India is ranked among the top 10 medical tourism destinations in the world. According to a 2024 report in The Times of India, 2023 data from the Ministry of Tourism shows that a significant portion (22.7%) of visitors from West Asia, travelled to India for medical purposes. Despite the challenges posed by the COVID-19 pandemic, the India Medical Tourism Market showed resilience with an estimated value of USD 7.69 billion in 2024. The future forecasts also predict growth with a projection to reach USD 14.31 billion by 2020 as reported by the Mordor Intelligence report on the Indian medical tourism market.
While, on one hand, medical tourism is booming in India, what is the actual status of healthcare within the country? Is quality healthcare within the reach of the common man? Studies show that India is grappling with the issue and facing its own set of unique challenges in the delivery and accessibility of healthcare in urban and rural areas.
Urban healthcare
According to a paper, ‘Urban Health – unique problems, need unique solutions’, by Dr Sanjiv Kumar, a large chunk of poor population has moved into environmentally deprived urban areas which are overcrowded, have no access to safe water, sanitation, safe accommodation and often lack access to basic services. The urban population in India has increased from 28.53% (2001) to 31% (2011) and projected to be 46% (2030). It is estimated that 30 to 40% of the population in metros lives in slum or slum like habitation.
Overcrowding, poor sanitation, increase in lifestyle diseases, rise in accidents and injuries, and affordability as well as lack of access to quality healthcare are other factors affecting the urban population. And that’s an issue that needs to be addressed as the urban population in India has increased from 28.53% (2001) to 31% (2011) and is projected to touch 46% by 2030. It is estimated that 30 to 40% of the population in metros lives in slum or slum like habitation.
“Studies done the world over show that once people reach the age of 65, the life expectancy for women is 22 years and men is 17 years,” says Dr A V Srinivasan, Emeritus Professor, Tamil Nadu Dr. M.G.R. Medical University and former head and professor of neurology, Madras Medical College. “After 60, many people suffer from diseases, which I categorise as A (arthritis, acidity, Alzheimers), B (blood pressure), C (cancer, cerebrovascular accidents, cardiovascular instances, coronary artery disease), D (diabetes, depressive, dementia) and E (elevated cholesterol and epilepsy. These disorders are common in urban areas where stress levels are high.”
Rural areas and healthcare challenges
There is a limited availability of healthcare facilities in rural India. Many villages lack even the most basic healthcare infrastructure, such as primary health centers (PHCs) and hospitals, says a report published on IIHMR Delhi. This results in residents having to travel long distances to seek medical care, often at great personal and financial cost.
There is also a shortage of healthcare personnel, financial barriers as the expenses involved in transportation and treatment can deter rural populations from seeking healthcare.
There is also limited awareness about preventive healthcare practices and need to seek medical attention immediately. This is further hampered by culture and traditional practices that may delay people from seeking modern medical care.
“In rural areas, people suffer from water-borne diseases, diarrhoea, and poor maternal care,” says Dr Srinivasan. “Alcohol, beeda, cigarettes also cause health issues.”
Common healthcare challenges in India
There are disparities in the quality of care between public and private sectors. Public facilities often lack resources. Many people, especially in low-income brackets, lack health insurance, leading to financial hardships due to medical expenses. Both urban and rural areas face challenges from communicable diseases, non-communicable diseases and emerging health threats.
Policy implementation is another challenge though various government initiatives have been launched for more effective delivery of healthcare services.
According to a 2024 article in The Times of India, nearly 80% of public health facilities in India do not meet the minimum essential standards for infrastructure, manpower, equipment and other benchmarks set by the government. This was revealed in a self-assessment exercise carried out by the government in which public health facilities in states and union territories covered under the National Health Mission were asked to fill in details, such as the number of doctors, nurses or basic medical equipment they have.
“We have to update healthcare delivery institutions in urban and rural areas. Affordability is another factor – the rich can go to corporate hospitals, and the poor can go to the general hospitals, but the middle class find it difficult to go to either,” says Dr Srinivasan, adding that doctors are also heavily burdened, which affects the quality of healthcare delivery. “Government facilities are crowded. Usually there are 10 doctors to attend to 200 patients in the OP. So they can spend roughly five to 10 minutes with each patient.”
Government initiatives to ensure healthcare delivery
India has implemented several government healthcare policies aimed at improving access to healthcare for the poor and vulnerable populations. Ayushman Bharat, launched in 2018, aims to provide health insurance coverage of up to ₹5 lakh per family per year for secondary and tertiary care hospitalisations. It targets poor and vulnerable families and is one of the largest healthcare programmes in the world.
The National Health Mission (focuses on strengthening healthcare delivery, especially in rural areas. It includes programmes for maternal and child health, disease control and improving healthcare infrastructure.
Pradhan Mantri Jan Arogya Yojana (PM-JAY), which is a part of Ayushman Bharat, provides cashless and paperless access to healthcare services for eligible families, facilitating treatment at empanelled hospitals.
Need for doorstep delivery of healthcare services
“Everywhere, the challenge is having adequate human resources. We need qualified doctors and trained medical personnel as there is a huge dearth,” says Dr Amar Agarwal, chairman, Dr Agarwal’s Eye Hospitals group.
He also believes in taking healthcare to the doorstep. “That’s something we have been trying to address. We need to create hospitals in every location. For instance, if a person is at the Chennai airport and needs an eye surgery they have to travel an hour to reach our main hospital but that will be overcome if we have hospitals in every location,” he says, adding that they are tying up with medical practitioners across the country to achieve this goal. “The doctors need to only focus on the medical part of it, we take care of everything else, whether it’s infrastructure or the daily running of the facility. We are opening a hospital a week in urban and rural areas to deliver eye care to the doorstep.”
NGOs play a vital role
The government, private sector and NGOs have to work hand in hand to address the challenges and to ensure that quality healthcare is accessible to all.
For instance, Smile Foundation’s healthcare intervention provides primary healthcare facilities at the doorsteps of the underserved communities in the identified rural areas and urban slums. The aim is to reach the vulnerable population who cannot afford basic healthcare facilities.
Two new technology platforms have been integrated in the healthcare programme. ReMeDi, an integrated telemedicine solution, enables teleconsultation where doctors are remotely connected to see patients, talk to them, and access past medical records. The device enables doctors to conduct over 30 point-of-care diagnostic tests in real-time. Results from these tests are transmitted automatically to the EMR. Doctors can prescribe medicines and also refer for follow-up visits and continuous care.
Health Cube, a state-of-art portable diagnostic system, provides results in three to 30 minutes for over 30 tests across various parameters. The system allows smart diagnostics and artificial intelligence to facilitate rapid screening of patients.
“We are leveraging technology to bring healthcare closer to underserved communities. By integrating solutions like ReMeDi for telemedicine and Health Cube for rapid diagnostics, we ensure timely and accurate medical care right at the patient’s doorstep.” shares Satnam Singh, General Manager of Smile Foundation’s health programme.