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- International Journal of Management (IJM) Volume 11, Issue 5, May 2020, pp. 120-125, Article ID: IJM_11_05_012 Available online at http://www.iaeme.com/ijm/issues.asp?JType=IJM&VType=11&IType=5 Journal Impact Factor (2020): 10.1471 (Calculated by GISI) www.jifactor.com ISSN Print: 0976-6502 and ISSN Online: 0976-6510 DOI: 10.34218/IJM.11.5.2020.012 © IAEME Publication Scopus Indexed VISION “HEALTHY INDIA”- CHANGES AND CHALLENGES IN HEALTHCARE MANAGEMENT SYSTEM Sarita Department of Business Administration, Chetan Dattaji Gaikwad Institute of Management Studies, Pune, India Amitesh Datta Department of Microbiology, Maharaja Agrasen Medical College, Agroha, Hisar, Haryana, India ABSTRACT Health is the state of complete physical, mental, social well-being and not merely in the absence of disease and infirmity. Every residents of the country have the right to the highest attainable standard of health both physically and mentally. A strong healthcare management system will ensure the adequate number of trained health- care workers for better services through e-Health (Healthcare using Internet technologies), mobile wireless technology (mHealth) through mobile apps and MEDIDRONE based technology can play an important role for the access of healthcare to the population all over the world. This study highlights the changes and challenges faced by Indian healthcare management system in recent time, especially against the pandemic disease COVID-19 and other life-threatening diseases throughout the country. India needs to focus on accessibility and affordability of health care, human resource, infrastructure development, e-health, IoT (Internet of things) technology in healthcare sector, research and innovation development to contain the spread of diseases (like, break the chain of Coronavirus) and other life- threatening diseases. Keywords: Changes and challenges, COVID-19, e-health, Infrastructure development, Healthcare management Cite this Article: Sarita and Amitesh Datta, Vision “Healthy India”- Changes and Challenges in Healthcare Management System, International Journal of Management, 11 (5), 2020, pp. 120-125. http://www.iaeme.com/IJM/issues.asp?JType=IJM&VType=11&IType=5 http://www.iaeme.com/IJM/index.asp 120 editor@iaeme.com
- Vision “Healthy India”- Changes and Challenges in Healthcare Management System 1. INTRODUCTION Health is a primary human right for every individual in this world. Declaration of health as a fundamental human right in WHO agenda, “Health for All” means the resources for healthcare evenly distributed and accessible to everyone.[1] To achieve this goal, the Government of India has taken initiative like vision “HEALTHY INDIA” to provide preventive, affordable and quality healthcare for all.[2] Quality care can be delivered by an effective healthcare management system which determines the service quality in hospitals by healthy interactions and staff engagement results desired outcome.[3] A sounded healthcare management system is helpful to fight against deadly diseases like “COVID- 19”, a pandemic outbreak throughout the world. But today’s healthcare services facing lot of challenges like health awareness, infrastructure planning and supply chain management to save the life of country’s 1.37 billion people. When challenges demand changing, few initiatives can improve our entire health care system to provide better health for everyone. 2. INFRASTRUCTURE DEVELOPMENT Achievable healthcare services is the constitutional rights of peoples of India. Every individual of the country deserves a cost effective and optimal standard healthcare services for their physical and mental development.[4] But at present, the standard of health care infrastructure is not enough improved and needs fundamental reform in order to combat against emerging deadly pandemic disease “COVID-19.” It was estimated (2017) based on service target approach, a normative need of around 11,304 healthcare management professional’s (HMP’s) position were vacant for hospital management sector in India. Around a thousand of consultants would be required in future institutes like National Institute of Health and Family Welfare (NIHFW), National Health Systems Resource Centre (NHSRC), State Health Resource Centre (SHSRCs) etc. to work in project management section. It was assumed that, the additional requirement of healthcare management professional’s (HMP’s) are 2435 by 2020,5681 by 2024 and 7300 by 2026, to achieve our nation vision “Healthy India.” [5] In April 2020, WHO (World health organization) released a report showing, there is global shortfall of 5.9 million nurses as world battling against coronavirus outbreak.[6] Table 1 Data show health workforce (in numbers) in India by Global observatory data repository [7] Year Medical Nursing Community Physiotherapist Medical and Pharmacists Doctors and Health Personals Pathology Midwifery Workers Laboratory Scientist 2018 11,59,309 23,36,204 97,07,676 1,20,000 5,00,000 11,99,518 (8.571) (17.271) (8.868) 2017 10,41,395 28,21,815 - - - - (7.779) (21.029) 2016 10,05,281 19,80,536 - - - - (7.590) (14.953) (Note: Figure shows in brackets represents per 10,000 population health workforces by Global Health Observatory Repository in India) 2.1. Quality Care Customer satisfaction is most important parameter for judging the delivery of quality care. Service quality in hospital is determined by healthy staff interactions with patient. Human resource management practices play a significant role in recruitment and retention of high http://www.iaeme.com/IJM/index.asp 121 editor@iaeme.com
- Sarita and Amitesh Datta calibre hospital staffs.[8] India has made strategic investment to renovate healthcare management system. National Rural Health Mission (NRHM), currently known as National Health Mission (NHM) was launched in year 2005 to ensure quality and affordable healthcare for all.[9] But the biggest challenge in rural healthcare system is lack of adequate infrastructure, underfinanced, low supply of medicines, illiteracy, affordability, unawareness for providing standard of care. The solution of this problem is improvement of quality care, increase awareness, community participation, AYUSH services, collaborative approach and health education to achieve the Sustainable Development Goals (SDA) and Healthy India.[10] 2.2. Affordability of Healthcare It is well known that the private sector is the dominant player in the healthcare arena in India. Almost 75% of healthcare expenditure comes from the pockets of households and catastrophic healthcare cost is important aspect of improvement. The public sector offers healthcare at low or no cost but is perceived as being unreliable of different quality and generally is not the first choice, unless one can’t afford private care. The solution to the problem of affordability of healthcare lie in national and local initiative. Nationally, boost the needed infrastructure and manpower, education, insurance schemes should be affordable and accessible to everyone throughout the country. Locally, a consciousness of cost needs awareness to be built into healthcare sector, from the smallest to the highest level.[11] Currently India is spending 1.6% of GDP which is lowest with compared to global data. It is assumed that the share of consumer expenditure on healthcare is expected to increase by amount of 13% across the country in 2025. So, Government of India needs to declare some SOP (Standard, operative, procedures) to raise the percentage of spending in healthcare sector on technology, education, innovation and research.[12] 1.8 1.58 1.6 1.48 Value In Trillion Indian Rupees 1.4 1.22 1.16 1.2 1.12 1 0.8 0.6 0.4 0.2 0 FY 2014 FY 2015 FY 2016 FY2017 FY 2018 Public Health Expenditure From Financial Year 2014-2018 (Current health expenditure as percentage of GDP) Graph 1 Data shows current health expenditure as percentage of GDP (%) in India [13] http://www.iaeme.com/IJM/index.asp 122 editor@iaeme.com
- Vision “Healthy India”- Changes and Challenges in Healthcare Management System Research and development expenditure 1 0.9 0.859 0.813 0.831 0.805 0.8 0.757 0.757 [VALUE].704 0.726 0.7 0.639 0.62 0.597 0.6 0.5 0.4 0.3 0.2 0.1 0 1996 1998 2000 2002 2004 2006 2008 2010 2011 2015 2018 Graph 2 Data shows research and development expenditure (percentage of GDP) in India by World bank [14]: 3. TECHNOLOGY CHALLENGES Big data refers to the data generated in large volumes with complexities involving many parameters and relevance. Every industry is going through transformation so as healthcare also. Emerging and re-emerging diseases are threatening us constantly in today’s world. The new way of treatment based on research, new drugs, advancement in procedures and use of micro tools has changed the heath sector.[15] The assessment or monitoring the whole population of India is the biggest challenge to measure the patient’s health parameter, processing and analysis. To deal with such challenges, the digital revolution plays an important role such as IoT (Internet of things), cloud computing technology, wearable devices for monitoring, body area network devices and the MEDIDRONES. BAN (Body area network, used for monitoring patients) and MEDIDRONE has been designed to provide on time emergency services to people in rural villages using drones which is biggest challenge for India.[16] 4. RESEARCH AND INNOVATION Healthcare sector is one of the important sectors that require improvement and innovation. As new technology evolves around us in day to day life events, there is a need for improved operations in healthcare services.[17]According to World Bank report, India spent 0.597% of total GDP in research and development in 2018.[18] According to Economic Advisory Council to Prime Minister, “The research expenditure should be increased with the economy growth and targeted to reach at least 2% of the GDP by 2022. It was pointed out that India’s public investment in research and development as a fraction of GDP has remained stagnant over the last two decades.[19] Healthcare offers the opportunity to find ways to make medical services “more understandable, affordable and accessible”. So, to take the opportunity in healthcare sector, there should be contribution of research and innovation in medical industry, e-health, digital system, m-health, artificial intelligence, electronic health records, IoT technology, http://www.iaeme.com/IJM/index.asp 123 editor@iaeme.com
- Sarita and Amitesh Datta AYUSH services and Robotic services which will contribute to economic growth of country.[20] 5. CONCLUSION Health is a state of complete harmony of the body, mind and spirit. A person is supposed to be healthy if their surrounding environment is clean and living in a well-developed health care management system. Healthcare covers not merely medical care but also all aspects of preventive care too. This study concludes and suggests that a developing country like India should focus on e- health, IoT based care, artificial intelligence, supply chain management, infrastructure development, technology advancement, quality of delivery care, human resource ratio, research and innovation in healthcare sector. Health awareness, collaborative approach may be helpful to break the chain of today’s biggest challenge like COVID-19 and others life threatening diseases. REFERENCES [1] “Health for All” Available from https://www.medicinenet.com/ [2] “Healthy India “Available from https://www.narendermodi.in>healthy-india. [3] SC Jacob, J Manalel, MC Minimol, Service quality in healthcare sector: do HRM practice matter?” British journal of heathcare management, 26 (2), pp 1-9. 2020. [4] D. Sangeetha, M Venkata Rathnam, R. Vignesh, Jitta Sai Chaitanya, V. Vaidehi “MEDIDRONE- a predictive analysis- based on smart healthcare system” published in book of Proceedings 6th International Conference on Big Data & Cloud Computing Challenges. pp 19-33. 2019. [5] Ritika Tiwari, Himanshu Negandhi, Sanjay P. Zodpey “Study on health management workforce for India in 2030” Aug 20, 2018 available from https;//www.ncbi.nlm.nih.gov/pmc/article/PMC6110161 [6] Berkeley lovelace Jr “article WHO says there a global shortfall of 5.9 million nurses as world battles coronavirus pandemic” available from https://www.cnbc.com published April 6, 2020. [7] Health workforce by Global observatory data repository in India available from https://www.who.int. [8] Khushboo Sabhrwal Gupta, Varsha Rokade, “study on importance of quality in healthcare sector: A review” published in Journal of health management 18(1), pp 84-94. 2016. [9] Ritika Tiwari, Himanshu Negandhi, Sanjay P.Zodpey “Study on health management workforce for India in 2030” Aug 20, 2018 available from https;//www.ncbi.nlm.nih.gov/pmc/article/PMC6110161. [10] Nenavath Sreenu “healthcare infrastructure development in rural India: a critical analysis of its status and future challenge” British Journal of Healthcare management on 25(12), pp 1-9. 2019. [11] Arvind Kasthuri “study on challenges to healthcare in India-The five A’s” Published in Indian journal of community medicine on 43(3), pp 141-143. 2018. [12] Sanika Diwanji “study on Health in India- Statistics and facts on March27, 2020. available on https://www.statista.com/topics/5191/state-of-health-in-India/. [13] Current health expenditure as percentage of GDP available from https://www.statista.com/statistics/684924/india-public-health-expenditure/. [14] Research and development expenditure data available from https://data.worldbank.org http://www.iaeme.com/IJM/index.asp 124 editor@iaeme.com
- Vision “Healthy India”- Changes and Challenges in Healthcare Management System [15] Siddharth Kale, Harsh Tamakuwala, V. Vijayakumar, Longzhi Yang, Bharat S. Rawal Kshatriya “study on Big data in healthcare: challenge and promise” published in book of Proceeding 6th International conference on Big data and cloud computing challenges Oct5, pp 3-17. 2019. [16] D. Sangeetha, M Venkata Rathnam, R. Vignesh, Jitta Sai Chaitanya, V. Vaidehi “study on MEDIDRONE- a predictive analysis- based on smart healthcare system” in Proceeding of 6th International conference on big data & cloud computing challenges on Oct 5, pp 19-33. 2019. [17] Study: top innovation to expect from heath care published by science hub April4, 2020. [18] “India spends in research and development in 2018” available from http://data.worldbank.org/indicator/GB.XPD.RSDVGD.Zs? [19] “Target research and development expenditure of 2% of GDP by 2022: EAC-PM available from https://www.the Hindu businessline.com published on July24,2019 [20] How technology is changing Heath care in India available on “https://knowledge- wharton.upenn.edu/article/technology-changing-health-care-in-india/ published on Jan 28, 2020. [21] N. Kamakshi Priya and Dr. M. Kalyana Sundaram, A Study on Relationships among Job Satisfaction, Organizational Commitment and Turnover Intention in Kolors Healthcare India Pvt ltd, Chennai. International Journal of Advanced Research in Management, 7(1), pp. 58–71. 2016. [22] M.A. Shanti, K. Saravanan, An Effect of Data Mining Techniques in Public Healthcare-A Case Study. International Journal of Civil Engineering and Technology, 9(9), pp. 115-122. 2018. [23] Ayan Chattopadhyay, Arpita Banerjee Chattopadhyay, Healthcare Management Status of Indian States-An Interstate Comparison of the Public Sector Using a MCDM Approach, International Journal of Advanced Research in Management, 3(2), pp. 11–20. 2012. http://www.iaeme.com/IJM/index.asp 125 editor@iaeme.com
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