15-20% of income in semi-rural and rural household spent on medical expenses; 23% reply on loans and borrowing: Survey

PayNearby, India's largest branchless banking and digital network, carried out a survey titled Bharat Health Index (BHI) 2023 that highlights only 25 percent of the semi-rural and rural population in India have access to modern healthcare within their localities. The accessibility index saw a major dip as one moved from urban to rural India, with only 10 percent of the rural respondents citing that they had access to healthcare within a 10km radius.

The conclusions drawn stem from the feedback collected from over 10,000 retailers situated in semi-rural and rural regions of India during the span of a month.

One-fifth of income spent on treatment

The lack of proficient healthcare providers in remote areas presents a significant obstacle to accessibility. Merely 15 percent of participants affirmed the presence of a doctor's clinic or healthcare establishment within a 5 km radius. When it comes to medical practitioners, although 25 percent had access to general physicians in their vicinity, 92 percent faced the absence of specialized doctors like cardiologists, gynaecologists, or paediatricians, thus adversely affecting medical care.

For intricate treatments such as cancer, neurological issues, or blood disorders, a substantial 90 percent had to take a journey to a different location for medical assistance. A concerning five percent reported the loss of a loved one due to the lack of specialist doctors at their local healthcare facility. The survey also assessed the accessibility and convenience of local pharmacies. Interestingly, 52 percent of respondents had a pharmacy within a five km radius of their dwelling, facilitating access to essential medications. However, a significant 85 percent had to cover distances exceeding 10 km to procure specialised medications, indicating potential hardships for individuals with specific medical requirements.

Surprisingly, 47 percent of the participants had a thermometer at their residence, whereas a mere 7 percent possessed devices for monitoring blood pressure and blood sugar levels, implying an opportunity for enhancing self-monitoring and preventive measures.

Furthermore, the survey investigated the funding mechanisms for medical costs and explored ways to enhance affordability at the local level. According to the report, the average household in Bharat allocated around 15-20 percent of their annual income to medical expenditures. Among these, 23 percent relied on informal loans or borrowing to meet hospital costs, while 6 percent had to resort to selling assets in order to settle their medical bills. Notably, a substantial 53 percent tapped into various forms of savings to manage these financial burdens.

Anand Kumar Bajaj, Founder, MD & CEO, PayNearby, said, “Over 70 per cent of India resides in rural and semi-rural regions. This survey reinforces the urgent need to scale healthcare services for the masses.  More than 80 per cent of doctors, 75 per cent of dispensaries, 60 per cent of hospitals are concentrated in urban India, leaving out marginalised population in SURU to fend for themselves. While infrastructure scaling takes time, leveraging technology for distribution breakthroughs is crucial to cater to a wider audience. Reliable teleconsultation platforms and easy-to-use online pharmacy modules can greatly contribute. Our recently launched Health Correspondent program is a step in that direction. Together with our retailers, the mission is to spread medical awareness and create local health hubs, ensuring the reach of critical primary health services through technology.

Insurance still a novel concept in rural areas

Considering the heavy reliance on personal funds for medical expenses, the survey underscored the pressing requirement for establishing a financial framework to address the increasing healthcare costs at the grassroots level. The adoption of financial products such as insurance was identified as pivotal in enhancing the affordability and accessibility of healthcare. However, the report brought to light the alarmingly low level of insurance awareness among the underserved population in Bharat. A significant 55 percent of the participants had never even heard of insurance. Among those familiar with insurance, only 32 percent had opted for insurance at some point, and merely 28 percent possessed health insurance for themselves or their families. Of those with insurance, 88 percent obtained it through government or state-sponsored schemes, while fewer than 10 percent acquired it from private insurance providers.

For those without insurance, reasons varied. A substantial 38 percent pointed to affordability as a major obstacle, while others cited uncertainty about where to purchase insurance (36 percent) or its benefits (24 percent). Respondents identified the limited availability of health insurance providers and a lack of information (32 percent) as the primary challenges. This was closely followed by high premiums (28 percent), intricate documentation procedures (15 percent), limited coverage for specific healthcare needs (18 percent), and language or literacy barriers (7 percent).

Palpable effect of digital transformation in medical field

To enhance the overall accessibility of healthcare services, the survey also gauged the receptiveness toward online medicine procurement and teleconsultation within this demographic. Approximately 35 percent expressed interest in purchasing medicines online, 32 percent favored telemedicine consultations, and an equal 32 percent displayed enthusiasm for online awareness initiatives and online appointments for diagnostics and lab tests. This positive response toward digital integration underscores the necessity for technology-driven innovations and distribution models to expand the reach of healthcare throughout the nation.

Jayatri Dasgupta, CMO, PayNearby said, “As India celebrates its 76th Independence Day, an important yardstick to measure the health of the nation is to understand the state of health infrastructure and awareness among the country’s last mile. Affordable and accessible healthcare is pivotal for the country’s progress. PayNearby’s Bharat Health Index (BHI) 2023 initiative addresses gaps in existing healthcare infrastructure and outlines ways to enhance it.  The survey highlights the need for more trained medical professionals in rural areas, a better financial support system for medical expenses, accelerated insurance penetration, and the strategic use of technology for distribution breakthroughs.”

The survey further accentuates the limited presence of insurance within our population. To tackle this issue, increased discussions and proactive measures are essential to promote broader insurance coverage across the nation. This Independence Day, PayNearby has launched the “Risk se Freedom Pao” campaign, aimed at not only raising awareness but also removing barriers that hinder individuals from accessing insurance offerings. It holds significant importance for individuals to perceive health insurance in the correct context, ensuring a more secure and improved future for both themselves and their families.