Five charts that explain India’s healthcare crisis

In its recent assessment of the Indian economy, the Organization for Economic Co-operation and Development (OECD) identified India’s poor health outcomes as one of our major developmental challenges. India is a laggard in health outcomes not just by OECD standards, but also by the standards of the developing world. In 2012, India witnessed 253 deaths per 100,000 persons due to communicable diseases alone, much higher than the global average of 178. India faces a higher disease burden than other emerging economies such as China, Indonesia, Brazil, Mexico and Sri Lanka, as the charts below illustrate. Even poorer neighbours such as Nepal and Bangladesh have a better record in health compared to India.

While India has made rapid strides in raising economic growth and lifted millions out of poverty, progress in improving health outcomes has been slow. As a result, India continues to face an extraordinarily high disease burden, which saps the productivity of Indian workers and lowers their earnings. According to a 2010 World Bank estimate, India loses 6% of its gross domestic product (GDP) annually because of premature deaths and preventable illnesses.

A key reason behind the poor health of the average Indian is the low level of public investments in preventive health facilities such as sanitation and waste management, as well as in medical care facilities such as primary health centres and health professionals. Even when public health facilities are available, they are often of poor quality. The poorest income classes receive fewer benefits from the public health system than their better-o peers. The lack of reliable public health services and the absence of health insurance compel the poor to spend heavily on private medical care. According to a 2011 research paper by Soumitra Ghosh of the Tata Institute of Social Sciences, Mumbai, out-of-pocket health expenditures account for nearly one-sixth of India’s poverty burden. The high costs of healthcare also act as a deterrent for poor people in seeking treatment, leading to delays and aggravating health problems.

1) India has one of the highest disease burdens in the world. Many more die of preventable diseases in India than in other countries.

2) One big reason driving India’s health crisis is the unavailibilty of doctors and nurses.

3) Another key reason for poor health of Indians is the high proportion of out-of-pocket expenditure on health because of low insurance coverage and weak public health systems, which forces even poor people to visit private medical practitioners, and drives up average health costs. High healthcare costs often lead people to delay treatment, aggravating health problems.

4) Public health expenditure in India has moved up over the past decade, but still remains among the lowest in the world.

5) India’s public health expenditure is not just low, it is also regressive. The poorest income classes benefit less from the public health system than the better-off sections of society.