Every day, close to five lakh citizens use eSanjeevani to seek treatment for a range of health issues. The service is a blessing for those in remote and hard-to-reach areas
Digital health is a blessing, and India has just started counting. Prime Minister Narendra Modi recently highlighted the reach of the country’s telemedicine initiative eSanjeevani that has resulted in 10 crore tele-consultations. Every day, close to five lakh citizens use eSanjeevani to seek treatment for a range of health issues. While the service is available to every citizen, it is indeed a blessing for those in remote and hard-to-reach areas. These people can now easily access free medical consultation and treatment from the comfort of their homes.
These numbers tell a more heartening story – 57% of these consultations have been made by women, who otherwise are victims of neglect in a health delivery system. We can imagine the eSanjeevani platform connect several women from a village of Rajasthan to doctors and specialists through medical officers stationed in Ayushman Bharat’s Health & Wellness Centre (HWC). There are close to one lakh HWCs in India.
The national telemedicine service of India is the world’s largest telemedicine implementation in the primary healthcare. We envisage that in a few months, we would be able to target a million tele-consultations in a day. With such digital facility, a woman from an Andhra Pradesh village, who is otherwise burdened with housework, could now ‘visit’ an OPD on her smartphone and talk to a doctor. Even in the islands of Andaman and Nicobar, a young woman now has the means to speak to a specialist about her health concerns without reservations. In barely three years, digital health has accelerated access to medical care in India and reached some of the most vulnerable groups.
Studies indicate gender discrimination and gender stereotyping prevent women from accessing basic treatment. An AIIMS-Harvard University 2016 study pointed towards sharp differences in ability to access treatment. The study emphasised that women were less likely to reach a hospital/health centre because of the costs incurred in travelling. This also implies that women have less chances of being taken to a specialist for treatment. Digital health has leveraged the immense potential of technology and seeks to make healthcare more equitable through its easy reach and quality care.
In recent years, the Prime Minister has launched initiatives like the Ayushman Bharat Jan Arogya Yojana (PMJAY), aiming at key principles of Universal Health Coverage: Efficiency, Accessibility, Inclusiveness, Affordability, Timeliness and Safety. Besides PMJAY, promotion of a network of super-speciality hospitals by the government has further closed the gaps found in a health delivery system. Through various initiatives, the government is striving to address issues of physical shortage of doctors and health workers, inadequate infrastructure in far-flung areas and lack of diagnostics, and regular counselling.
During the early COVID-19 pandemic phase, when health crisis engulfed the entire world, as per the World Health Organisation (WHO) report on World Health Statistics 2022, in many low-income countries (LICs) only three in ten healthcare workers had been fully vaccinated against COVID-19 by April 2022, compared with a global average of 80%. Only 25% of adults aged over 60 years were fully vaccinated in African countries and only 11% of people with co-morbidities had completed the primary series. India, on the other hand, demonstrated how technology can underpin a massive public health drive of vaccinating various age groups. Digital technology – apps, telemedicine, social networking sites – helped millions of Indians during the extreme phase of COVID-19 access the vaccination programme, track the virus, consult a doctor online and connect to a counsellor.
In recent years, some small steps powered by digital technology have made a significant impact in healthcare: the launch of ABHA (Ayushman Bharat Health Account) has resulted in better patient experience. It has enabled close to 25 crore Indians register for OPD consultation. The QR-code based instant registration service has drastically reduced waiting time in several hospitals across 125 districts in various states/ UTs.
Today, an upgraded Mother and Child Tracking System (MCTS) benefits crores of pregnant women by providing them a range of family planning, antenatal, intranatal, postnatal and immunisation services. Another digital scheme, Kilkari (baby’s gurgle) delivers free, weekly, time-appropriate audio messages to women from the second trimester of pregnancy until the child is one year old. Digital measures are providing critical testing facility for anaemia in several states. Timely testing and treatment of anaemia – among women and young girls – will accelerate our mission of Anaemia Mukt Bharat (anaemia-free India).
At the upcoming G20 Health Working Group meet in Goa (17-19 April), a more accessible world will be imagined by various world delegates. India’s presidency has already spurred discussions on innovations towards quality healthcare for all. A collaborative approach can make access more equitable – data on particular diseases and illnesses can be shared with more countries. At the Goa meet, we also hope to give shape to the concept of Data Solidarity, aiming to bring more facilities online without compromising on privacy and safety of patients.
In January 2023, I stated at the first G20 Health Working Group Meeting at Thiruvananthapuram, Kerala, that COVID-19 may not be the last pandemic. However, its learnings have helped us prepare for better responses to health crisis. A galaxy of health experts, pharma and IT companies will discuss on how to collaborate towards a digitally powered future. Artificial intelligence, cloud computing and digital therapeutics across the globe are helping manage diseases ranging from neurological and mental disorders to diabetes. In countries like India, the government and entrepreneurs are exploring ways to align digital health solutions to global health priorities. I am enthused by the start-ups in this field and the range of services they have to offer.
India is signatory to the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) that makes it obligatory for the government to eliminate any discrimination against women, specifically in healthcare. India is home to close to 28% of the world’s tribal people. More attention needs to be paid to tribal women and adolescent girls. In many countries including India, tribal population faces multiple burdens of communicable and non-communicable diseases, malnutrition and also mental health. Prevalence of pulmonary tuberculosis is also significant among tribal population.
Digital health is already proving to be a game changer. In February 2023, AIIMS Rishikesh successfully delivered TB medicines via a Vertiplane X3 drone in a hilly terrain. Experts are now calculating how besides TB medicines, sputum samples to laboratories can be transported through drones. This technological innovation will not only help in speedy diagnosis but facilitate TB treatment and reduce transmission among vulnerable communities.
At the Bharat Drone Mahotsav (drone festival) in May 2022, the Prime Minister emphasised that “technology has helped a lot in furthering the vision of saturation and in ensuring last-mile delivery”. Given the pace of innovations, technology will eventually fast-track our national target of eliminating TB by 2025. Indeed, this would be a giant leap not only for India but also for the global health ecosystem.
India’s rich experience in health crisis management and wise leadership in harnessing technological innovation have received praise from many global leaders. In Goa, we hope to create a blueprint of digital health for global health.
(Dr. Bharati Pravin Pawar is the Union Minister of State for Health & Family Welfare).