Health Policy in India and COVID-19

India is the second largest country in terms of population next only to China. Naturally, whenever any infectious pandemic/epidemic hits the country, it spreads in no time. The health policies in India are inadequate to cater to such a large population. The average % GDP spent on health care in India is around 1.28%. This is too low compared to many other countries where the GDP spent on health care is around 4% average.

COVID-19 was declared by WHO as a Global Pandemic in March 2020. It is caused by SARS-CoV-2 virus belonging to Corona virus family. Mode of transmission is droplet spread and is highly contagious and infectious. The average incubation period is 14 days. Personto-person spread is high. Hence, India’s population density is a fertile ground for the spread of the virus. Indian hospitals were not prepared to handle such a big pandemic. The second week of March 2020 witnessed a national stock out/shortage of facemasks, gloves and alcohol based hand sanitizers. Hence, Govt of India undertook many steps to limit the spread of the virus, thereby reducing the burden on the healthcare system. Govt of India announced a 21 day nationwide lock down which was continued for the next three weeks with gradual relaxation till June 2020. This gave some breather for the healthcare to implement strategies for the management of COVID-19, to increase the facilities for testing and increase the production of personal protective equipments and N-95 masks. Continuous education of public on the do’s and dont’s related to Covid created awareness.

The healthcare infrastructure and availability of appropriate medical care across the length and width of the country have been major concerns. The preparedness of the country to deal with a mammoth pandemic of the magnitude of COVID-19 has made us question the Public Health Policy of India.

The National Health Policy of India

Public health has been given an important place in Indian public policy. The health policies used to play vital role in deciding how health issues and concerns would be taken care of.¹ The health policies of the GOI had started soon after its independence and more precise with the establishment of the Bhore Committee Report in 1946.³

To provide the preventive and curative healthcare systems in rural and urban areas, the Bhore Committee made three important recommendations in a three-tiered model, such as a public healthcare system, healthcare workers on government payroll, and emphasis on limiting the need for private practitioners.

The first National Health Policy (NHP) of India was formulated in 1983 to provide primary healthcare access for all Indian citizens by 2000.⁴

National Health Policy of India 2017

The primary aim of the National Health Policy, 2017, was to inform, clarify, strengthen and prioritize the role of the Government in shaping health systems in all its dimensions- investments in health, organization of healthcare services, prevention of diseases and promotion of good health through cross sectoral actions, access to technologies, developing human resources, encouraging medical pluralism, building knowledge base, developing better financial protection strategies, strengthening regulation and health assurance.²

Recommendations for inclusion

With the emergence of COVID-19 pandemic, there is a need to strengthen the health policy so as to be prepared for the future; be it COVID-19 and any other pandemic (Communicable disease).

Infrastructure requirements

The infrastructure requirements for hospitals to cater to COVID-19 patients need to incorporate the following

1. Separate entry and exit doors.

2. Facility for separate donning and doffing areas for healthcare professionals.

3. Facility for shower after doffing for the healthcare professionals.

4. Facility for isolation wards with HEPA filters.

5. Facility for oxygen delivery in the wards.

6. Separate building to cater to non-Covid patients.

Availability of Personal Protective Equipment (PPE)

There is a need for certified N 95 masks and PPE kits which will enable the healthcare professionals to work in Covid areas.

Adequate manpower

Recruitment of adequate manpower to man Covid wards 24X7 in shifts with mandatory time off from work for the healthcare professionals is the need of the hour.

Conclusion

India has a public-private partnership model that has helped in combating and dealing with COVID-19 pandemic. But the magnanimity of this pandemic was so much that any healthcare system, even in the developed nations fell short of handling it. Hence, appropriate additions in our health policy with emphasis on public health sector and better budget for healthcare will help in the future.