Universal Health Care and Challenges | UPSC

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IASbhai Daily Editorial Hunt | 27th Oct 2020

“Either you run the day, or the day runs you.” – Jim Rohn

Dear Aspirants
IASbhai Editorial Hunt is an initiative to dilute major Editorials of leading Newspapers in India which are most relevant to UPSC preparation –‘THE HINDU, LIVEMINT , INDIAN EXPRESS’ and help millions of readers who find difficulty in answer writing and making notes everyday. Here we choose two editorials on daily basis and analyse them with respect to UPSC MAINS 2020-21.

EDITORIAL HUNT #209 :“Universal Health Care and Challenges | UPSC

Universal Health Care and Challenges | UPSC

Soumya Swaminathan
Universal Health Care and Challenges | UPSC

Soumya Swaminathan is Chief Scientist at WHO

      HEADLINES:

The many lessons from COVID-19

      CENTRAL THEME:

What we have done so far, and what all remains to be done

SYLLABUS COVERED: GS 3 : Health : Diseases

      MAINS QUESTION:

Achieving Universal Health Care for all post pandemic is a bumpy ride for state and the stakeholders. Critically Analyse the impact of pandemic on women and children.-(GS 3)

      LEARNING: 

  • Pandemic Lessons
  • Gender Impact
  • Essential Services
  • Digital Intervention

      INTRODUCTION: 

  • THE MARCH IS ON : The global pandemic is marching on detonating the healthcare infrastructure and knowledge systems.

The most important lesson and the one most significance is- investing in public health and primary healthcare.

  • REAPING BENEFITS : Countries that invested in primary healthcare over the past decade or two are reaping the benefits now.
  • ROLE OF SCIENCE : Another lesson is the positive role of science and scientists.
  • SCIENCE VS PANDEMIC : The global collaboration between scientists is forwarding advances in knowledge so that science and people are continuously informed.

      BODY: 

GENDERED IMPACT

  • WOMEN IN PANDEMIC : In India, the pandemic has had a differential impact on women.
  • MATERNAL MORTALITY RATES : Despite gaps, India had seen progress in maternal mortality.

There have been significant gains in infant mortality, institutional births and replacement level fertility.

  • CONTRACEPTIVES : There is still a high unmet need for family planning and improved access is required to contraceptive services and safe abortions.
  • CHILD WASTING : A recent modelling study showed that because of the reduction in coverage of essential services, the prevalence of wasting in children could increase by 10% to 50%.
  • STERILE BIRTH ENVIRONMENT : There could also be 60% more maternal deaths because interventions like the administration of uterotonics and antibiotics, and clean birth environments, are no longer available.
  • THE MID DAY MEAL : COVID-19 has also disrupted the education system. It has also adversely affected access to nutritious food as a huge number of children depend on school meals.
  • GENDER VIOLENCE : Another worrying development is the surge in domestic violence.

In India, a third of women said that they had previously experienced domestic violence, but less than 1% sought help from the police.

  • RESPONSE TIME : Governments can include response to violence against women in the package of essential services.
  • LOST LIVELIHOOD : Many women have lost their work and livelihoods.
  • DEPRECIATING INCOME LEVELS : More women than men work in the informal economy and therefore their income fell by over 60% during the first month of the pandemic.
  • EXTREME DEPRIVATION : In India, the number of women and girls living in extreme poverty is expected to increase from 87 million to 100 million.
  • GENDER ANALYSIS : A few months ago, the World Health Organization (WHO) emphasised the importance of gender analysis and gender-responsive public health policies.
  • DATA MANIPULATIONS : One of the major issues is the lack of availability of data that is disaggregated by sex and age.
  • DATA SNIP : We also do not have data on violence against women and children.

WHO Member States have been urged to collect data, report and analyse it.

  • ANALYTICAL DATA : The data should be disaggregated by sex, and include responses to violence against women as an essential service.
  • VACCINATION PROGRAMS : Over 70% of countries reported partial or complete disruption of immunisation services.

Other services disrupted include diagnosis and treatment of:

  • Non-communicable diseases
  • Cancer diagnosis and treatment
  • Family planning, contraception
  • Antenatal care
  • Malaria and TB case detection
  • Treatment facility-based births
  • Urgent blood transfusions
  • Emergency surgery

ESSENTIAL SERVICES

  • SOCIAL PROTECTION : On the one hand, essential services have to be provided; on the other hand, we must ensure financial protection.
  • SCHEMES : This can be guaranteed only if there is either a health coverage scheme, like Ayushman Bharat, or through private health insurance.

Out-of-pocket payments cause about 100 million to fall into extreme poverty every year.

  • HOUSEHOLD HEALTH BUDGET : 800 million globally spend more than 10% of their household budget on healthcare.
  • WHO RECOMMENDATIONS : The World Health Organization has been urging countries to ensure financial protection and effective coverage of health services.
  • COVERAGE INDEX : The effective coverage index is a useful measure of the quality of health services — it looks at the provision and efficacy of services in terms of health outcomes.

This metric suggests that 3.1 billion people worldwide would still not be covered if we continue to do what we’re doing.

  • OUTCOME BASED APPROACH : The index enables us to move away from just measuring process towards measuring outcomes.
  • INADEQUATE DATA SYSTEMS : Many countries do not have the data systems to be able to accurately measure both mortality and the incidence of certain diseases.
  • COMPILATION OF DATA : India needs to invest more in its vital registration system.

WHAT CAN WE DO BETTER?

  • DIGITAL INTERVENTIONS : Many countries have moved to digital technology, especially using platforms to provide telemedicine.

EXAMPLE
Platforms like ECHO have been used in many States to train healthcare workers and e-Sanjeevani platform is enabling telemedicine appointments.

  • A ROADMAP : We now have a national digital health blueprint and a road map.
  • INCLUSION OF PORTABILITY : We want to move towards electronic and portable health records.
  • IMPROVISED USE OF DATA : It is important to think new ways of collecting, using and sharing data, enabling local, contextualised decision-making.
  • PRIVATE SECTOR : We also need to think about working with the private sector, which is already playing a very big role in technology.
  • TECHNOLOGY AND PUBLIC HEALTH : We need to think about technologies that are considered public health goods.

EXAMPLE
At the Aravind Eye Hospital in Puducherry, for example, they did an experiment with shared medical appointments.

  • BENEFITS OF IMPROVISATION : This seemed to result in better health outcomes as well as higher productivity, apart from reducing costs and saving a lot of time for doctors.
  • INTEGRATION OF SYSTEMS : We need to further integrate social protection systems, food systems and health systems in order to really have an impact on nutrition.
  • ADDRESSING WEAKER SECTION : India has done much to ensure these services, but it needs to expand these to protect its most vulnerable population groups.
  • FOOD SECURITY : We must ensure that the pandemic does not further increase food insecurity.

False or misleading information leads to harmful behaviours, and mistrust in governments and the public health response.

  • INFODEMICS AND BEHAVIOUR : Infodemic management is not straightforward; it is linked to people’s beliefs and behaviour.
  • COUNSELLING : Therefore, we’ve set up a behavioural insights group to provide advice on behaviour change.
  • SERVICES DELIVERY : We often think about health as purely as delivery of services to take care of the sick.
  • THE RISK FACTORS : The social and environmental determinants of health, such as the quality of water and air impact our health.

      IASbhai Windup: 

  • EMPOWERING THE WARRIORS : Empowering our frontline health workers will yield rich dividends.

We need to invest in them to ensure that they have the tools they need, receive regular training and mentoring, and are well paid.
 

  • INSTITUTIONAL MECHANISM : We need to invest in strong institutional mechanisms and capacities in our regulatory bodies, research centres and public health institutions.
  • STEREOTYPES : We have seen so much fear, stigma and discrimination circulated on social media. This must be countered by health literacy.
  • RESOURCE ALLOCATION : Financial resources are very important for this, but we also need investment in human resources and to engage and empower communities.
  • COMMUNITY APPROACH : It has to keep in mind how to involve citizens and the people it is trying to serve and have them involved in developing the services that we are bringing to them.
       SOURCES:   THE HINDU EDITORIAL HUNT | Universal Health Care and Challenges | UPSC

 

TRENDING NOW : Important The Hindu Editorials 

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