Dismal Healthcare systems in South Asia needs attention

Synopsis:

The second wave of pandemic highlighted the lacunas in the healthcare systems in South Asia. The situation now demands the replacement of short term measures with a well-thought-out vision and political commitment for long-term healing.

Background:

The pandemic managed to penetrate across the countries due to the dismal state of health infrastructure and reluctance to enhance public health care spending. For example,

  • India recorded 4,529 deaths from COVID-19 on 18th May 2021. It is the highest daily death toll recorded in the world, beating 4468 deaths recorded by the US in January 2021.
  • The virus has consolidated itself in other South Asian countries as well.
    • Sri Lanka added 78,218 cases in May.
    • Pakistan crossed over 200 daily deaths in April, its highest since the pandemic started.
    • Bangladesh detected the highly contagious Delta variant of Covid-19
  • The consolidation of the virus has been attributed to the dismal state of healthcare systems in South Asian countries.

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Dismal State of Healthcare systems in South Asia:
  • Funding: The Indian government spends around 1.4 % of its GDP on public healthcare. There is a lack of prudent expenditure towards public health in other south Asian nations as well.
  • Doctor to Population Ratio: In India, there are only 0.08 doctors per 1000 population in the public health sector. But the WHO standard is 1 per 1000 population. Pakistan and Bangladesh also have less than one doctor per 1000 population.
  • Bed Availability: India has only half a bed available for every 1,000 people. Similarly, Bangladesh and Pakistan have a bed to patient ratio of 0.8 and 0.6 respectively.
  • Out of Pocket Expenditure: The ideal out-of-pocket expenditure should not surpass 15% to 20% of the total health expenditure. However it is 62.67%, 73.87% and 56.24% for India, Bangladesh and Pakistan respectively.
Other factors behind the spread of the virus in South Asia:
  • First, superspreader events in India gave a lucrative opportunity for the spreading of the virus
  • Second, the citizens violated the Covid protocols by disregarding social distancing, not wearing masks etc.
  • Third, the logistical mismanagement in the countries delayed the accessibility of vaccines and other life-saving drugs.
  • Fourth, the increase in health expenditure remained well below the desired levels. For instance, Pakistan’s defence budget was increased by 12% in 2020-21 to reach $7.85 billion. On the other hand, the spending on health remained around $151 million.  

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Way forward:
  • The South Asian countries can learn from the Bhutan Model. There has been only 1 death and 1724 cases of Covid-19 in the country. 
    • Its success is owed to a well-funded and prepared public health system with stringent measures, responsible citizenship, and an accountable government.
  • There is a need to enhance public expenditure, especially towards rural healthcare. In Rural India, the poor health care system enhanced the hardships of people –
    • Patients were treated on the hospital floor for lack of beds, 
    • Some had to walk hundreds of miles just to reach a hospital and 
    • Many were compelled to resort to homemade concoctions and local quacks
  • The South Asian nations can also take lessons from the Southeast Asian countries including Vietnam, Laos, Cambodia etc. 
    • They prioritised investments in healthcare systems while broadening equitable access through universal health coverage schemes.

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Source: The Hindu

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