Sustainable and inclusive health care

Abstract

The substantial progress in health over the recent decades has been deeply unequal. While there has been advanced technical improvements in tertiary care, there is also this acute shortage of physicians with multiple competencies who are accessible, affordable and who can resolve the most common needs and emergencies. The nature of the health problems has changed in ways that are partially anticipated and at a rate that is wholly unexpected. Ageing and the effects of ill-managed urbanization has accelerated transmission of communicable diseases and increased the burden of chronic and non-communicable disorders. Accessibility and affordability of quality health care services in developing countries like India is crippled with issues like deteriorating infrastructure, the issue of prevalent healthcare divide, lack of insurance, lack of availability of trained medical professionals, poverty, and the ineffectiveness of government interventions. This study used a semi structured interview approach with the founding members and proponents in addition to secondary research of 4 health care models which have provided affordable, inclusive and sustainable health care for people at the base of the pyramid. Results show that there are multiple dimensions for these issues. There is no uniform pattern to suggest which model is more successful. There is a need for symbiotic coexistence of models like Aravind Eye Hospital that provide focused and specialty health services, models that have strategically diversified like Narayana Hrudayalaya and also models that leverage public private partnership like Rogi Kalyan Samiti. There is an enormous potential to reach people through technological advances like telemedicine that can play a pivotal role. In addition to government policy support, visionary leadership, social entrepreneurship, and relationships based on trust between the players are equally important for model to provide sustainable and inclusive health care.