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Indian Public Healthcare Infrastructure and Role of CSR in its Improvement

Shantanu Houzwala 
on 04 January 2021

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Introduction:

"There's enough on this planet for everyone's needs but not for everyone's greed" - Mahatma Gandhi

"Development has to be achieved collectively and it has to be quick paced and inclusive" - PM Narendra Modi.

The above quotes are the mere indication that the development of the country is very important provided it should not harm the wholesomeness or goodness of nature as well as society. Along with economic development, there must exist a sustainable society. It is not necessary that only the Government should be held responsible for the development of the country and responsibility towards society. The private sector should equally be held responsible for the development of society along with economic development. This is where Corporate Social Responsibility (CSR) comes into the picture.

CSR activities are not only beneficial to society but it will bring a good image to the participating organization also. CSR activities of the organization should be designed or selected in such a way that they will contribute to the development of the nation. At present CSR activities are designed by the companies with the help of NGOs, Trusts, and Foundations or with partnership with other companies.

Indian Public Healthcare Infrastructure and Role of CSR in its Improvement

Healthcare Sector in India:

The healthcare sector in India is ailing, the doctors attending to it don't seem to be making real progress. The government spending on healthcare is estimated to be about 1.5% of the GDP. In comparison to other countries, this is significantly lower. Maternal and infant mortality is high, which is unacceptable in any country. Although life expectancy has increased substantially, it is still low compared to many countries. Private hospitals provide excellent care but are beyond the reach of most people. Public hospitals are affordable but are terribly overcrowded and lack responsiveness.

Healthcare systems have contributed enormously to better health but their contribution could be greater, especially for marginalized people. With its billion-plus population and less than equitable access to healthcare, India has the responsibility to utilize these building blocks to transform its health system, especially in the wake of the pandemic.

Areas where Indian Healthcare System needs Improvement:

• To develop district hospitals as the centre of excellence for providing training, technical and professional support to public and private sector institutions in the district - local capacity needs to be strengthened.

• The generation and strategic use of information on health systems is an integral part of governance. A well-functioning health information system ensures the production, analysis, dissemination, and use of reliable and timely health information by decision makers at different levels.

• Recent experience of Covid-19 pandemic strongly suggests revisiting the Indian Public Health Standards (IPHS) for district hospitals, sub-district hospitals, community health centres, primary health centres together are the nerves of the public health system in

India, their standards in terms of service delivery, human resources, equipment, supplies, and infrastructure need to be re-visited.

• The need for primary healthcare centres to provide humane care closer to home, focusing on prevention and early detection, has never been so acute in India. Instituting more of them will significantly improve the population's health outcomes even as they reduce the overall need for hospital care, in turn reducing the load on doctors, nurses, lab-workers, technicians, and other hospital staff.

 

• Lack of manpower: India faces a shortage of trained and skilled doctors, nurses, technicians, and other medical staff. This leads to other problems like poor equipment maintenance, limited diagnostic services, etc. The shortage of manpower and the hesitation of existing manpower to work in smaller towns and villages limits the expansion of better medical facilities across the country, thus leading to the skewed distribution.

• Poor infrastructure: Public health facilities comprise of 20% of the Indian primary healthcare system. The majority of the secondary and tertiary care centres come under the private sector. A typical government hospital doesn't have sufficient doctors, nurses, or staff. Such hospitals are often crowded because they are catering to a large population in the surrounding area.

Role of CSR in Improvement of Indian Public Healthcare Infrastructure:

Corporate Social responsibility (CSR) is the continuing commitment by businesses to integrate social and environmental concerns in their business operations. India became the first country to legislate the need to undertake CSR activities and mandatorily report CSR initiatives under the Companies Act, 2013.

The quality of healthcare services in India is alarming. With the annual spending on the sector remains among the lowest globally, it is high time to channel the focus on the poor condition of public health across the country. Though the government has the responsibility to provide last mile healthcare facilities to the citizens, yet it will be unfair to hold it accountable entirely. There is much that companies can do to support health care as a part of their 2% mandatory spending.

Companies focus significantly on healthcare. A study conducted in 2018 by economic times on India's top companies for sustainability and CSR shows that the top 200 companies spend around Rs 1369 crores on healthcare and wellness. However, much of the spending tends to be focused on health camps and building hospitals or donating to hospitals for the upkeep of facilities. Health camps tend to have a short-term orientation and are number driven. Setting up and running hospitals are often poorly targeted.

Given the above issues, companies need to find more ways to engage in CSR activities around healthcare. Following are few themes where companies could refine their focus and their attention:

1. Improving primary care: There is a need to focus on primary care rather than tertiary care.

The local youth could be trained to advise residents on simple treatments. Pharmacies could be trained to provide medicines for common ailments. They could also help with basic diagnostics like blood pressure, pulse, and sugar testing. These will provide people with cheap and efficient health services.

2. Getting doctors to rural areas: Given that companies are already running hospitals near their plants and have access to greater resources than the government, they could provide incentives to doctors to spend time in rural/remote areas and take healthcare where it is desperately needed.

3. Increase the number of doctors: India has a significant shortage of doctors and more importantly well-trained doctors. Companies could subsidize medical education for bright youngsters. They could also partner with existing medical colleges for expansion of facilities, upgrading teaching methodologies, providing access to medical literature, etc.

4. Promote traditional medicine: Traditional medicine systems under the umbrella of AYUSH needs to be promoted and can be an excellent ancillary to the mainstream healthcare system. Companies can do a lot to support these alternative medical systems.

 

5. Support non-mainstream illnesses: Both the government and companies tend to focus on illnesses that affect the physical body. There is a greater need to focus on mental health, autism, and such conditions.

The CSR mandate in India has shown significant involvement in the healthcare sector post- 2013, making it the second most preferred sector for involvement, next to education. The involvement of corporate houses has opened avenues for improved technology, equipment, services as well as finances, which in turn has benefitted the citizens, especially in the rural areas.

Some of the best CSR initiatives undertaken by companies in providing comprehensive healthcare facilities during the pandemic are as follows:

1. Infosys Ltd.

Among the main initiatives in the Financial Year 2019-20 were a 100-bed quarantine setup in Bengaluru in partnership with Narayana Health City, and another one which had 182 beds for COVID-19 patients for Bowring and Lady Curzon Medical College & Research Institute.

2. Bharat Petroleum Corporation of India Ltd.

As part of its CSR for COVID-19 relief, the PSU organized 'Swachhata Pakhwada 2020' from July 1 to 15, 2020. This special initiative was in support of the Indian government's Swachh Bharat Abhiyan. The CSR team also went around villages with a medical team and distributed special kits comprising dustbins, face masks, and a hand sanitizer to 400 families.

3. Mahindra & Mahindra Ltd.

Anand Mahindra, Chairman of the company, declared a series of interventions after the pandemic hit the nation, from manufacturing ventilators to using Mahindra Holidays resorts for COVID-19 patient care.

Conclusion

CSR activities are a critical part of the business strategy today. It gives the companies an opportunity to pay back to the community. A properly implemented CSR concept can bring along a variety of competitive advantages as well, such as enhanced access to capital and markets, increased sales and profits, operational cost savings, improved productivity and quality, efficient human resource base, improved brand image and reputation, enhanced customer loyalty, better decision making, and risk management processes. CSR should mean sharing the prosperity with the Entire Community /Society at large. The role of corporates is very critical as it strongly influences the service delivery of a health system. There is a lot that businesses can do to help Indians live longer and more fulfilling lives. The money is there, and the intent is there. Only the right channels need to be tapped.


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