Hindu Editorial Analysis : 24-February-2024

A recent study highlights a significant issue in India’s health policy committees since Independence: they often neglect diverse perspectives that are crucial for effective public health systems. This centralization of health policy, where the central government plays a dominant role, has led to an unbalanced representation in decision-making bodies.

Centralization of Health Policy

Centralization in India’s health sector is characterized by:

  • Dominance of the Central Government: The central government formulates and implements most health policies.
  • Focus Areas: This centralization is evident in policy-making, funding, and regulation.

Lack of Representation

The study reveals that key health committees are primarily composed of:

  • Overrepresented Groups: Most members are men, doctors, and bureaucrats from New Delhi.
  • Underrepresentation of Women: Women make up nearly half of India’s health workers, but few reach leadership positions.
  • Regional Disparity: Almost half of health committee members are from the Delhi-NCR region, leading to a lack of regional voices in decision-making.

Progress and Challenges

Since 2000, there has been some improvement:

  • Increased Diversity: More women, NGOs, and non-medical experts are now included in health committees.
  • Continued Centralization: However, the centralization has risen from 53% to 83%, limiting broader participation.

Neglect of Preventive Care

India often approaches public health from a clinical perspective, focusing on curing diseases rather than preventive care. This neglect is seen in:

  • Treatment of Nurses and ASHAs: Poor pay and recognition for nurses and community health workers like ASHAs.
  • Overrepresentation of Doctors: Doctors dominate health committees, sidelining other vital perspectives.

Leadership Gaps

The National Health Policy and NITI Aayog’s Vision 2035 emphasize the need for diverse leadership. However, a Lancet paper pointed out:

  • Leadership Competency Gaps: There are significant gaps in leadership skills across various dimensions, including gender representation.

Funding Issues

The National Urban Health Mission (NUHM) suffers from inadequate funding, which has led to:

  • Shortages of Services: Many public health services were severely lacking during the COVID-19 pandemic, especially in urban areas.

Reaching Marginalized Communities

There are considerable challenges in ensuring equitable health outcomes for poor and marginalized communities:

  • Focus on Rural Areas: Much policy attention has been directed toward rural and tribal areas, neglecting urban health disparities.

Why In News

A new study found that key health policy committees since Independence have been neglecting diverse perspectives critical for effective public health systems, which undermines the ability to address the varied health needs of the entire population.

MCQs about India’s Health Policy

  1. What key issue did the recent study highlight regarding health policy committees in India?
    A. They are highly diverse and representative of the population.
    B. They often neglect diverse perspectives that are crucial for public health systems.
    C. They focus exclusively on rural health issues.
    D. They have reduced the central government’s role in health policy.
    Correct Answer: B. They often neglect diverse perspectives that are crucial for public health systems.
    Explanation: The study found that key health policy committees since Independence often neglect diverse perspectives, which are essential for addressing the varied health needs of the population.
  2. Which group is notably underrepresented in India’s health policy leadership?
    A. Men
    B. Bureaucrats
    C. Women
    D. Doctors
    Correct Answer: C. Women
    Explanation: Although women constitute almost half of India’s health workers, very few reach leadership and decision-making positions within health policy committees.
  3. What trend has been observed in the centralization of health policy in India since 2000?
    A. Decrease from 83% to 53%
    B. Increase from 53% to 83%
    C. No significant change
    D. Total decentralization
    Correct Answer: B. Increase from 53% to 83%
    Explanation: Since 2000, the centralization of health policy in India has increased, rising from 53% to 83%, indicating a growing concentration of power in the central government.
  4. What significant challenge does the National Urban Health Mission (NUHM) face?
    A. Excessive funding leading to wastage
    B. Inadequate funding resulting in shortages of public health services
    C. Overrepresentation of rural health needs
    D. Lack of interest from community health workers
    Correct Answer: B. Inadequate funding resulting in shortages of public health services
    Explanation: The NUHM suffers from inadequate funding, which has led to major shortages of public health services, particularly highlighted during the COVID-19 pandemic.

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