consistent monitoring as part of India’s healthcare future. This shift to prevention could reduce the overall strain on healthcare facilities and significantly cut down healthcare costs in the long run.

The Critical Role of Technology in Healthcare

Technology is set to play a transformative role in India’s healthcare sector. In the opinion of Ms Urvashi Prasad, technology will be the backbone of future healthcare delivery in the country. The integration of advanced technologies like artificial intelligence (AI), machine learning, advanced diagnostics, and 5G will fundamentally change how healthcare is accessed, delivered, and experienced in India. Ms Prasad particularly highlighted the growing importance of artificial intelligence (AI) in healthcare. AI is already making its presence felt in India’s healthcare system, and it has the potential to expand significantly in the coming years.

AI algorithms are capable of analyzing vast amounts of medical datasuch as patient history, lab results, and imaging scansmuch faster and more accurately than traditional methods. By doing so, AI can help identify patterns, make predictions about disease progression, and suggest the best course of treatment, even in cases where a human doctor might struggle to detect nuances. This capacity for deep data analysis and precision diagnostics can save lives, particularly in critical or time-sensitive situations.

One of the key applications of AI that Ms Prasad emphasized was in the expansion of telemedicine. AI-powered platforms are already enabling millions of patients across India, especially in rural and remote areas, to access healthcare services without having to visit a doctor physically. These platforms allow patients to consult with doctors, share their symptoms, and receive prescriptions all from the comfort of their homes. This is particularly significant in a country as vast as India, where access to healthcare services is often limited by geographical, infrastructural, and economic constraints. AI not only facilitates remote consultations but can also triage patients by assessing their symptoms and categorizing the urgency of their condition before they even speak with a doctor.

Tele-ICUs are another exciting development mentioned by Ms Prasad. These initiatives allow doctors in urban areas with advanced medical facilities to provide expertise and guidance to their counterparts working in rural hospitals with fewer resources. Through real-time video consultations, monitoring devices, and AI-assisted tools, specialists in urban centers can guide local doctors in treating critically ill patients, providing real-time, life-saving support. This significantly improves healthcare delivery in regions that lack specialist care, reducing mortality rates and improving overall health outcomes.

Perhaps the most groundbreaking technological advancement discussed in the talk was the potential of 5G to revolutionize healthcare delivery. According to Ms Prasad, the ultra-low latency and high-speed connectivity offered by 5G will unlock new possibilities in medical care, particularly in areas like remote surgery. With 5G, surgeons in one part of the country or even the world could operate on patients located thousands of miles away.

By using robotic instruments controlled in real-time through a 5G connection, surgeons will be able to perform intricate operations with the same precision they would have if they were in the same room as the patient. This development is especially important for rural and remote areas, where access to specialized surgery is often lacking.

Ms Prasad explained that 5G-enabled surgeries will allow patients in underserved areas to receive complex treatments without the need for expensive travel or relocation to urban hospitals. This will dramatically increase the accessibility of specialized healthcare services and reduce regional healthcare disparities. Additionally, 5G technology will enhance the speed and accuracy of diagnostic services, allowing doctors to receive high-quality imaging and lab results in real-time, even from distant locations. This instantaneous sharing of data will lead to faster diagnoses, better decision-making, and improved patient outcomes.

Expanding Healthcare in Tier 2, Tier 3 Cities, and Rural Areas

In addition to the technological advancements that will shape the future of healthcare, Ms Urvashi Prasad also discussed the government’s commitment to expanding healthcare infrastructure in Tier 2, Tier 3 cities, and rural areas. A significant portion of India’s population still resides in these regions, and the disparities in healthcare access between urban and rural areas have been a persistent challenge for the country. To address this, Prasad outlined several key strategies being implemented to bring high-quality healthcare to smaller cities and rural areas.

One of the most significant efforts is the promotion of the Public-Private Partnership (PPP) model, which incentivizes private healthcare providers to set up hospitals and clinics in underserved regions. Ms Prasad emphasized that the government recognizes the importance of leveraging private sector expertise, resources, and innovation to complement the public healthcare system. Through these PPP initiatives, the government aims to bridge the gap between urban and rural healthcare facilities, ensuring that citizens in smaller cities and rural areas have access to quality care without having to travel long distances to major metropolitan
centers.

A crucial component of this strategy is ensuring that medical devices and healthcare technologies are available at reasonable rates in these regions. Ms Prasad pointed out that India’s Production-Linked Incentive (PLI) scheme, which aims to promote domestic manufacturing of medical devices, will play a key role in this effort. By encouraging the production of affordable medical devices within India, the government hopes to make advanced healthcare technologies more accessible to people living in Tier 2 and Tier 3 cities, as well as rural areas. This initiative will reduce dependence on imported medical equipment, lower healthcare costs, and create more job opportunities in the healthcare manufacturing sector.

Ms Prasad also spoke about the growing acceptance of integrative medicine in India, especially in rural areas. Integrative medicine, which combines modern medical practices with traditional systems like yoga and Ayurveda, is gaining traction as a holistic approach to healthcare. In many rural communities, where traditional medicine is often preferred, the introduction of integrative medicine departments in hospitals is seen as a way to bridge the gap between conventional and alternative healthcare practices. Ms Prasad noted that this hybrid model allows patients to benefit from both worlds, receiving modern medical treatments while also adhering to cultural preferences for traditional remedies.

Laboratories, Diagnostics, and Preventative Screening

Ms Prasad highlighted that alongside the expansion of healthcare infrastructure, there is a growing demand for preventative screening and advanced diagnostics. Both individuals and employers are increasingly prioritizing health check-ups and wellness packages, recognizing the importance of early detection in preventing serious health conditions. In her talk, Ms Prasad emphasized the need for more sophisticated and precision-based diagnostic tools, which can deliver faster and more accurate results than traditional methods.

The role of artificial intelligence (AI) in diagnostics was a key focus of the discussion. Ms Prasad explained how AI-driven diagnostics can revolutionize preventative care by identifying health risks before symptoms manifest. Portable screening devices equipped with AI could be deployed even in rural areas, providing quick and reliable diagnoses without the need for fully equipped laboratories. This would allow for early interventions, particularly in the case of NCDs like diabetes, hypertension, and cancers, where early detection is critical for effective treatment.

Ms Prasad stressed that AI-powered screening tools would not only benefit individual patients but also ease the long-term burden on India’s healthcare system. By catching potential health issues early, hospitals and healthcare providers could prevent the progression of diseases, reducing the number of patients requiring advanced or emergency care. This preventative approach is expected to be a game-changer in reducing the load on India’s already stretched healthcare facilities.

Virtual Healthcare and Telemedicine

Ms Urvashi Prasad devoted significant attention to the growing role of virtual healthcare in India. Virtual healthcare, particularly telemedicine, has seen a massive rise in demand, especially in the wake of the COVID-19 pandemic. She explained how AI-powered telemedicine platforms are transforming the healthcare landscape, enabling patients to access medical consultations, prescriptions, and health advice from the comfort of their homes.

Telemedicine is especially valuable in a country as vast and diverse as India, where geographic and economic barriers often limit access to healthcare. By allowing patients to consult with doctors remotely, telemedicine addresses one of the most significant challenges of healthcare delivery in India Accessibility. Ms Prasad highlighted that telemedicine goes beyond simple doctor-patient consultations.

Initiatives like Tele-ICUs allow for real-time collaboration between specialists in urban centers and doctors in rural hospitals. These virtual ICUs enable healthcare professionals in rural areas to consult with specialists for critical cases, improving patient outcomes and saving lives. With the support of AI, these Tele-ICUs can monitor patient vitals, provide real-time alerts to doctors, and even suggest possible treatments based on the patient’s condition.

5G technology, as discussed earlier, will play a transformative role in the future of telemedicine. With its ultra-low latency and high-speed connectivity, 5G will enable real-time interactions between healthcare providers and patients. More importantly, it will facilitate remote surgeries, allowing surgeons in one part of the world to operate on patients in another location. This will dramatically increase access to specialized medical care, particularly in underserved regions of India.

Ms Prasad’s talk provided a comprehensive vision for how virtual healthcare and telemedicine will continue to expand, addressing some of the most pressing challenges in India’s healthcare system—geographical disparities, accessibility, and the shortage of medical professionals in rural areas. The integration of AI and 5G technology into telemedicine platforms will further enhance the quality of care, making healthcare more inclusive and equitable for all Indians.

Women’s Health: Challenges and Opportunities

Ms Prasad devoted a significant portion of her talk to discussing the critical challenges and opportunities in women’s health. Despite considerable progress, there are still several areas where improvements are needed to ensure better health outcomes for women in India. One of the most encouraging trends highlighted by Ms Prasad was the significant decline in maternal mortality in India over the last two decades. However, she noted that state and district-level disparities remain a major concern, with some regions showing much higher maternal mortality rates than others . Addressing these disparities will require targeted interventions and policies tailored to the specific needs of different regions.

The talk also emphasized the importance of family planning and contraception. According to data shared by Ms Prasad, the contraceptive prevalence rate increased from 54% in NFHS-4 to 67% in NFHS-5, indicating progress in this area. However, there is still a significant unmet need for family planning services, particularly among women in rural areas . Domestic violence remains another critical issue in women’s health. Ms Prasad shared troubling data on the percentage of women who have experienced spousal sexual violence, which increased from 7% in NFHS-4 to 14% in NFHS-5 This statistic highlights the need for more robust policies to protect women from violence and abuse and to ensure their safety and well-being.

The talk also touched on the growing challenge of non-communicable diseases (NCDs) among women. Cardiovascular diseases, cancers, and diabetes now account for over 53.5% of deaths among women, up from 33% in 2000 . Ms Prasad pointed out that gender biases in healthcare access exacerbate the problem, with households often prioritizing healthcare for male members over female members. This inequality underscores the need for a gender-sensitive approach to health policy in India.

Aging Population: Addressing the Needs of India’s Elderly

India’s aging population presents one of the most pressing challenges for the future of healthcare. The share of the population aged 60 and above is projected to increase from 10.5% in 2022 to 20.8% by 2050, as reported by the UNFPA . Ms Prasad noted, by the end of the century, the elderly will constitute over 36% of India’s total population. This demographic shift will require a comprehensive strategy to address the healthcare needs of the aging population, particularly as they are more susceptible to NCDs and mental health issues such as depression and anxiety. One of the key solutions proposed by Ms Prasad is the expansion of home-based healthcare.

Doorstep delivery of healthcare services is expected to grow, with long-term care becoming increasingly important for those unable to perform everyday activities independently . Home-based care, supported by family members and supplemented by formal caregivers, such as nurses and allied health providers, will play a crucial role in meeting the healthcare needs of the elderly. Telehealth and digital tools will also be vital in providing care to the elderly, particularly in rural areas. By integrating these technologies into home healthcare, India can ensure that the elderly population receives consistent, high-quality care, even in areas with limited healthcare infrastructure.

Public-Private Partnerships (PPP) in Healthcare

Public-Private Partnerships (PPP) are emerging as a critical strategy for expanding healthcare services across India. Prasad spoke about the government’s focus on encouraging PPP models, especially in smaller cities and rural areas. The government is also pushing for large-scale screening initiatives and ensuring that affordable medical devices and drugs are made available to the public . These partnerships will be essential for addressing the growing demand for healthcare services, particularly as India’s population continues to grow and age. By involving the private sector, the government can leverage additional resources, expertise, and innovation to improve healthcare delivery nationwide.

Conclusion

In her talk, Ms Urvashi Prasad provided a comprehensive overview of India’s healthcare system and the opportunities and challenges that lie ahead. The shift from curative to preventative care, driven by advancements in technology and AI, is poised to revolutionize healthcare delivery in India. Expanding healthcare access in rural areas, addressing the unique health needs of women, and preparing for the challenges of an aging population will be crucial to ensuring equitable healthcare access for all.

The government’s focus on public-private partnerships and the integration of digital tools like AI, wearable devices, and telemedicine will further enhance the quality and accessibility of healthcare services. As India continues to evolve its healthcare system, the policies and strategies discussed in Ms Prasad’s talk will play a pivotal role in shaping the future of healthcare in the country. By adopting a preventative approach, addressing gender disparities, and embracing technological advancements, India’s healthcare system can meet the needs of its diverse population and achieve better health outcomes for all.

About The Author: The article has been written by Mannat Ghumman, a research intern at Impact and Policy Research Institute.

Disclaimer: All views expressed in the article belong solely to the author and not necessarily to the organisation.