Problems in the Health Care System

According to Arvind Kasthuri there are five challenges to Healthcare in India – The Five A’s

  1. Awareness or the lack of it: – Behaviors, such as losing weight and stopping smoking, may be indirectly encouraged by the health care system through lifestyle advice.
  2. Access or the lack of it: -Access to the health care delivery system affects health behaviors. For example, obtaining a regular Pap smear, getting mammograms, and receiving immunizations for childhood diseases depend on access to health care.
  3. Absence or the human power crisis in healthcare- India has only 0.75 psychiatrists per lakh population largely concentrated in urban areas even though nearly 70% of the country’s population resides in rural areas, against the desirable 3 per lakh population- a deficit that would take at least 42 years to meet given the current pace of psychiatric education in the country.
  4. Affordability or the cost of healthcare:– Health care costs are rising rapidly, particularly for prescription drugs and for hospital and nursing home care.
  5. Accountability or the lack of it: – Medical research in the country needs to be focused on drugs and vaccines for tropical diseases which are normally neglected by international pharmaceutical companies on account of their limited profitability potential. The growth of health facilities has been highly imbalanced in India. Rural, hilly and remote areas of the country are under served while in urban areas and cities, health facility is well developed. The SC/ST and the poor people are far away from modern health service.


Kasthuri A. (2018). Challenges to Healthcare in India – The Five A’s. Indian journal of community medicine : official publication of Indian Association of Preventive & Social Medicine43(3), 141–143.

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