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Published by: to_coolvishal on Oct 26, 2009
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ASSIGNMENT OF SERVICES MARKETING.ONMEASUREMENT OF SERVQUAL OF VARIOUS HOSPITALS IN JAMMU & ANALYSIS OF INDIAN HEALTHCARE SECTOR.BY:-VISHAL SHARMA.HEALTHCARE SECTOR OF INDIA.India's rapid growth has brought about many changes in demographics and lifestyle.Rising incomes, hectic pace of life and stress have resulted in a change indisease patterns, even as there is greater awareness about health and a demand forquality healthcare.Healthcare, which is a US$ 35 billion industry in India, isexpected to reach over US$ 75 billion by 2012 and US$ 150 billion by 2017according to Technopak Advisors in their report - 'India Healthcare Trends 2008'.The healthcare industry is interestingly poised as it strives to emerge as aglobal hub due to the distinct advantages it enjoys in clinical excellence and lowcosts. The industry, which was once the exclusive domain of the government, hasseen a steady participation of major corporate houses which have helped set uppremium hospitals and medical facilities across the country. The sector offersimmense potential to healthcare players as the country witnesses a rise in theincidence of lifestyle-related and other diseases. A growing elderly populationand rise in income levels are also pushing for better facilities in thecountry.Driving the sector's growth will be the health-conscious middle classwhich can afford and wants quality healthcare. Over 150 million Indians haveannual incomes of more than US$ 1,000, and many who work in the business servicessector earn as much as US$ 20,000 a year. If the economy continues to grow at thecurrent rate and the literacy rate keeps rising, much of western and southernIndia will be middle class by 2020.To meet this growing demand, the country needs US$ 50 billion annually for thenext 20 years, says a Confederation of Indian Industry (CII) study. India needs toadd 2 million beds by 2027 to the existing 1.1 million, and requires immediateinvestments of US$ 82 billion as per the Technopak Advisors report. Today Indiaoffers World Class Medical Facilities, comparable with any of the westerncountries. India has state of the art Hospitals and the best qualified doctors.With the best infrastructure, the best possible Medical facilities, accompaniedwith the most competitive prices, you can get the treatment done in India at thelowest charges.Patients from around the globe are beginning to realize theenormous potential of modern and traditional Indian medicine. Indian hospitals,medical establishments and the government of India have also realized thepotential of this niche segment and have begun to tailor their services forforeign visitors. International marketing divisions have been set up by most ofthe top India Hospitals like Apollo, Max, Fortis, Wockhardt, etc.At a regionallevel, this nascent healthcare industry came to limelight with the arrival of'Naby Noor' from Pakistan, who came for her Heart Surgery treatment to a hospitalin Bangalore. Quite a few Indian state governments have with time, realized thepotential of this 'Healthcare industry' and have been actively promoting it.Visitors, especially from the United States of America, United Kingdom and themiddle-east find Indian hospitals a very affordable and viable option to copingwith insurance and National medical systems in their respective countries.Travellers prefer to combine their medical treatments with a visit to the 'exoticeast' with their families, visiting places like the Taj Mahal in Agra, the palacesin Rajasthan, the serene beaches in Goa and the mountains of Kashmir and thebackwaters of Kerela among others. The total price of an overseas treatment withairfare, hotel accommodation and even a few days of vacation is often far lessthan just the procedure cost back in the US or UK.
The year 2003 and 2004 saw a trickle of tourists from the healthcare systems ofwestern countries seeking medical treatment in India. By the year 2005 and 2006this became a deluge, much of it propelled by a blast of free publicity fromprogrammes like 60 Minutes.Judging by the buzz in the hospital circuit, it won't be very long before everycosmopolitan private hospital offers yoga, ayurvedic massages, aromatherapy,mudbaths, pranic healing, reiki and meditation classes. With time more and morevisitors will flock to this part of the globe for their treatment and relaxationneeds.HEALTHCARE STATUS DEFICIENT IN STATETribune News ServiceJammu, February 12Though the state government has initiated various efforts to upgrade two of itspremier health institutes on the lines of the All-India Institute of MedicalSciences (AIIMS), the healthcare structure in the state cannot provide standardhealthcare facility to majority of its people.As per official documents, there are only 3,698 health centres in the state whereone health institution caters to a population of 3,127 persons. Further disturbingfigures are that in Jammu and Kashmir, there is only one doctor against apopulation of 2,266 persons.Pointing a finger on the poor healthcare infrastructure in the state, the reportshows that against a population of 1 lakh, there were only 108 beds available inthe hospitals. Commenting on the healthcare infrastructure, the report states thatthough there had been a steady increase in healthcare infrastructure sinceindependence, yet the state faced shortage of infrastructure both qualitativelyand quantitatively.To augment the healthcare infrastructure and to provide better health care to thepeople, the state government has projected the additional requirement of 1,288healthcare institutions of various categories from the Centre.The state is also contemplating to establish a super-speciality hospital under thepublic private partnership mode, in this context the state government has alreadyapproached the Apollo and the Fortis group.Another major aspect which the report points out is the low awareness level ofHIV/AIDS among the people. “The HIV/ AIDS awareness level among people is quitelow as compared to other states,” the report reads out. The state also has a lowercouple protection rate, only 15.9 percent as against the 46.6 percent at thenational-level.The state health department also suffers with a deficiency of 2,922 MBBS doctors,and little is being done to fill in the vacancies. A proposal worth Rs 1051.57crore to upgrade the healthcare scenario of the state has been forwarded to theGovernment of India for its approval.“As a major step to provide better healthcare in the tertiary health sector, theGovernment Medical College, Jammu and Srinagar, have been approved to upgrade tothe level of AIIMS at an estimated cost of Rs 120 crore each with a share of Rs 20crore under the Prime Minister’s reconstruction plan,” the report reads.HEALTH SECTOR REFORM IN INDIA.The decade of the 1990s is seen as a marker for the beginning of health sectorreform in South Asia. These reforms are premised on four cardinal marketprinciples that shifted the discourse from the centrality of public provisioningto greater role for markets. The four cardinal principles were:1.Individual, charities and private organizations should be made responsiblefor health care2.Public funding must be restricted to health promotion and prevention ofdisease3.Central government’s role should be restricted to policy formulation and
technical guidance, with delivery of services left to the private sector and localauthorities4.Private and non governmental sector should be supported to become the keyproviders of health and social services.It is these principles that guided the design of health sector reforms acrossSouth Asia with the active support of multilateral and bilateral agencies. Mostof these countries initiated reforms in the 1990s and has been guided by a similardesign for these reforms. This paper presents some of the similarities andvariations with these reforms across South Asia and explains it terms of thecomplex interaction between a variety of factors like the role of global actors;the character of the state; domestic capital and the growth of middle classes.1.Global actors that include bilateral and multilateral agencies,pharmaceutical, medical equipment industries, insurance company and researchinstitutions. These actors have played a critical role in shaping health policiesacross the world.2.The role of the state in each of the countries, especially in terms ofsocio-political contexts; investments in social sectors especially public healthservices.3.The role of domestic capital in the provisioning of health services,pharmaceutical, medical equipment and insurance sectors within each of thesecountries4.The growth and role of the middle classes, their influence on both thesupply and demand for public and private health services (Baru, 2003).History of Health Service Development in South AsiaAll the countries in this region have a shared history of being former colonies ofthe British and have varied socio-political contexts and welfare provisioning.Although all these four countries belong to the same region, they presentvariability in terms of size, population, political regimes and state investmentin welfare schemes. Amongst all the South Asian countries, historically, Sri Lankahas the strongest tradition of welfarism followed by India while Pakistan andBangladesh have weaker welfare provisioning. These factors reflect the variationsin access to basic needs and subsequently health outcomes. While the indicatorsof Sri Lanka are on par with developed countries, Bangladesh, Pakistan and Indiafare poorly when compared to Sri Lanka (HDR, 1999)Table 1: Health Status Indicators of Countries in South AsiaCountriesLife Expectancy at BirthInfant Mortality Rate (per 1000 livebirths)Maternal Mortality Rate(per 100,000 live births)Child Mortality RateBangladesh58 years81850112Pakistan60 years38340136Sri Lanka73 years16140 19India62 years70570 73Source: Human Development Report, Delhi, Oxford University Press, 1999.The health sector reform has privatization at its core and the restructuring ofpublic sector through the introduction of market principles. This trend isclearly discernable across South Asia the outcome varies depending on theinteraction of factors discussed above.Role of the State in Public Provisioning of ServicesThere is variation in the extent and nature of state involvement in ensuringaccess to basic needs including health services across countries in this region.In Sri Lanka the role of the state was central wherein ‘public action and stateresponses had politically and socially constructed health care as a public good, abasic right for all citizens.” (Mills, 2002: 217). This was a result of a strong

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