Dismal Healthcare systems in South Asia needs attention


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.


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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