A Literature Review of the Healthcare System: Evidence From the State of Punjab, India

Introduction: Health And Healthcare System

“Health is Wealth” and good health is a valuable asset for the nation. The human resource of any country is productive only when it has good health otherwise it is a burden on the growth and development of the country. The World Health Organisation (WHO) defines health as a complete state of physical, mental and social well-being and not merely an absence of infirmity and disease (Arya, 2012; Svalastog et al., 2017). In the Constitution of India, health is given due consideration under different parts of it. The Preamble of the Constitution gives direction to the State for ensuring social, economic & political justice and health sector falls under the term social justice. Article 21 under fundamental rights guarantees protection of life and personal liberty to every citizen. Under the Directive Principles of State Policy (DPSP), Clause No.38 gives direction to the State for the promotion of the welfare of the people and Clause No.47 says that the State shall record the level of nutrition, standard of living of its people and improvement in the public health as its primary duty. Clause 51A of the Fundamental Duties states that there is joint responsibility of State and citizens to ensure maintenance of human and animal health (Mathiharan, 2003; Arya, 2012). The United Nation General Assembly in 2015 gave a collection of 17 Sustainable Development Goals (SDGs) for 2030 Agenda (Transforming our World: the 2030 agenda for sustainable development). The Goal 3 namely, Good health and well-being, ensures universal access to healthcare services, quality & affordable medicines and family planning etc. (Aftab et al., 2020).

In Indian healthcare system, services are delivered through a decentralised approach and organized by a complex network of public and private healthcare providers of states. Public sector includes Ministry of Health and Family Welfare (MoH&FW), state owned Directorate of Health Services and Department of Health and Family Welfare, and after that district-level health services which are providing a link between each state and primary healthcare services. There is lack of information for clear understanding about regulating the private sector in India as there are multiple agencies to regulate under different ministries (Thomson et al., 2013).

Method

For achieving the objectives, literature review is stepping stone towards it. It plays a critical role to critically analyse the existing knowledge and identifying research gaps in that subject (Wanjohi, 2014). A few studies have been done on the state’s public healthcare system only. There is lack of specific research on the both the public and private healthcare system of Punjab. The review is done on the basis of reliable publications that tried to contribute in the related area. To find out reliable publications, the multidisciplinary databases are accessed like EBSCOhost, JSTOR, PubMed, ResearchGate, SCOPUS, MedLine and Google Scholar are considered. The published national and international reports are also considered for the review i.e., Statistical Abstract of Punjab, Economic Survey of 2019-2020, Budget 2020-21, Punjab Human Development Report, Punjab Health Report by Directorate of Health Services, International Healthcare System Profiles, National Health Profile and other policy documents related to healthcare.

The period of study for reviewing the literature is post-independence to 2020. The reason for considering the period since independence is to make the readers understand the developments in healthcare system. The SAARC countries of which India is a member are given due consideration in the review. The keywords, ‘Healthcare’, ‘Service Quality’, ‘Financing’, ‘Patient satisfaction’, ‘Punjab’, ‘SAARC’ with Boolean characters are used for searching the articles and other published sources. From the search results, the research articles that are not concerned with healthcare utilisation, access, service quality, financing along with articles related to a specific disease or illness are excluded from the review. By following the exclusion/inclusion criteria total 21 studies are taken for this review.