Given that the majority of India’s population lives outside the jurisdiction of Tier-1 cities, it is imperative to address the healthcare needs of cities of Tier 2 and 3 (and below) for weeding out the obvious inequality in healthcare and serve the larger cause of India’s health and wellbeing.
The quality of healthcare penetration in Tier 2 and 3 cities has always been a huge concern in India. Today, if one looks at the doctor-patient ratio, it is heavily skewed in favour of urban areas which has led to a massive urbanization of healthcare. A minuscule percentage of doctors volunteer to work in Tier 2 and 3 cities despite the acute need for quality healthcare in non-metros and rural areas, both in communicable and non-communicable diseases. The advent of Covid only worsened the situation, as the footfalls in rural areas took a massive hit which in turn adversely affected outcomes in diseases like cancer where early detection is extremely crucial.
There is an immediate need to set up a credible healthcare ecosystem in Tier 2 and 3 cities to make treatment equitable and accessible for all. Prudence calls for setting up well-equipped hospitals to create ample job opportunities for competent doctors, well-trained nurses, competent administrative and housekeeping staff, and conscientious healthcare activists in these deprived areas. This will have a beneficial impact on the demand-supply dynamic of healthcare in Tier 2 and 3 cities as both service providers and patients will not have to travel to metros, whether for seeking job opportunities or for availing medical treatment.
Now how to make this ecosystem sustainable in every respect while incentivising the care providers to settle in Tier 2 and 3 cities is the moot point of this sticky challenge. For this purpose, a brownfield approach to healthcare projects is the most feasible in a country like India. Already, we have many hospitals in non-metros facing severe constraints across multiple fronts. More and more investments into plagued but promising healthcare systems will fuel the penetration of quality healthcare pan India. By taking strategic stakes in such entities, the bigger hospitals can reignite and rejuvenate the distressed players to help them enhance healthcare in Tier 2 and 3 cities.
A brownfield approach is more attuned to the ground realities of any given geography. So, unlike the high-cost proposition of a Greenfield approach, it is prudent to go the brownfield way by collaborating with local entities and helping them upgrade their facilities and equipment. This approach is integral for developing a pan India network to make cancer care accessible and affordable to the community at large. It alone can help bring high-end technology to Tier 2 and 3 cities and towns such that units in these areas can thrive on the power of technology across its network to make the most of tele-health and disruptive innovation like immersive reality-based solutions and AI and ML-powered systems.
This private sector effort must run in tandem with government measures like the development of AIIMS facilities in Tier 2 and 3 cities and community-centric initiatives like Ayushman Bharat, Ayush Mission, and Pradhan Mantri Swasthya Suraksha Yojna. There is an immediate need to rescue Indian healthcare from the eddy of financial doom and systemic deprivation. Following in the footsteps of other nations, our government should proactively help private hospitals infuse more liquidity and bring in fresh capital. It is pertinent to note that private healthcare entities provide 75 to 80% of healthcare in India. If the small and mid-sized hospitals are forced to close down for good, the cascading impact on the quality of healthcare could prove fatal. The government hospitals would be in no position to cater to the exponential rise in the number of unattended patients.
The advisors on the government side are mostly bureaucrats or at best government doctors with limited understanding of healthcare intricacies or priorities. Ideally, domain experts need to be made part of expert committees to help prudent and purposeful policy making. This will help make healthcare at the grassroots more accessible and affordable.
Both as a practicing oncologist and entrepreneur, I firmly believe a disease like cancer can be prevented and fought only through the collaboration between like-minded stakeholders of the fraternity and community. Hence, the public and private sectors must collectively create an enabling environment at the grassroots to create mass awareness about cancer prevention and early detection.
(DISCLAIMER: The views expressed are solely of the author and ETHealthworld does not necessarily subscribe to it. ETHealthworld.com shall not be responsible for any damage caused to any person / organisation directly or indirectly)
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