Market Gaps and Challenges in Healthcare

Affordability, inequality, and infrastructure are some of the major challenges faced by the Indian people.

We need an all-encompassing vision of future demand for health services guiding this vision and roadmap for Indian health system. Further, prevention and early stage management should be a core focus area particularly in the context of the rising burden of NCDs. Such investments can significantly mitigate disease and cost burden. Constructive and transparent dialogue will be needed between public and private sectors at this early stage of the journey and the focus needs to be on efficiency, especially through better utilization and project implementation.


Some major challenges and gaps in the industry are listed below:


  1. Infrastructure gaps remain substantial, and are exacerbated by underutilization of existing resources.
  2. Health indicators continue to lag: outcome indicators like Mother, and child morbidity and mortality and life expectancy continues to lag behind. India has failed on almost all important parameters set for the millennium goals 2015. As against some parameters it has even regressed (for e.g. control of malaria) The NCD burden has grown to 53 percent of the total disease burden by 2008, according to the WHO.
  3. Health spend is not growing at the same pace as GDP, as per WHO National Health Accounts, India’s healthcare spending as a percentage of GDP has dropped from 4.4. percent in 2002 to 4 percent in 2010. India’s healthcare expenditure has grown at a slower rate than the country’s GDP.

  1. Out of pocket spending continues to be high: This is despite the fact that the public spend has increased, and implying that this public spending has struggled to keep pace with the rise in healthcare demand.
  2. Health workforce remains inadequate and underutilized: The total number of allopathic doctors and nurses in the country lags the WHO benchmark of 2.5 doctors per 1,000 population at 2,2 per 1,000. Problem of underutilization exists, with a high proportion of nurses inactive and registered medical practitioners not actively involved in the formal sector, the density of practicing workforce falls to 1.9 per 1000.
  3. We lack a holistic regulatory framework – A well-functioning and effective system is required to manage the large and diverse set of service providers in India. New legislations (e.g. the Clinical Establishments Registration Act) have been passed but implementation has lagged.
  4. PPP collaboration has not yet achieved scale: several pilots of PPP have been successful. However, none of them has been scaled up to meet India’s health challenges. While government sponsored social insurance programs have grown rapidly, nearly 75% of the population remains uncovered.

The management of some or many of the above said gaps & challenges requires a deep understanding of the multiple & varied aspects of the Healthcare Delivery system both in the Public Health and Private Sector domain.

The PGDM Healthcare Management Program offered at IFIM B School is one such holistic program that brings the candidate a diverse understanding of all aspects and components of healthcare industry that will equip them to have an innovative and solution based approach to handle these challenges efficiently.


Dr Rakesh Verma, MBBS, PGDM (UK)

Managing Director, Falcon Skills

Formerly Group Head Learning & Development, Narayana Health

Faculty Member PGDM Healthcare Management Program – IFIM B School


Learn more about IFIM’s PGDM in Healthcare Management program in association with Falcon Skills.