Equity in healthcare: Aim For More Than Just More AIIMS

Source: The post is based on the article “Aim For More Than Just More AIIMS” published in The Times of India on 2nd January 2022.

Syllabus: GS 2 – Issues relating to development and management of Social Sector/Services relating to Health.

Relevance: About achieving equity in healthcare.

News: India’s primary level can take care of almost 70-75% of the population’s healthcare needs. About 20-25% is addressed at the secondary level. Around 5-10% need tertiary-level care.

More AIIMS-like institutions are required to promote equity in India’s healthcare environment.

What is equity in healthcare means?

In healthcare, equity means two things a) People with the same health needs get the same care (horizontal equity) and b) People with an advantage take on a greater share of the responsibility for paying for health services (vertical equity).

A pursuit of excellence or equity is conditioned by one’s background and training. For example, as a general principle, clinicians are trained to support excellence and public health people advocate equity.

Excellence is a measure of the quality of care and equity is a measure of access to care. Both are important. For instance, equity has no meaning if excellence is not a part of it and, excellence is wasted if restricted to a few. So, neither equity nor excellence is achieved without effort.

How India can achieve equity in healthcare?

a) India needs to stop seeing excellence as an individual choice and pursuit, but rather as a health system goal. For this to happen, a sharing of a vision of excellence by all levels of leadership is needed.

b) India needs to change the work ethos at all levels to reinforce quality and rigour and ensure commensurate investment in infrastructure and human resources.

c) India needs newer AIIMS-like institutions to achieve the ‘excellence’ of AIIMS New Delhi will need time and effort.

d) Promoting equity requires a reconceptualisation of the health system itself, especially healthcare financing so that barriers to access are removed.

e) India needs smaller health and wellness centres near villages with appropriate size, each catering to the population subset that needs primary, secondary or tertiary care.

Overall, India should ensure providing equity in healthcare is a population-level outcome.