The Indian health sector, governance and managerial challenges

Abstract

The global health care industry estimated at $ 5 trillion, is one of theworld's largest and fastestRgrowing industries. India’s healthcare industry which is expected to be around $45 billion by the end of 2013 accounts for less than 1 % of the global healthcare industry, but has to address the healthcare needs of 17 % of the global population. The India health sector therefore faces severe resource constraints to deliverhealthservices. Indiaspendsabout5%ofGDPonhealthcarecomparedwith 10R12 % of GDP on healthcare spending by developed countries. The government’s shareinthetotal healthcareexpenditureinIndiahasremainedaround1%ofGDP,and therefore theprivatesectorhasbecomeadominantplayer inhealthservicedelivery. Regulation of theprivate sector is essential for successfulPublicprivatePartnership. The unregulated private healthcare sector also raises serious concerns regarding the accountability,equityandqualityofservicedelivery.Indiaranks112outof193WHO countries on health system performance. The WHO Report on Macroeconomics and Health[JefferySachs,etal2001],followedbytheReportoftheNationalCommissionon MacroeconomicsandHealth[GoI,August2005]providestrategicdirectionstoimprove ourhealthsystemperformance. Improvements inourhealthsystemperformancecall for a significant scaling up of resources by theGovernment of India, and tackling the nonRfinancial obstacles that have limited the capacity to deliver health services. Buildinghealthsystemsthatareresponsivetoclientneedsrequirespoliticallydifficult andadministrativelydemandingchoices.