Strengthening public health capacities

Context- Lessons learnt by India’s healthcare sector in the light of the COVID-19 pandemic and possible solution.

What is Disaster management act 2005?

The stated object and purpose of the Disaster Management Act is to manage disasters, including preparation of mitigation strategies, capacity-building and more.

• It came into force in India in January 2006.
• The Act provides for “the effective management of disasters and for matters connected therewith or incidental thereto.”
• DM Act in COVID-19 pandemic- measures included from imposing lockdowns to price control of masks and medical services.

What are the issues pertaining to Disaster Management response during COVID?

The COVID-19 pandemic has exposed-

• The approach which continues to be reactive.
• Significant gaps particularly in terms of medical preparedness for disasters.

The lesson learnt –

• Health services and their continuing development cannot be ignorant to the possibility of disaster-imposed pressures.
• The legal framework for disaster management must push a legal mandate for strengthening the public health system.

What are the issues associated with healthcare systems in India?

1. Issues pertaining to health Insurance – The future development of hospital care services is being envisaged chiefly under publicly financed health insurance, which would very likely be private-sector led.

• A large majority of private hospitals in the country are small enterprises which cannot meet the inclusion criteria for insurance
• Private hospitals under health insurance often prefer high-paying, non-communicable disease-related interventions.

2. Private healthcare interests aren’t particularly aligned with managing infectious diseases and emergencies.

• Private health sector services during disasters can hardly be a dependable option as there were many instance of overcharging and weak response to treatment.

3. Lack of integration of disaster management with primary health care-

• The lack of Community engagement and local bodies has been a major criticism of the Disaster Management Act
• The existing public primary health care model in the country is limited in scope. It is implicit that the primary healthcare sectors network lags training to deal with the emergency situations like COVID-19 pandemic.

What are the possible solutions?

• Making primary health care central to disaster management can be a significant step towards building health system and community resilience to disasters.
• A legal mandate to strengthen public sector capacities via disaster legislation, including relevant facets such as capacity-building of staff.