CONTEXT : World Health Day on April 7 focuses on health equity, a crucial aspect of global health and justice. The WHO emphasizes health as a basic human right, with this year’s theme being “My Health, My Right”

SITUATION

• COVID-19, environmental issues, and socio-economic gaps reveal a healthcare access gap.
• WHO Council on the Economics of Health for All : Over half the world lacks full access to essential health services.
• 140+ nations recognize health as a right, yet the gap persists.
• World Health Day 2024 emphasizes health equity’s significance beyond legal or social aspects.

THE MEANING OF HEALTH EQUITY

Understanding Health Equity

• Health equity ensures equal opportunity for optimal health, regardless of circumstances.
• Social, economic, and environmental factors influence health outcomes, surpassing genetics.
• WHO aims to eliminate unfair health disparities among different social and economic groups.

Addressing Root Causes

• True health equity tackles underlying issues like poverty, discrimination, and limited access to essentials.
• It goes beyond equal healthcare access to include education, diet, water, air quality, and housing.
• For instance, a child in rural poverty lacking clean water, food, or immunizations faces long-term health risks.

Impact of External Factors

• Pandemics, climate change, and sociopolitical unrest worsen existing disparities.
• India’s diversity and socioeconomic gaps amplify these challenges.

Healthcare Disparity in Rural Areas

• Rural areas face significantly lower healthcare access compared to cities.
• Social and economic barriers worsen this gap.

Comprehensive Approach for Health Equity

• Health equity requires more than legislative changes; it needs a holistic strategy.
• Socioeconomic determinants of health must be addressed.
• Collaboration among governments, communities, and individuals is crucial to overcome these barriers.

Complexities on the Road to Health Equity

• Deep-rooted social injustices and systemic health concerns pose challenges.
• Multicultural countries like India face unique obstacles in ensuring health equity.
• Diverse populations struggle to access high-quality healthcare.

Global Challenges to Address

• Infectious diseases like COVID-19 target marginalized groups, widening the health equity gap.
• Climate change disproportionately affects low-income and vulnerable populations, posing serious health risks.
• Conflicts disrupt healthcare provision, destroying infrastructure and cutting off access to vital services.

INDIA’S HEALTH EQUITY CHALLENGE

Challenges to Health Equity in India

• Persistent obstacles due to a large and diverse population.
• Significant differences in health-care outcomes and access.
• Improvement in healthcare access, especially in rural areas, but more work needed.
• Urban slums, constituting over 17% (2011 Census) of metropolitan areas, face serious health disparities.

Health Risks in Urban Slums

• Overcrowding, poor sanitation, and limited access to clean water increase health risks.
• Infectious diseases like tuberculosis are 1.5 times more common in slums.

Caste, Gender, and Economic Disparities

• Scheduled Castes and Scheduled Tribes have higher child mortality and lower immunization rates (National Family Health Survey (NFHS)-5 (2019-21) data)
• 59% of women in the lowest wealth quintile suffer from anaemia, highlighting the intersection of caste, gender, and economic status in health outcomes.

Non-communicable Diseases (NCDs) Challenge

• NCDs contribute to over 60% of deaths in India.
• The Public Health Foundation of India stresses equitable treatment access and preventive healthcare due to the potential economic impact, estimated at over $6 trillion by 2030.

Doctor Shortage and Regional Disparities

• WHO data reveals a critical shortage with only 0.8 doctors per 1,000 people.
• Majority of healthcare professionals are in urban areas, leaving rural regions underserved.
• Including other medical practitioners may balance the doctor-to-patient ratio

EFFECTIVE WAYS TO ADDRESS THE CHALLENGES OF HEALTH EQUITY IN INDIA

Comprehensive Approach Needed

• Addressing India’s health equity requires looking beyond healthcare facilities.
• Socioeconomic determinants of health must be tackled.
• Collaboration among government, civil society, healthcare providers, and communities is crucial for universal health coverage and a more equitable future.

Importance of Health Literacy

• Raising health literacy is crucial for achieving health equity.
• Health education in NHM can empower people to seek equitable care and make informed health choices.

Collaborative Efforts

• Public and private healthcare sectors, along with the government, serve underprivileged communities.
• Emphasis on preventive education, workforce development, and infrastructure improvement for better healthcare access.

NGO and Civic Engagement

• Engage in community outreach to address regional health concerns effectively.
• Collaborate with international and governmental organizations to tailor culturally sensitive health initiatives.

International Institutions’ Support

• WHO, Global Fund, Gavi, and others support health initiatives in resource-limited areas.
• Promote information sharing and resource allocation to enhance healthcare systems, especially in countries like India.

Commercial and Charitable Contributions

• Digital health innovations by the commercial sector and charities improve accessibility and affordability.
• Extend reach and efficacy of healthcare services through technical advancements.

Role of Research and Academia

• Research institutes and academic institutions provide crucial insights into health inequalities.
• Assist in creating evidence-based practices and policies supported by scientific studies

ROLE OF LOCAL ORGANISATIONS

Importance of Local Organizations

• Actively participate in all phases of health programs.
• Ensure relevance, effectiveness, and understanding of community needs.

Key Factors for Successful Collaborations

• Open communication, respect, and shared goals.
• Adaptability to shifting health concerns and community demands.
• Emphasis on empowering communities, sharing knowledge, and building capacity.

Impact of Effective Collaboration

• Enhances health equity significantly.
• Paves the path towards shared access to high-quality healthcare

GOVERNMENT INITIATIVES FOR HEALTH EQUITY

• Ayushman Bharat: Offers free health coverage to the bottom 40% economically, reducing disparities.
• National Health Mission (NHM): Includes NRHM and NUHM, expanding access and services for vulnerable populations.

CONCLUSION

In conclusion, achieving inclusive healthcare in India requires a multifaceted approach that addresses socioeconomic determinants, leverages government initiatives like Ayushman Bharat and the NHM, promotes health literacy, encourages collaborative efforts among stakeholders including NGOs, international institutions, and the private sector, and recognizes the pivotal role of local organizations in ensuring relevance and effectiveness in healthcare programs. By emphasizing open communication, respect, adaptability, and empowerment of communities, effective collaboration can pave the path towards shared access to high-quality healthcare, ultimately enhancing health equity across the nation.