As India grapples with the rising burden of non-communicable diseases (NCDs) such as diabetes, hypertension, and Alzheimer’s, healthcare experts are urging reforms to achieve Universal Health Coverage (UHC). Swami Subramaniam, a physician-scientist, and Aparajithan Srivathsan, a hospital strategist, highlighted the need to transform primary healthcare into a comprehensive, community-driven system during a discussion on their new book.
The experts emphasized that India’s healthcare system must adopt innovative approaches, including industrial concepts and technology, to manage NCDs, which require consistent, long-term care. Srivathsan noted that while ASHA workers contribute significantly, their role is project-based, lacking the continuity needed for addressing chronic illnesses. This gap, according to the duo, can be filled by a dedicated cadre of trained community health workers.
The book proposes an affordable model: one health worker for every 1,000 citizens, requiring approximately 1 million workers for the nation. Each worker, earning around ₹5,000 per month, would amount to an annual expenditure of ₹500 crore—manageable for a country of India’s size. These workers would undergo a week-long, intensive 40-hour training to acquire essential skills, including operating blood pressure monitors, glucose meters, and haemoglobin tests, as well as inputting data into mobile health apps.
Subramaniam stressed the importance of a national health record system for every citizen, which would enhance efficiency and reduce errors, fraud, and waste. He also called for a robust public healthcare network to prevent the dominance of for-profit providers, which could overwhelm the system financially.
The book also critiques existing schemes like Ayushman Bharat and eSanjeevni, noting that they only partially address the challenges. Many individuals are either unaware of their benefits or not enrolled in these schemes. Community health workers, with their training, can play a vital role in bridging this gap by ensuring greater awareness and enrollment.
The proposed reforms aim to modernize healthcare delivery, ensure equitable access, and tackle the growing challenge of NCDs. With a comprehensive approach, experts believe India can pave the way toward achieving UHC and improving the overall health outcomes for its population.
(Input from various sources)
(Rehash/Ankur Deka/MSM)