In India, there is a need to shift focus from a curated-oriented mindset to a preventive one when it comes to building the healthcare ecosystem. To set the context, there are ideally two healthcare strategies: preventive and post-diagnosis. Preventive healthcare or preventive medicine or prophylaxis is related to an absence of disease, either by preventing the occurrence of a health problem or by slowing and averting resulting complications after its onset. It pertains to measures taken to preserve health, as opposed to the treatment of disease. All in all, preventive strategies in healthcare refer to measures taken to prevent illnesses from occurring. On the other hand, post-diagnosis strategies refer to measures taken to cure an illness.
All these years, there have been many post-diagnosis strategies introduced in India. For instance, in its endeavour towards a healthy nation, the government has undertaken various initiatives like Health for All and The National Health Assurance Mission to reduce the burden of chronic diseases. The healthcare modalities being implemented are pivoted towards the prevention, screening, early intervention and new treatment platforms for patients. Similarly, there is Ayushmann Bharat, which includes an insurance scheme for secondary and tertiary care. However, the design of preventive strategies has been given relatively less importance than post-diagnosis strategies. For example, according to a 2018 NITI Aayog report: In India, of the total expenditure on health, preventive care accounts for only 6.7%. Similarly, in 2015, the number of sub-centres fell short of requirements by 20% in rural India.
It is pertinent to note that India has tasted success in preventive healthcare through the Pulse Polio Immunization Programme, which was rolled out on 2 October 1994, when the country accounted for around 60% of the global polio cases. The last polio case in India was reported a decade ago and the country has been free of polio.
GAIN AN EDGE
To achieve preventive healthcare, it is imperative to kickstart from the core idea: prevention is better than cure. Ideally, preventive healthcare starts with a change in the way we approach our health and healthcare ecosystems.
Moreover, preventive healthcare leads to better chronic disease management and reduces mortality. Essentially, preventive measures such as getting annual health check-ups keep one informed and lowers healthcare costs. The preventive health check-up lets an individual know what’s going on inside the body, and what needs to be worked upon and what doesn’t. Armed with this information, a person can adopt a few simple lifestyle and nutrition changes and, in many cases, reduce the necessity of having to go to a specialist doctor, such as a diabetologist, a neurologist or a cardiac surgeon, or even a physiotherapist for getting a treatment done for a protracted ailment.
The government of India has also realised the significance of wellness programmes to reduce healthcare expenditure and encourage healthy living. Initiatives like International Yoga Day and the formation of the Ministry of AYUSH, which underline the government’s intention to promote traditional health practices such as Ayurveda, Siddha, Unani, and Yoga, Naturopathy, and Homoeopathy.
SETTING THE GROUND FOR PREVENTIVE HEALTHCARE
As envisaged by the Nation Health Policy, 2017, there should be an investment in preventive healthcare — like health and hygiene and early diagnosis, among others. According to a 2018 NITI Aayog report, multiple channels such as schools, colleges, women’s groups, social media platforms, among others should be activated — for catalysing behavioural change towards greater recognition of preventive healthcare.
In the Indian context, however, the population burden and the doctor-to-patient ratio in the country is woefully low, which is merely 0.7 doctors per 1,000 people. This compared to the World Health Organisation (WHO) average of 2.5 doctors per 1,000 people. Improving this is a long-term process.
Ideally, using digital healthcare solutions and connecting them to a larger population of people, and build population health can be a game-changer for this cause. The idea and will to use digital healthcare technology can also propel preventive healthcare frameworks. The use of health-tech devices and collecting and connecting data from these devices to the mainstream ecosystem is needed. Additionally, collaboration and research initiatives will help in preventive healthcare overall.
Preventive healthcare can be achieved using data-driven informed decisions. Longitudinal clinical data for patients is critical for the preventive healthcare ecosystem. In addition, there is a need to promote better educational and awareness initiatives as well.
The healthcare ecosystem needs to be enabled with a framework of preventive caregiving using clinical knowledge, access to clinical data, and usage of new-age clinical tools to enable predictability using Artificial Intelligence (AI), Machine Learning (ML), and Natural Language Processing (NLP) to alert the patient-caregiver and the entire health ecosystem about the probable adverse event.
The road towards building a robust preventive healthcare system may seem long but definitely achievable if the right steps are initiated.
