Healthcare General Knowledge ques bank

1. What is Universal Health Coverage (UHC)?

Universal Health Coverage (UHC) refers to ensuring that all individuals and communities
have access to essential health services without suffering financial hardship.
 Equity in access: Everyone should receive the health services they need, irrespective
of their financial or social status
socio-economic status, geographic location, or background.
women, children, low-income populations, and rural communities.
 Quality of services: The health services provided must be of sufficient quality to
improve the health of the people who receive them.
primary healthcare, access to essential medicines, vaccination programs,
maternal and child healthcare, treatment for diseases, mental health services,
and emergency care.
 Financial protection: People should not be put in financial distress because of
healthcare costs, such as paying out of pocket for services or medicines (Catastrophic
health expenditures), systems like insurance, subsidies, or public healthcare to cover
medical costs.
Importance of UHC
 Health Equity: UHC ensures that vulnerable and marginalized populations, such as
the poor, have access to necessary healthcare services.
 Economic Benefits: A healthy population is more productive, contributing to national
economic growth.
 Global Goals: UHC is a target under the United Nations Sustainable Development
Goal (SDG) 3, which aims to ensure healthy lives and promote well-being for all by
2030.
UHC is essential in reducing disparities in healthcare access and improving the overall
health of the population. Countries with strong UHC systems generally have better
health outcomes and lower inequality in healthcare access.

Challenges in Implementing UHC

1. Resource Constraints:
o Many developing countries face challenges in financing UHC due to limited
government revenues, inefficient taxation systems, or competing priorities.
2. Workforce Shortages:
 o UHC requires an adequately trained healthcare workforce to deliver services,
particularly in rural or remote areas. Many countries face shortages in skilled
healthcare professionals.
3. Healthcare Infrastructure:
o Inadequate healthcare infrastructure, including hospitals, clinics, and medical
equipment, hampers the effective delivery of services.
4. Out-of-pocket Payments:
o Despite progress, many countries still rely heavily on out-of-pocket payments,
which limit access for the poor and lead to inequalities in healthcare access.
5. Policy and Governance Issues:
o Successful implementation of UHC requires strong political commitment and
effective governance. Corruption, inefficiency, and a lack of accountability can
undermine progress.
Global Efforts to Promote UHC
 WHO’s Role:
o The World Health Organization (WHO) is a key advocate of UHC and works
with governments to improve their healthcare systems by providing technical
support and resources.
o WHO also tracks progress toward UHC using two primary indicators: coverage
of essential health services and financial protection.
 Country-Specific Examples:
o Countries like Japan, the UK, and Canada have well-established UHC systems,
where healthcare is mostly funded through taxation or public health
insurance.
o Thailand and Rwanda have made impressive strides in achieving near-
universal coverage through a combination of community-based health
insurance schemes and government support.
 India’s UHC Initiative:
o India has taken significant steps toward UHC through programs like
Ayushman Bharat. Launched in 2018, it aims to provide free healthcare
coverage for low-income households and improve primary healthcare
infrastructure through Health and Wellness Centres.
2. What are the main objectives of the National Health Mission
(NHM) in India?
Public health initiatives, aimed at improving healthcare access and outcomes for the
country, especially in rural and underserved areas. It was launched in 2013 by merging
two earlier programs: the National Rural Health Mission (NRHM), started in 2005, and
the National Urban Health Mission (NUHM).
 Reduce Maternal and Child Mortality:
initiatives such as safe delivery practices, access to antenatal care, and
immunization programs to reduce infant and maternal mortality rates.
 Strengthen Healthcare Infrastructure
 Improve Disease Control:
The NHM has targeted programs to combat communicable diseases like
tuberculosis, malaria, and HIV/AIDS, while also addressing the rising burden
of non-communicable diseases (NCDs) such as diabetes, cardiovascular
diseases, and cancer.
 Enhance Access to Affordable Healthcare:
The NHM focuses on reducing out-of-pocket expenditure by providing free or low-
cost healthcare services, improving health insurance coverage, and ensuring that the
poorest sections of society have access to basic healthcare.
 Human Resource Development:
It aims to address healthcare workforce shortages by recruiting and training
community health workers, such as Accredited Social Health Activists (ASHAs), and
improving the skills of doctors, nurses, and paramedical staff.
 Public Health Innovation and Governance:
Encouraging better governance, transparency, and accountability within the
healthcare system by involving local communities and using information technology
to track and manage healthcare outcomes.
 Ayushman Bharat:
A significant initiative under the NHM is Ayushman Bharat, introduced in 2018,
which has two components:
o Health and Wellness Centres (HWCs) to provide comprehensive primary
healthcare.
o Pradhan Mantri Jan Arogya Yojana (PM-JAY), offering health insurance
coverage to economically weaker sections, covering up to ₹5 lakh per family
per year for secondary and tertiary care hospitalization.

This year 36000 cr is allocated to NHM under budget; 14% higher than prev
year.
60:40 ratio between gvmtn of india and states
 India's maternal mortality rate (MMR) has been declining over the years, and the country
is on track to meet its targets:
 MMR decline: India's MMR has declined from 384 in 2000 to 97 in 2018-20.
 National Health Policy (NHP) target: India has achieved its NHP target of less than
100/lakh live births.
 SDG target: India is on track to achieve its SDG target of less than 70/lakh live births
by 2030.
 Leading causes: The leading causes of maternal death are obstetric hemorrhage,
pregnancy-related infection, and hypertensive disorders of pregnancy.

The main difference between neonatal mortality and infant mortality is the age at which
the death occurs:
Neonatal mortality: The number of children who die within 28 days of birth, per 1,000
live births.
 22 per 1000
 The National Health Mission (NHP) has set a target of reducing the NMR to 16 per
1,000 live births by 2025. To meet the Sustainable Development Goals (SDG) target of
12 per 1,000 live births, India needs to reduce its NMR by 6.3% annually.
 Infant mortality: The number of children who die within one year of birth, per 1,000 live
births.
 25-26 per 1000

The neonatal mortality rate (NMR) is a key indicator of a community's health.

 Facts and Figures
DATA Reference : IBEF(India Brand Equity Foundation)
https://www.ibef.org/industry/healthcare-india
1. India's hospital market was valued at US$ 98.98 billion in 2023, projected to
grow at a CAGR of 8.0% from 2024 to 2032, reaching an estimated value of
US$ 193.59 billion by 2032.

2. Healthcare comprises
 hospitals,
 medical devices,
 clinical trials,
 outsourcing,
 telemedicine,
 medical tourism,
 health insurance and
 medical equipment
3. The Indian healthcare sector is growing at a brisk ( Active and energetic) pace
due to its strengthening coverage, services, and increasing expenditure by
public as well as private players.
4. The government, i.e., the public healthcare system, comprises limited
secondary and tertiary care institutions in key cities and focuses on
providing basic healthcare facilities in the form of Primary Healthcare Centers
(PHCs) in rural areas.
5. The private sector provides most secondary, tertiary, and quaternary care
institutions with a major concentration in metros, tier-I, and tier-II cities.
6. large pool of well-trained medical professionals. India is also cost-
competitive compared to its peers in Asia and Western countries.
 7. The cost of surgery in India is about one-tenth of that in the US or Western
Europe. The low cost of medical services has resulted in a rise in the
country’s medical tourism, attracting patients from across the world.
8. India has emerged as a hub for R&D activities for international players due to
its relatively low cost of clinical research.
9. Globally, the size of the sector is $10 trillion. The Indian healthcare sector
accounts for about $372 billion and is growing at a compounded annual
growth rate (CAGR) of 22%
MARKET SIZE
The Indian Healthcare industry continued its healthy growth in 2023 and reached a
value of US$ 372 billion driven by both the private sector and the government.
1. As of 2024, the Indian healthcare sector is one of India’s largest employers as
it employs a total of 7.5 million people. Progress in telemedicine, virtual
assistants, and data analytics is expected to create 2.7-3.5 million new tech
jobs.
2. India’s public expenditure on healthcare touched 2.1 % of GDP in FY23
India's rising public expenditure on healthcare, increasing to 2.1% of GDP in
FY23 from 2.2% in FY22 and 1.6% in FY21, highlights a significant shift in
government priorities, particularly driven by the COVID-19 pandemic. Here's
a breakdown of this trend:
1. Pandemic Response: The jump from 1.6% in FY21 to 2.2% in FY22 is largely due to
the massive healthcare spending triggered by the pandemic. This included
vaccination drives, strengthening healthcare infrastructure, and other emergency
responses.
2. Government Focus on Health: The increased spending aligns with the government's
broader focus on improving public healthcare access, especially through programs
like Ayushman Bharat, which aims to provide affordable healthcare to the lower-
income population.
3. Health Infrastructure Improvement: The additional funds have been directed
towards building more healthcare facilities, improving medical research, and
ensuring better rural healthcare infrastructure.
4. Long-Term Economic Strategy: Enhancing healthcare expenditure is seen as crucial to
sustaining economic growth, as healthier populations are more productive, and
improved healthcare can lead to a more robust workforce.

3. India's hospital market was valued at US$ 98.98 billion in 2023, projected to
grow at a CAGR of 8.0% from 2024 to 2032, reaching an estimated value of
US$ 193.59 billion by 2032.
4. In FY24 (Till February 2024), premiums underwritten by health insurance
companies grew to Rs. 2,63,082 crore (US$ 31.84 billion). The health segment
has a 33.33% share in the total gross written premiums earned in the country.
 The health insurance segment accounted for 33.33% of the total gross written
premiums in the Indian insurance market. This means that about a third of all
 insurance premiums collected in the country are from the health insurance segment,
underscoring its importance and growing market share.
 Government initiatives, like Ayushman Bharat and regulatory changes like the
standardization of health policies have made it easier for consumers to compare and
choose health insurance products.

 For example, if a company sells a 1-year policy worth ₹10,000 in January, the entire
₹10,000 is considered premium written when the policy is sold.

 In the example above, the ₹10,000 premium would be "earned" gradually over the 12-
month policy period. If the policy covers one year, each month, the insurer would earn
about ₹833.33 as it provides coverage.

So, by the end of June, 6 months of coverage have been provided, and
the insurance company would have earned ₹5,000 of the total
premium.

The rest is considered unearned premium until the company fulfills

the entire coverage period.

 Indian medical tourism market was valued at US$ 7.69 billion in 2024 and is expected
to reach US$ 14.31 billion by 2029.
 Medical tourism in 2023 contributed 6.87% of the total international tourists who
visited the nation.
 With US$ 5-6 billion size of medical value travel (MVT) and 500000 International
patients annually, India is among the global leader destinations for international
patients seeking advanced treatment. explain this
 The cost of treatments in India is much lower compared to countries like the U.S. or
the U.K., often up to 60-80% cheaper. For instance, a heart bypass surgery in the U.S.
might cost upwards of $120,000, while the same procedure in India could be done for
$10,000–$15,000, with comparable outcomes.
 Currency advantage also plays a significant role. Foreign patients can benefit from the
lower Indian Rupee value, stretching their budgets further.
 India boasts world-class hospitals with state-of-the-art technology and highly
qualified doctors, many of whom have been trained or have worked in developed
countries.
 The country has many JCI-accredited hospitals (Joint Commission International),
which ensures that facilities meet rigorous international healthcare standards.
 The Indian government has implemented simplified visa processes for patients and
their companions. The introduction of a medical visa category and initiatives to
streamline medical travel have further boosted India’s reputation as a medical
tourism hub.
 The Indian government has implemented simplified visa processes for patients and
their companions. The introduction of a medical visa category and initiatives to
 streamline medical travel have further boosted India’s reputation as a medical
tourism hub.
 Countries like India, Thailand, Singapore, Mexico, and Turkey are popular MVT
destinations due to their ability to combine quality care, lower costs, and accessibility
to international patients.

 The e-health market size is estimated to reach US$ 10.6 billion by 2025.
 The doctor population ratio in the country is 1:854, assuming 80% availability of 12.68
lakh registered allopathic doctors and 5.65 lakh AYUSH doctors. The doctor-
population ratio in India is 1:834, which is better than the World Health Organization's
(WHO) standard of 1:1000

Investments and developments

 Between April 2000-March 2024, the FDI(Foreign direct investment) inflow for the
drugs and pharmaceuticals sector stood at US$ 22.57 billion. (FDI is crucial because it
brings capital, technology, and expertise into the country, aiding in economic growth
and employment generation.)
 Inflows in sectors such as hospitals and diagnostic centres and medical and surgical
appliances stood at US$ 10.26 billion and US$ 3.28 billion, respectively, between April
2000-March 2024.
 DocPlix, a health-tech startup, raises Rs 1.2 crore (US$ 0.14 million) in a bridge round
led by Inflection Point Ventures (IPV)( Startup Investing Platform that connects
Startups with Angel Investors; Founder Vinay Bansal) , aiming to digitize health
records for India's 1.4 billion population and enhance healthcare accessibility.
 IIT Bombay partners with Blockchain for Impact (BFI) to receive a US$ 900,000
investment aimed at developing affordable healthcare technologies, as part of
a broader US$ 15 million BFI-Biome initiative to address urgent health
challenges and advance biomedical innovation. (CAR-T cell therapy.)

Healthcare: Blockchain can securely store patient records, ensure data privacy, and
improve the accuracy of medical histories.
Sandeep Nailwal, co-founder of Polygon, created Blockchain for Impact (BFI). BFI's
BFI-BIOME Virtual Network Program is a collaboration with the Indian Institute of
Science (IISc) and others to advance biomedical research and innovation in India.
BFI is a global organization that leverages blockchain technology to create solutions
for social and environmental challenges. Blockchain technology, known for its
decentralized, secure, and transparent nature, can be used for:
 Tracking and verifying medical data securely.
 Supply chain management of medicines and healthcare products.
 Developing decentralized healthcare systems that improve access and efficiency.
Blockchain for Impact (BFI) is a philanthropic initiative led by Sandeep
Nailwal, originally formed during the COVID-19 pandemic to support India's
 healthcare infrastructure. Initially, BFI focused on emergency relief such as
distributing medical supplies, vaccines, and hospital equipment. Over time, it
has evolved into a more structured organization aimed at addressing long-
term healthcare challenges through innovation and research in biomedical
fields.
It seeks to foster advancements in biomedical innovation, particularly in areas
like diagnostics, disease research, and affordable healthcare solutions.
The initiative forms strategic partnerships with leading Indian research
institutes such as IIT Bombay, IISc, and CSIR-CCMB.
The broader BFI-Biome Virtual Network Program supports collaborative
research across various institutes and aims to bridge gaps in India's
healthcare infrastructure.

CAR-T cell therapy (Chimeric Antigen Receptor T-cell therapy) is a type of

immunotherapy that harnesses a patient's own immune system to fight cancer. It is a
breakthrough treatment specifically for certain types of blood cancers like leukemia
and lymphoma.
How It Works:
1. Collection of T-cells: The patient’s T-cells (a type of white blood cell that fights
infections) are extracted from the blood.
2. Genetic Engineering: In a lab, the T-cells are genetically modified to produce
chimeric antigen receptors (CARs) on their surface. These receptors allow the T-cells
to specifically recognize and target cancer cells.
3. Reinfusion into the Patient: The engineered T-cells are multiplied in the lab and then
infused back into the patient’s body. These CAR-T cells can now seek out and destroy
the cancer cells.
4. Cancer Cell Destruction: The modified T-cells attach to the cancer cells and trigger an
immune response, destroying them.
Challenges:
 Side Effects: CAR-T therapy can cause significant side effects, such as cytokine
release syndrome (CRS), which is an intense immune response that can be life-
threatening.
 High Cost: It is one of the most expensive cancer treatments available, limiting its
accessibility.
 Limited Application: While highly effective in blood cancers, it is less effective in solid
tumors (like lung or breast cancer).
Example of CAR-T Therapy Success:
CAR-T therapy has led to remission in many patients who previously had no other
treatment options, especially those with relapsed or refractory cancers.
IIT Bombay’s Role:
In India, IIT Bombay has played a significant role in developing indigenous CAR-T cell
therapies to make this treatment more affordable and accessible. The development
of these therapies aligns with their partnership with Blockchain for Impact (BFI) to
drive healthcare innovation(iit bombaY).
 In May 2023, Temasek, a Singaporean investment company, invested US$ 2 billion in
Manipal Health Enterprises, a leading healthcare provider in India, highlighting the
growing interest in the Asian healthcare market.
 In September 2023, Nirma acquired a 75% stake in Glenmark Life Sciences, a
pharmaceutical company, for US$ 689 million. This transaction marked one of
the biggest Indian healthcare M&A deals of the year.

Nirma, which has roots in the detergent and consumer goods sectors, has been
actively diversifying its portfolio. By acquiring Glenmark Life Sciences, a leading
player in active pharmaceutical ingredients (APIs), Nirma has strengthened its
presence in the lucrative pharmaceutical sector. This move aligns with its long-term
strategy to expand beyond its traditional consumer goods business and leverage
opportunities in high-growth sectors like healthcare.

As the global pharmaceutical market continues to grow, especially in the generic

drugs segment, demand for APIs has surged.

This acquisition continues Nirma’s history of successful M&A deals, including its 2016
acquisition of Lafarge India’s cement business. These acquisitions reflect Nirma’s
ambitions to grow through strategic investments in high-potential sectors.

 As of October 2023, a total of 26 crore Ayushman cards have been created. To

prevent, detect, and deter healthcare fraud and to ensure that eligible beneficiaries
receive adequate treatment, the Government of India is using Artificial Intelligence
(AI) and Machine Learning (ML).
 Multinational healthcare company Abbott has committed to converting 75 Primary
Health Centers (PHCs) to Health and Wellness Centers (HWCs) in nine Indian States,
in collaboration with Americares India Foundation, a nonprofit organisation
dedicated to relief and development in the field of health. This will benefit over 2.5
million people from under-resourced communities every year.
 In November 2022, diabetes management app BeatO raised US$ 33 million in its
Series B funding round led by impact investor Lightrock India. (India is the diabetic
capital of the world, with over 77 million adults living with the condition.)
 In August 2022, Edelweiss General Insurance partnered with the Ministry of Health,
Government of India, to help Indians generate their Ayushman Bharat Health
Account (ABHA) number. Edelweiss General Insurance leveraged its digital platform
to assist people in generating their ABHA number. They made the process more
accessible by allowing users to create their ABHA number via Edelweiss's website
and mobile applications.
 As of 2023, the number medical colleges in India stood at 706.
 In July 2022, the National Pharmaceutical Pricing Authority (NPPA) fixed the retail
prices for 84 drug formulations, including those used for the treatment of diabetes,
headache, and high blood pressure. The decision to fix these prices is part of the
NPPA's ongoing efforts to regulate drug prices under the Drugs (Prices Control)
Order, 2013, which empowers the authority to ensure that critical and life-saving
drugs remain accessible to the public at reasonable prices, with chronic conditions
 like diabetes and hypertension, who require long-term medication. Include
combinations of metformin for diabetes management, atenolol and other
antihypertensive drugs for blood pressure control, and various analgesics for pain
relief.
 In March 2022, Hyderabad-based pharmaceutical company Biological E applied for
emergency use authorisation (EUA) for its Covid-19 vaccine Corbevax for the 5-12
years age group.
 As of March 2024, there are approximately 1,70,242 Ayushman Bharat Health and
Wellness Centres (AB-HWCs) established across India.
 638 e-Hospitals have been set up as part of the Digital India initiative
 In November 2021, Aster DM Healthcare(Dubai based healthcare providers)
announced that it is planning Rs. 900 crore (US$ 120.97 million) capital expenditure
over the next three years to expand its presence in India, as it looks at increasing the
share of revenue from the country to 40% of the total revenue by 2025.
 Biocon Biologics Limited, a subsidiary of Biocon (Indian company headquartered in
Bengaluru), announced a strategic alliance with Serum Institute Life Sciences, a
subsidiary of Serum Institute of India (SII). The alliance is expected to strengthen
India's position as a global vaccine and biologics manufacturing powerhouse.

GOVERNMENT INITIATIVES
1. India's union budget 2024-25 emphasizes transforming the healthcare sector through
increased digital infrastructure and a revised health expenditure of Rs. 89,287 crores
(us$ 10.70 billion)
2. Union Ministers of State for Health and Family Welfare, Mr. Prataprao Ganpatrao
Jadhav and Mrs. Anupriya Singh Patel, recently unveiled three key initiatives at the
Ayushman Bharat, Quality Health event. These initiatives aim to enhance healthcare
quality and facilitate ease of doing business in India, including a virtual NQAS
assessment for Ayushman Arogya Mandirs, an IPHS compliance dashboard for real-
time monitoring of public health facilities, and a spot food licence initiative for food
vendors.
3. Union Minister of Health and Family Welfare and Chemicals & Fertilizers Dr. Mansukh
Mandaviya, virtually launched 'MedTech Mitra,' a platform designed to support young
Indian innovators in the MedTech sector by aiding in their research, development, and
regulatory approvals, aiming to reduce import dependence and transform India into a
leading US$ 50 billion MedTech industry by 2030, while fostering indigenous
development of affordable, quality medical devices and diagnostics, in line with the
vision of Viksit Bharat and Atmanirbhar Bharat.
4. PoshanAbhiyan is a Centrally Sponsored Scheme with the implementation of the
scheme being done by States/UTs. To ensure that all Anganwadi Centres are
equipped with Smartphones and Growth Monitoring devices (GMDs) such as
Infantometer, Stadiometers, and Weighing Scale for Mothers and Infant, the Ministry
has released revised guidelines for technical specifications and replacement of GMDs
by the States.