November 30, 2023

HPAS Mains Syllabus: GS 2(Governance)


  • Health care delivery is in State List.
  • Most provisions related to health are in Part-IV {Directive Principles}. These are: Article 38, 339(e), 41,42, 47 and 48 A
  • Panchayats and Municipalities also have some provisions related to health. These include drinking water, health and sanitation, family welfare, women and child development, social welfare etc.
  • The right to life provided under Art. 21 of the Constitution of India have been used time and again to demand access to health care.


Health Infrastructure

  • Insufficiency of Hospital Beds: Penetration of healthcare infrastructure, much lower than that of developed countries and even lower than the global average, the bed density in the country is 0.7 per 1,000 population, far below the global average of 2.6 and WHO benchmark of 3.5.
  • Shortage of staff: India faces a shortage of about 6 lakhs doctors, one million nurses, 2 lakhs dental surgeons and a large number of paramedical staff.

Less government spending on Public health:

  • Government spending on public health- just about 1 per cent of its gross domestic product (GDP), compared to 3 per cent in China and 8.3 percent in the United States.

Dependency on Private Hospital:

  • Private sector funding in India’s annual health burden is about 75%. It is amongst the highest in the world in percentage terms. Public spending on the other hand, is amongst the lowest and is even lower than the global average.

Neglect of Rural Population:

  • According to health information 31.5% of hospitals and 16% hospital beds are situated in rural areas where 75% of total population resides. Moreover the doctors are also unwilling to serve in rural areas.

Neglect of traditional health care system:

  • The health system of India depends almost on imported western models. It has no roots in the culture and tradition of the people.

Social Inequality:

  • Rural, hilly and remote areas of the country are under served while in urban areas and cities, health facility is well developed. The SC/ST and the poor people are far away from modern health service.

Lack of Regulations: 

  • The lack of regulation by the government in private sector allows doctors and hospitals to adopt unethical practices.

Inadequate health Insurance: 

  • Government contribution to insurance stands at roughly 32%, as opposed to 83.5% in the UK. 75% of the Indian population paying for healthcare services from their own pockets, it puts tremendous financial burden.

Geography of India: 

  • Sub-Tropical Climate provides a ground for germination of diseases. Due to a cumulative effect of poverty, population load and climatic factors India’s population is seriously susceptible to diseases.

Fragmented Health Information System:

  • Data is incomplete and often it is duplicated.
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