Edition 28 | January 26, 2023

Dear Friends,

We are delighted to present to you the next edition of the monthly newsletter by the Lancet Citizens' Commission on Reimagining India’s Health System. This week's newsletter covers the future trends of Indian healthcare, explores AI's advancements in healthcare, and emphasizes the enduring role of physicians. We delve into how 2024 will look in terms of universal health coverage, the strides taken in AI and its potential to improve diagnostics and streamline processes, and the central role of physicians despite technological advancements.

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This Month's Highlight

Balance AI and human intelligence for better healthcare

AI has already started making its presence felt in many areas of healthcare. The rush to extend its use to the whole spectrum of healthcare is spurred by several expectations: improved diagnostic and prognostic assessment; accurate risk prediction models for personalized healthcare and ‘precision’ public health interventions; better design and delivery of treatment protocols; relief from laborious documentation for doctors and nurses; increased efficiency of hospital management and health insurance systems; engaging interactions with patients; creation of ‘virtual medical assistants’; enhanced quality and pace of medical research; and sped up design and development of new therapeutic agents, writes K. Srinath Reddy.

Views & Opinions 

Take PMJAY to the next level

Given its funding limitations, PMJAY has not yet moved towards total health system financing in any part of the country, but its move towards paying hospitals on a package basis and not on a procedure-by-procedure basis has shown beneficial impacts, writes Nachiket Mor and Shuchin Bajaj.

Shaping India's healthcare future: Trends in 2024

The landscape of Indian healthcare is undergoing rapid advancements, with notable changes anticipated in 2024. Among these changes are groundbreaking developments in preventative care and wearable technologies, the transformative influence of IoT, ML, and AI in healthcare, an increase in Electronic Health Records (EHR), and the growing prominence of geriatric healthcare as a key specialty, among others, writes Vivek Desai.

Human resources for health

Health is one of those services which, even with all the AI/LLM developments, will perpetually need a human interface. There is, therefore, always an ongoing debate about how we meet gaps in the availability of human resources for health, writes Nachiket Mor.

What ails India's approach to Universal Health Coverage

From poorly maintained registers of doctors to an opaque style of functioning of regulatory bodies, a study by the Vidhi Centre for Legal Policy on Universal Health Coverage Day finds how the present system ends up posing hassles for doctors and patients alike, write Shreyashi Ray, Rituparna Padhy, Nihal Sahu and Kim D’Souza


Extending Kingdon's multiple streams policy framework through an analysis of how community health workers are driving policy changes

This study aims to develop and provide a novel account of the process through which the Accredited Social Health Activists (ASHAs), a cadre of seemingly powerless community health workers in India, are navigating a complex policy process to incrementally achieve their goals. ASHAs have been demanding better working conditions, better compensation, and regularisation as public service employees through protests and strikes and have managed to gain concessions from both the Central and various State governments. The study observed that two important aspects emerged: (a) ASHAs achieved incremental increases in their wages despite being the lowest in the health system hierarchy, and, (b) major gains were made during the 2 years of the pandemic. It examines and analyzes ASHAs’ engagement and strategies used, both overt and covert, sometimes with the government, and the role of other actors in determining these policy outcomes, write Sanjana Santosh and Sumit Kane

A critical analysis of newspaper accounts of violence against doctors in India

This paper presents a critical analysis of newspaper articles (N = 60) published in a leading vernacular newspaper about violence against doctors in India. Three overlapping key themes emerged from the analysis, namely the narrative of victimization, the changing doctor-patient relationship, and the crisis facing the ‘noble profession’ of medicine. The study highlights how the findings are not merely the dominant ways in which the rise in incidents of violence against doctors is reported and is understood in society, but how media might have shaped the popular discourse around the issue and why. The analysis reflects on what the reportage says about the state of the medical profession and its standing in society in India, write Mayuri Samant, Micheal Calnan and Sumit Kane

Featured Partner

The Swasth Alliance is a collaborative that leverages digital technologies to drive healthcare inclusion and better health outcomes. They are currently anchoring the community-led development of Health Claims Exchange: a set of common e-insurance claims exchange specifications along with a digital platform to enable this exchange. Swasth is supporting the doctors' survey as part of the Commission work.

Help us develop a roadmap to achieve universal health coverage in India by visiting our website: https://www.citizenshealth.in/

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We love hearing back from you! Please send your comments, suggestions, and contributions for these newsletters, including research highlights and published features to [email protected]

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