Innovative Solutions to the Healthcare Crisis in New Delhi

Authors

Sarah Staller, School of Biomedical Engineering

Emilia Swihart, College of Liberal Arts

Min Thaw Ko, School Of Mechanical Engineering

As the capital of India and a rapidly urbanizing city, New Delhi faces a plethora of issues in its urban core. One of these issues is its healthcare system. There are many contributing factors and effects of this issue, and there are several past and current solutions to this problem. Furthermore, there are several future directions that can be taken to appropriately address this issue. We explore some of these in this essay.

Mohalla Clinics in New Delhi

https://mohallaclinic.in/

When tackling an issue in a city, all terms must be defined precisely for a clear understanding of the problem to take place. In terms of this situation healthcare is defined as the organized provision of medical care to individuals or a community. [1] Medical care is done to help maintain and restore the health of an individual and prevent diseases. New Delhi, like many other major cities has struggled with providing healthcare to all people. Currently, healthcare in New Delhi has been restricted to the rich who can afford adequate healthcare. [2] These are business institutions who can charge large sums to keep their businesses running without the input of the government. Public healthcare, specifically for low-income individuals, is the biggest issue. Public healthcare is classified as the organized effort of society to keep people healthy, usually in the form of clinics or public hospitals.

New Delhi's government has been slowly putting in efforts in improving medical care, one of these solutions drawing on the Millennium Development Goals created by the UN and utilized by the Indian government to help address challenges related to population health. [3] The goals that involved healthcare were combating diseases, reducing child mortality, and improving maternal health. There is slow progress in the improvement of health, even though it was the prime focus.

However, a lack of accessibility to adequate healthcare remains a problem for the lowincome urban population. [4] Slum communities live in unsanitary conditions that do not have the proper resources to have a thriving population. While these development goals are attempting to help relieve these issues, the core factors that cause these problems remain. Factors that need to be addressed in the future are as follows: poor access to water and sanitation, extreme crowding, location, and cost of health services. By fixing the factors that cause these health issues in the first place, it will help alleviate the weight that medical institutions have to carry.

Most of the New Delhi population is uninsured, and the city government is determined to expand coverage and increase spending on health. [5] The most important achievement on health is the starting of Mohalla (neighborhood) clinics in New Delhi to provide primary healthcare services within Delhi communities to remove congestion in local hospitals. [6] While there are current systems in place, there is still a lot of work that needs to be done. The poor quality of public healthcare causes more than 57% of households to prefer private care. [7] Because most of the public healthcare system caters to the affluent, those in the poor urban sectors are left as “bottom feeders,” living in both bad conditions and with bad healthcare.

Overall, this all inlays with the idea that while small projects have been done to help alleviate the problems of healthcare, not enough has been taken on to improve the mammoth issues that are presented. The next section presents issues of healthcare and the attempted solutions in more detail. By tackling both issues at once, there can be a determination if there is enough being done on both prevention and treatment to help the length and quality of life for the people of New Delhi, India.

There are several contributing factors that can negatively affect health and healthcare in New Delhi, India. First, one of the biggest environmental factors that seriously impacts New Delhi every day is air pollution. Air pollution is caused from a variety of factors, including crop burning, vehicular emissions, and city festivals with high firecracker usage, such as Diwali. [8] Secondary particles from industrial plants and road dust from vehicles also contribute to this issue. [9] The pollution is so extreme that Delhi is now dubbed “the world’s most polluted capital.” [10] In fact, Delhi’s particulate matter levels are about ten times the maximum level, as reported in 2011 by the World Health Organization. This air pollution has serious consequences for the citizens of New Delhi. Air pollution negatively affects the respiratory system, and long-term exposure can lead to an increased risk of developing illnesses such as asthma, lung cancer, and respiratory diseases. [11] Each year, around 10,000 premature deaths occur due to air pollution. [12] Furthermore, children and the elderly are disproportionately affected by the consequences of air pollution. [13] One study reports that if the air quality of New Delhi matched those given by the World Health Organization, New Delhi citizens would live an average of nine years longer. [14]

Overcrowding is another factor that impacts the health of New Delhi citizens. New Delhi’s rapid population expansion causes issues when urbanization and city growth is unable to keep up. When this occurs, many people are left without basic necessities, including food, clean water, shelter, sanitation resources, and more. [15] This can majorly impact the health of those affected.

Overcrowding due to rapid urbanization and a lack of affordable housing leads to the development of slums, which are defined as “a residential area where dwellings are unfit for human habitation by reasons of dilapidation, overcrowding, lack of ventilation or sanitation facility and having drinking water facilities in unhygienic conditions.” [16] A census found that about 20% of the total population of Delhi resides in slums. [17] The inhumane conditions of slums also pose many health hazards to their residents. [18] One estimation states that a slum with 20% of a city’s population will also suffer around 50% of its diseases. [19]

In response to the many health and other challenges that come with rapid urbanization, including those previously discussed, the United Nations adopted the Millennium Development Goals (MDGs) in 2000. [20] The Millennium Development Goals consists of eight separate goals, with improving health being the main factor, to be achieved by 2015. [21] The first goal is to “eradicate extreme poverty and hunger.” [22] The targets of this goal are to reduce the numbers of people suffering from hunger and living on less than $1 per day. [23] The second goal is to “achieve universal basic education.” [24] The target for this goal is to make primary schooling accessible to all schoolchildren, regardless of gender. [25] The third goal is “promote gender equality and empower women.” [26] The main focus of this goal is to reduce the disparity in genders for primary school courses. [27] The fourth goal is “reduce child mortality,” which includes a wide range of policies and plans to achieve this. [28] The fifth goal is “improve maternal health” by reducing the maternal mortality ratio. [29] Next, “combat HIV/AIDS, malaria, and other diseases” is the sixth goal. [30] The National AIDS Control Program and the National Vector Borne Disease Control Program were implemented in India to help accomplish this goal. [31] The seventh goal is “ensure environmental stability, and the eighth goal is “develop a global partnership of development.” [32] While the Millennium Development Goals were noble in cause, their progress was slow and their goals ultimately unaccomplished.

The Aam Aadmi Party is a political state party in New Delhi, India. [33] During its tenure, it has revolutionized healthcare for its citizens. In fact, “Chief Minister Arvind Kejriwal launched several schemes to provide free medicines, diagnostics and several life-saving surgeries through a three-tiered network of Mohalla Clinics, Polyclinics and Hospitals.” [34] In particular, Mohalla Clinics, which are now in over 150 locations around New Delhi, are each staffed with a pharmacist, doctor, and clinic assistant and provide healthcare services to citizens free of charge. [35] Furthermore, the Aam Aadmi Party has established 23 Polyclinics, whose main function is to offer poor people specialized diagnoses and treatments free of charge. [36] Since the implementation of these facilities, conditions have greatly improved across New Delhi’s 38 public hospitals. [37] India suffers from providing access to basic healthcare services at affordable rates to citizens. Therefore, as a solution to tackle the problem of providing basic health care needs to the citizens, Mohalla Clinics have been set up all around the city of New Delhi. Firstly, Mohalla Clinics are basic and primary health centers in the state of New Delhi in India, and they are established to provide essential health services including medicines, diagnostics, and consultation free of charge. [38] As opposed to other counterparts that provide health care, such as hospitals, Mohalla clinics are able to successfully provide basic health care services in a timely manner at lower prices while also reducing referrals to other health facilities. [39] The goal of the Mohalla Clinics is to provide basic medical care based on standard treatment protocols, provide cost free drugs, and treat minor ailments. [40]

Although the Mohalla clinics are small walk-in health care centers, they are appropriately staffed to handle various situations related to health. In each of the clinics, there is a doctor, a nurse, a general worker, and a lab technician to diagnose the patients, perform lab tests, and prescribe medications to the patients. [41] Due to the cost-free medical services the Mohalla clinics provide, Mohall Clinics are directed towards the low-income communities. Even though Mohalla Clinics are set up for the purpose of treating minor ailments to citizens, the clinics provide a variety of unparalleled tests and a wide range of drugs to combat all types of illness and diseases. Mohalla Clinics provide up to 212 diagnostic tests, including basic tests, such as urine pregnancy tests, to complicated tests, such as HIV I and II. [42] Moreover, to provide comfort and to combat minor ailments and diseases, the clinics also offer over 100 medications.

Since the setup of first Mohalla Clinics in 2015, the clinics have provided health care to a huge population of people. Mohalla Clinics have served and provided health care to 16.24 million people and conducted at least 1.53 million pathological tests. [43] Among the 16.24 million people served, 80% of the patients were women, children and elderly people. Furthermore, Mohalla Clinics played a huge role in combating outbreaks, such as dengue, chikungunya, and the COVID-19 virus. [44] From the survey conducted by ID insights, 74% of the respondents who used the clinics will most likely return to the facility for future medical treatments, and 97% of the respondents believed that the medical care provided by the clinics are on par with the treatment provided at other facilities. [45]

Even though Mohalla Clinics are an “exemplary initiative for healthcare services,” there are shortcomings present in the clinics. [46] From the survey conducted by IDinsights, 40% of the respondents were not aware of the Mohalla Clinics, and 40% of the respondents stated there were staff issues. [47] To combat such issues, Mohalla Clinics could advertise themselves better, such as by being featured in a local newspaper or putting up posters all over the city. Furthermore, the Mohalla Clinics could also staff more medical staff, so that, during patient rush hour and pandemics, the patients don’t have to wait for a long time in an unhygienic environment.

Although New Delhi faces a plethora of issues, the government is implementing ways to combat them. Because New Delhi could not keep up with its booming population and the rapid urbanization, slums or slum-like communities developed, and issues such as overcrowding, air pollution and an inability to provide basic quality health care started to present themselves in New Delhi. However, through the implementation of Mohalla Clinics, New Delhi is combating diseases, reducing child mortality, improving maternal healthcare, and providing affordable health care to poor communities and slums. Due to the establishment of the Mohalla clinics, New Delhi was able to serve millions of people in just 4 years. Moving forward, the Aam Aadmi party plans to increase the number of Mohalla Clinics in hopes of reducing or eradicating issues related to healthcare.

Healthcare helps create a foundation for a successful community; if a community does not have a solid healthcare structure, it will eventually crumble. New Delhi understands the flaws in their system and is working to remedy the problem. Renovating an entire system is laborious and difficult to manage, so New Delhi is addressing the problems through acts of prevention. In tangent, there have also been efforts to improve the system itself. However, there is still much that needs to be done to help the citizens of New Delhi by providing satisfactory public healthcare.

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