Accessible, Affordable And Quality . - Vibrant Gujarat

Accessible, Affordable and QualityHealthcare for AllSector ProfileVibrant Gujarat 2017

Healthcare SectorIndia Scenario2

Overview: Factors for growth in healthcareGovt.initiativeswith a focuson PPPConducivepolicies awareness andpreventivehealthcareFactors forprojected growth ust onmedicaltourismHub forInnovation andR&Ddue to relativelylow cost ofclinical researchQualityhealthcare,coupled withskilled medicalprofessionaland lowtreatmentSource: Frost & Sullivan, LSI Financial Services, TechSci Research India is expected to rank amongst the topthree healthcare markets in terms ofincremental growth by 2020. Indian healthcare sector is expected toadvance at a CAGR of 22.87 per centduring 2015–20 to reach USD280 billion.Indian health sector is expected to create40 million new jobs by 2020. With the increasing medical infrastructureand skilled human resource (potential forforex), medical value travel market isexpected to grow at a CAGR of 30 per centbetween 2014 and 2019. India’s medical device market is currentlythe 4th largest in Asia with 700 medicaldevice makers, and ranks among the top20 in the world.3

Healthcare spend - India and Global Indian healthcare sector is forecasted to reach USD 160 billion (INR 10.4 lakh crores)in 2017, and is poised to reach USD 280 billion by 2020.Comparing healthcare spend - India and IndiaPublic USAPrivateUKGlobalSpending as % of GDPIndian healthcare expenditure is still amongst the lowest globally and there aresignificant challenges to be addressed both in terms of accessibility of healthcareservice and quality of patient care.4

Government Initiatives : FDIFDI received by the Healthcare Sector(hospitals and diagnostic chains)35001.430001.225001FDI split amongst the variouscomponents of 1220132014201571%Drugs & PharmaceuticalsHospitals & diagnostic centresFDI inflow accumulated since April 2011(USD million)% of total FDI receivedMedical & surgical appliances100 % FDI is permitted for health and medical services under the automatic route.5

Government Initiatives : Programmes and SchemesNational Health Mission The National Health Mission(NHM) through its sub-mission’s the National Urban Health Mission(NUHM) and the National RuralHealth Mission (NRHM) endeavorsto provide effective and affordablehealthcare to both the urban andrural citizens throughout thecountry and to improve the overallpublic health indicators, byfocusing on infrastructure, quality,efficiency and responsiveness inthe healthcare sector.National Program forHealthcare of the ElderlyTo provide accessible,affordable, and highquality long-term,comprehensive anddedicated care servicesto an Ageing population Pradhan Mantri SwasthyaSuraksha Yojna (PMSSY) Health Protection Scheme New scheme which willprovide health cover up toINR One Lakh per family, forpoor and economicallyweaker families.For Senior Citizens packageup to INR 30,000 will beprovided. Improving regionalimbalances in the availabilityof affordable/ reliable tertiaryhealthcare servicesUse of ICT in health sectorConstructing new and upgrading several existingmedical institutions indifferent states in the country6

Government Initiatives : Programmes and Schemese-health and m-health initiatives: Launched on World Health Day - 7th April 2016 ‘E-RaktKosh initiative.’ It is an integrated Blood Bank Management Information System Mobile application ‘India Fights Dengue’: empowers the community members how tocontribute towards prevention of Dengue Released the Guidelines for Dialysis Centre in a PPP Mode etc.Clean Street Food 20,000 roadside vendors to be skilledunder Pradhan Mantri Kaushal VikasYojana (PMKVY) in the first phaseMission Indradhanush: full immunizationdrive Phase-3: 216 districts have been identifiedon the basis of estimates where fullimmunization coverage is less than 60 percent and have high dropout rates.7

Government Initiatives : Programmes and SchemesNational Dialysis Services Programme Funds will be made available through PPPMode under the National Health Mission, toprovide dialysis services in all districthospitalsExemption on certain parts of dialysisequipment from basic customs duty,excise/CVD and SADMental Health PolicySuicide prevention services, work placestress management, life skills training andcounselling in schools and colleges 15 Centres of Excellence in Mental Health and35 PG training departments in mental healthspecialties to increase the PG trainingcapacity in mental healthJan Aushadhi Yojana 3,000 stores will be opened during 2016-17providing medicines at subsidized ratesIntegratedschemeChildDevelopmentServices The allotment of INR 16,120 crore toward thescheme, almost doubling the allotment madefrom the last budget of INR 8,000 crore Primary healthcare services for childrenunder six years of age and their mothers8

Government Initiatives : Programmes and SchemesJanani Suraksha YojanaLaunched in 2005Janani Shishu Suraksha KaryakramLaunched in 2011Pradhan Mantri Surakshit Matritwa YojanaLaunched in 2016The PMSMY is aimed at providing ante-natal care packages to around 3crore pregnant women on the ninth of every month by a specialist.Private practitioners willbe roped in whereenough doctors are notavailable in thegovernment sectorFree health check-upswere organised forpregnant women in 14states under the PradhanMantri SurakshitMatritwa Yojana(PMSMY)Program will runparallel to the JananiSuraksha Yojana (JSY)and Janani ShishuSuraksha Karyakram(JSSK)9

AYUSH (Ministry of Ayurveda, Yoga andNaturopathy, Unani, Siddha and Homoeopathy)The Ministry of AYUSH was formed on 9th November 2014 to facilitate thewith developing education, research and propagation of Ayurveda, Yogaand Naturopathy, Unani, Siddha, Homoeopathy and other alternativemedicine systems. Upgrade the educationalstandards of Indian Systemsof Medicines andHomoeopathy colleges inthe country 11 National institutionsunder AYUSH Evolve Pharmacopoeialstandards for IndianSystems of Medicine andHomoeopathy drugsAYUSHObjective Strengthen the existingresearch institutions Central Council forResearch are- 29 inAyurveda, 6 in Siddha,18 in Unani and 26 inHomoeopathy Promotion, cultivationand regeneration ofmedicinal plants usedin the systems10

Opportunities in HealthcareHealthcare Drives the GDP GrowthThe Indian healthcaremarket is expected to growto USD 280 billion by 2020,from the current market sizeof USD 100 billion at anCompound Annual GrowthRate (CAGR) of 23 %.Stronger healthcare systemwill augment GDP growth viaIndia would require additionalbeds that would need anindicative investment of USD 2530 billionThe Health sector would need agreater number of healthcarepractitioners and skilledworkforcePotential for enhancing laborproductivity by increasing theirphysical capacities Expenditure in health sector has beenincreasing in recent years. In 2015,Expenditure in Health sector is 4.7% ofGDPNational Programs to fasten investmenthave been proposed in recent years.Source: IBEF-Deloitte Report, KPMG in India analysis, 2015Forex generator: helpingstrengthen our position in theinternational market.Innovation & Entrepreneurship:advent of alternate and innovativehealthcare models11

Opportunities in Healthcare Additional 1.8 million beds needed for India to achieve the target of 2 beds per1,000 people by 2025HealthcareInfrastructure Additional 1.54 million doctors required to meet the growing demand forhealthcare Investment of USD 86 billion required to achieve these targets Diagnostic Services – Path Labs Information and Communication Technology (ICT) Enabled Healthcare Services –Tele-MedicineEducation andResearch &DevelopmentHealthInsurance Contract research is a fast growing segment in the Indian healthcare industry Cost of developing new drug is as low as 60% of the testing cost in the USA About 60% of global clinical trials is outsourced to developing countries Less than 15% of the Indian population is covered through health insurance The total market size of the insurance sector in India was USD 66.4 billion in FY 13.It is projected to touch USD 350–400 billion by 2020.12

Opportunities in Healthcare Indian medical tourism industry is expected to register a CAGR of more thanMedicalTourism20% during 2013-2015 Cost of surgery in India is nearly (1/10)th of the cost in developed countries SAARC countries such as Bangladesh, Pakistan,Afghanistan, Bhutan, Nepal, Maldives and SriLanka are major sources of medical tourists inIndia, owing to the physical vicinity andpolitical co-operation agreements. India’s traditional strength in yoga andayurveda adds a distinct angle to the country’smedical value travel proposition. Presence of healthcare facilities withinternational standards and highly skilledmedical workforce has helped India instrengthening its spot in medical travel.13

Healthcare sectorGujarat Scenario14

Towards a Healthy GujaratGujarat has intensified its focus on public health services by directing efforts towards upgradation of medical services & provision of affordable treatment for the citizens1Strengthening, Revamping and Rationalizing ofexisting primary health structure & Creation of new facilities2Deployment of HR(Doctors, Paramedics, ANMs, ASHAs)3Ensuring Quality Healthcare Services(Assured package of service)4Capacity building of stakeholders5Convergence, partnerships(NGOs, Profit, not-for-profit)6Use of technology for better service delivery,improved surveillance and monitoring15

Health IndicatorsParticulars2001Current level202(SRS-1999-01)112(SRS 2011-13)Infant Mortality Rate (IMR)(Per ‘000 live births)6035(SRS 2014)Under 5 Years -Mortality Rate(Per 1000 live births)7945 (SRS 2013)Crude Birth Rate (CBR)(Per 1000 population)24.920.6 (SRS 2014)Crude Death Rate (CDR)(Per 1000 population)7.86.2 (SRS 2014)Total Fertility Rate (TFR)2.92.3 (SRS 2013)Male62.3 (1997-01)66 (2009-13)Female64.2 (1997-01)70.5(2009-13)Maternal Mortality Ratio(MMR)(Per lakh live births)Life Expectancy at Birth(%)16

Gujarat Public Health InfrastructureGujarat Public Healthcare ant aryhealthCentersUrbanHealthCenters9156Sub centersAYUSH Facilities: Grant in Aid Ayurveda Hospitals: 2 Licensed Pharmacies: 500 Total Ayurveda Hospitals: 41 Homeopathy Hospitals: 18 Ayurvedic Dispensaries: 559 Homeopathy Dispensaries: 219Health and Family Welfare Dept., Govt. of Gujarat.17

Medical and Para Medical CollegesMedicalDentalTotal of 22 Institutions with 3480 Seats6 Government Colleges (1080 Seats)7 Gujarat Medical Education & Research Society(GMERS) Medical Colleges (1050)5 Private Colleges (650 Seats)3 Municipal Corporation College(550 seats)1 Deemed University (150 Seats)Total of 13 Institutions with 1240 Seats2 Government Colleges (200 Seats)1 SGDHER (100 seats)1 Municipal Corporation College (100 Seats)8 Private Colleges (740 Seats)1 Deemed University (100 Seats)Medical & ParaMedical CollegesNursingPhysiotherapyTotal of 41 Institutions with 2195 SeatsTotal of 53 Institutions with 2750 Seats8 Government Colleges (390 Seats)33 Private Colleges (1805 Seats)5 Government Colleges (360 Seats)1 Municipal Corporation College (50 Seats)46 Private Colleges (2310 Seats)1 Deemed University (30 Seats)Health and Family Welfare Dept., Govt. of Gujarat.18

Para Medical Colleges & Indian System ofMedicine & HomeopathyOptometryHomeopathy4 Self Financed Institutionswith a total of 125 Seats18 Institutions with 1800 Seats4 Grant-in-Aid Colleges (400 Seats)14 Self Financed Colleges (1400Seats)Para MedicalColleges & ISM&HAyurvedaOrthotics & Prosthetics1 Government College with a total of10 SeatsHealth and Family Welfare Dept., Govt. of Gujarat.11 Institutions with 480 Seats4 Government Colleges (240 Seats)1 Grant-in-Aid Colleges (60 Seats)5 Self Financed Colleges (340 Seats)1 University Ayurveda College(100 Seats)19