It’s time like-minded organisations come together to forge collaborations that can catalyse public health and expedite healthcare transformation, say Sita R Budaraju and Rajni Wadhwa
The vision of a sustainable and equitable world hinges on robust human capital. Knowledge, skills and health, which enable people to realise their full potential as productive members of society, are collectively termed as “human capital.” When nations invest in areas, including health, nutrition and education, they build a wealth of human capital. A study by the Institute for Health Metrics and Evaluation found that nations with greater improvements in human capital tend to have faster growth in per capita GDP. Health is an important barometer as well as means for human capital. While India has made significant improvements in health over the last decade, there are areas that still need targetted interventions. For instance, neonatal health. India loses about 7.47 lakh newborns every year. There is also a stark interstate variation in neonatal health. While Kerala has achieved single-digit neonatal mortality rate (NMR) of five deaths per 1,000 live births, there are States, which still lose over 30 newborns for every 1,000 live births.
Although India has made strides in improving maternal mortality ratio (MMR) — from 556 per 100,000 live births in 1990 to 130 in 2014-16 — there is still a long way to go to combat the wide interstate variation. While Kerala, Maharashtra and Tamil Nadu have already achieved the target of less than 70 deaths per 1,00,000 live births (as envisaged under the third SDG), some States need intensive efforts to reach the SDG target.
MMR is one among a total of 17 SDGs adopted by the United Nations to transform society. A baseline report and SDG index launched by the UN System in India and the Government gave the country an overall score of 58, while noting that there are wide variations between the States. The value of the score indicates the average performance of the State/UT towards achieving the 13 SDGs and their respective targets. To put it in perspective, Himachal Pradesh and Kerala lead the index, with a score of 69, followed by Tamil Nadu at 66 and Andhra Pradesh, Goa, Gujarat, Karnataka and Maharashtra, all with a score of 64. With a little over a decade to go to meet the 2030 deadline, goals are still achievable if there is wholehearted commitment and effort. It has to be a shared responsibility, a tri-sector collaboration between the Government, the private sector and civil societies/non-profit organisations because the SDGs are common goals for all. Synergistic partnerships will prove to be the key driver or catalyst to drive transformation and help us reach those goals.
Recent history witnessed some powerful examples of successful collaborations between Government and development partners. The National Polio Surveillance Programme (NPSP), Zila Swachh Bharat and Swasth Bharat Prerak programmes, Karnataka Integrated Tele-medicine and Tele-health Project, Urban Slum Health Care Project in Andhra Pradesh and Mission Indradhanush are good examples of how multi-sectoral commitment and collaboration can lead to a significant impact from the ground up. We have many lessons to learn and findings to implement from these past experiences.
Today, the private sector has increasingly become a valuable partner in addressing crucial healthcare and development issues. According to the India Philanthropy Report, 2019, by Bain and Company and Dasra, private Indian philanthropy grew at 15 per cent per year between 2014 and 2018 and even outpaced public funding growth. Also, the CSR budget outlays of domestic corporations and contributions of corporate charitable trusts, combined, grew at 12 per cent during this period. While increased financial aid is a welcome sign, it is not enough. With their expertise, resources, reach and experience, the private and development sectors can accelerate the strengthening of India’s health systems together. When philanthropies and corporates forge coalitions, their impact can be synergistic and exponential. Some examples of effective collaboration include the India Health Fund, which is focussed on strengthening India’s ability to fight and eliminate tuberculosis and malaria. Similarly, under the Healthy India Alliance, organisations working on NCD issues in India have come together to catalyse multi-sectoral action to enhance quality of life.
Despite these efforts, there is still a huge scope for alliances that focus on strengthening Government health systems. It is high time like-minded organisations came together to forge partnerships that catalyse public health. Such mergers can bring in the professionals, technology, expertise, capital and research prowess that can expedite health sector transformation. And this need not be restricted to Indian companies. Global firms, which have a huge market in India, too, need to participate in this process. The national development story will remain incomplete till we invest in building robust human capital, strengthen health systems and delivery at the last mile.
(Sita Rama Budaraju is a public health consultant for Tata Trusts and Rajni Wadhwa is head, programme management unit, ASMAN)