Introduction

The COVID-19 pandemic has delivered to mild the significance of not solely bettering the resilience of well being programs to crises but additionally of making certain their long-term sustainability. The Partnership for Health System Sustainability and Resilience (PHSSR) was established in 2020 with the objective of constructing extra sustainable and resilient well being programs all over the world.

One of the important thing aims of PHSSR is to construct data, understanding, and consensus on the scale of well being system sustainability and resilience, and the way they are often improved. To obtain this objective, PHSSR focuses on seven key domains:

• Governance: the wide selection of steering and rule-making associated capabilities carried out by governments and decision-makers as they search to attain nationwide well being coverage aims.
• Financing: how well being programs generate, pool, and allocate monetary assets and pay for well being companies.
• Workforce: how well being programs plan for, practice, recruit, reward, and deploy their workforce, and form the situations through which well being professionals work.
• Medicines and Technology: how well being programs make use of medicines and (info) applied sciences within the supply of well being companies.
• Service Delivery: how well being companies are organised and delivered, together with ambulatory and hospital care, and public well being.
• Population Health: how well being programs deal with the social determinants of well being and meet the wants and calls for of the inhabitants.
• Environmental Sustainability: how well being programs forestall and minimise their carbon footprint and the impacts of air pollution on the inhabitants’s well being.

By inspecting every of those domains, PHSSR seeks to determine strengths, weaknesses, alternatives, and threats to well being programs and to generate evidence-informed options and coverage suggestions to enhance sustainability and resilience.

A sustainable well being system improves inhabitants well being by regularly delivering the important thing capabilities of offering companies, producing assets, financing, and stewardship, incorporating ideas of economic equity, fairness in entry, responsiveness, and effectivity of care, and does so in an environmentally sustainable method.

A resilient well being system is ready to forestall, reply to, handle the well being system impression of, and get well and be taught from, acute and persistent crises (together with, however not restricted to, pandemic threats, local weather change, and financial and technological shocks), minimising their short-and long-term impacts on well being, social and financial wellbeing.

The COVID-19 pandemic has undeniably examined the Indian well being system, presenting unprecedented challenges and highlighting alternatives for development. PHSSR and Observer Research Foundation’s analysis throughout seven key domains supplies a holistic evaluation of the system’s response to the pandemic and its underlying strengths and weaknesses, pinpointing areas for enchancment to bolster long-term sustainability and resilience, together with preliminary suggestions for reform and coverage focus. The report attracts on latest information, well being coverage literature, and interviews with numerous stakeholders, aiming to supply a balanced and constructive evaluation.

India’s well being system has traditionally been characterised by a robust personal sector, which has made important developments in healthcare provision by comparability to the comparatively under-developed public sector. However, this has additionally resulted in excessive out-of-pocket funds, necessitating a deal with affordability and accessibility. In response, the final decade has witnessed an encouraging shift in the direction of public provision, with important initiatives aimed toward making certain high quality care and decreasing the price of medicines. This evolution displays the system’s capability for adaptation and progress.

In the area of governance, the report notes that the Indian well being system has a fancy and decentralised construction, with various ranges of capability and coordination throughout totally different states and territories. While the complexity of India’s well being system creates challenges of coordination at a nationwide stage, it additionally permits for innovation and experimentation on the native stage.

Financially, the nation has made notable strides in enhancing safety for the economically deprived and decreasing out-of-pocket expenditure. Continued public funding and environment friendly useful resource utilisation are essential in sustaining this optimistic momentum in the direction of monetary inclusivity in healthcare.

The chapter on India’s healthcare workforce acknowledges the crucial want for extra expert well being staff, particularly in underserved rural areas. Enhancing coaching and help for frontline staff is paramount in strengthening the spine of India’s healthcare.

In phrases of medicines and expertise, the main focus stays on enhancing regulation and high quality management to make sure the supply and affordability of important medicines and the security of medical units, whereas underlining the undoubted power of India’s prescription drugs and medical expertise sectors. Similarly, the chapter on service supply notes outstanding progress in entry to high quality care in latest occasions, whereas calling for sustained deal with addressing gaps, notably for these in rural settings and marginalised communities.

The inhabitants well being area describes a large number of initiatives to guard and uphold public well being, however highlights the necessity for a extra complete and joined-up strategy, together with higher funding in illness prevention and well being promotion.

The report additionally explores environmental sustainability, highlighting the significance of making certain that India’s well being system is sustainable within the face of local weather change and different environmental challenges. This consists of decreasing the environmental impression of healthcare practices, making certain that well being companies adapt to altering wants and in addition addressing social determinants of well being that enhance folks’s publicity and vulnerability to environmental dangers.

Finally, the report consists of two detailed case research, specializing in two key well being schemes in India’s journey to common well being protection: Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP). These case research underscore important progress in addressing crucial gaps in public medical insurance protection, and making certain entry to medicines and applied sciences, respectively. Such main initiatives spotlight the potential for optimistic change when ambitions are met with cautious coverage design and implementation, commensurate assets, and sustained political will.

This report is ORF’s contribution to the worldwide collaboration, Partnership for Health System Sustainability and Resilience. It was first revealed on 15 February 2024, and could be discovered right here: WEF_PHSSR_India_2024.pdf (weforum.org)

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Read all the report here.

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