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COVID-19: Lessons learnt for a better public health system

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Shuchin Bajaj, Shweta Jaiswal and DVR Seshadri* emphasises on the five key lessons for India’s public health system

The COVID-19 pandemic clearly showed us that India and the world at large were ill-equipped to deal with unforeseen medical emergencies. Although India’s medical, paramedical and the civil manpower stood firm, and were at the forefront of the fight, our public health infrastructure was overwhelmed at the first sight of a large wave of patients during the pandemic.

It is imperative that we learn from this unprecedented crisis and strategically strengthen India’s public health system to protect the country’s 1.3 billion people from future disease events. Ever since its founding in 1946, the country’s public health system has dynamically evolved, and has overcome many hurdles in its attempt to improve people’s health; yet there is still a lot to be done.

Government agencies anchor India’s public health system, with private healthcare providers and supportive organisations contributing in crucial ways. Historically, the training, equipment and infrastructure of India’s public health system has been geared more towards addressing maternal and child healthcare, and known infective diseases like malaria, cholera, tuberculosis, polio, etc. The National Disaster Management Authority, the focal point for managing all large community-affecting issues, is more attuned to natural disasters like earthquakes and floods, than a pandemic.

Three years into the pandemic, there are five key lessons for India’s public health system:

India has entered a new era in public health during the past few years, especially after the COVID-19 pandemic, with digital interventions and collaborations between contrasting agencies being the rule rather than the exception.

Develop and apply innovative technology to improve efficiency

There is no doubt that the pandemic accelerated the progress of telemedicine and AI-assisted decision-making tools. The ability to reach out to the community quickly and at scale using digital interventions like tele-health, including but not limited to tele-consultations and tele-diagnostics will considerably hasten diagnosis and intervention during future pandemics.

Focus on early detection and diagnosis

The terrible consequences of COVID-19 have prompted healthcare systems across the world to focus on early detection and diagnosis of life-threatening diseases. According to the World Health Organization, 30–50 per cent of cancers can be prevented by reducing risk factors and implementing evidence-based prevention strategies. India also needs to develop a robust health infrastructure with a focus on early detection and diagnosis. Central Reference Laboratories must be set up at each state capital and level II and level III labs should be set up at all district headquarters. The government must also ensure appointment of trained medical and paramedical providers to man these laboratories.

Increase the availability of trained providers in tier 2 & 3 cities

The glaring skew in availability of trained medical personnel in tier-1 versus tier 3 cities has to be addressed. The spending in infrastructure has to be efficiently utilised by posting more doctors and nurses in the rural areas. This can be encouraged by providing tax breaks and other financial and non-financial incentives to doctors and paramedics working in small towns and rural areas.

Improve coordination with all critical partners, from global agencies to private sector providers

COVID-19 taught us that nations across the globe need to work together, share data, exchange learning, and form a monitoring system to avoid, control or overcome any further pandemics. For a large and complex country like India, enough emphasis must be given to develop public- private partnership in the healthcare sector to provide better health services at scale.

Improve and scale-up health education for the public

Public health cannot move forward without the cooperation from the masses. Hence health education at all levels is very important. A focus on preventive healthcare and taking responsibility of one’s own health would go a long way in improving public health.

No public health intervention can succeed without the involvement of the community. Hence getting a feel of what the people want for improving their health will help in making  India’s public health system become more effective.

 

*About the authors

Dr Shuchin Bajaj is a doctor social entrepreneur. He currently operates 19 hospitals in five states of North India, supported by a network of outreach clinics and digital health services providing free tele consultations.

Dr Shweta Jaiswal is a senior healthcare professional with over 18 years of experience as an Anaesthetist & Intensivist. She is currently involved in research in the field of healthcare at ISB.

 D.V.R. Seshadri is a Professor of Practice in the Marketing Area at the Indian School of Business. His areas of interest are healthcare, business-to-business marketing, and climate change. He is currently the Director of ISB-CBM (ISB-Centre for Business Markets), a platform for the engagement of global top academics in B2B Marketing with the industry, particularly in India.

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