Prioritization of Candidates for HTA: Insights from Indian Healthcare Landscape

Reimagining India's health system: a Lancet Citizens’ Commission

India's healthcare system faces significant challenges, including inadequate access to quality care, disparities in healthcare delivery, and a growing burden of non-communicable diseases. Despite substantial investments, a large portion of the population, especially in rural and underserved regions, still lacks adequate healthcare access. This paper discusses recent reforms and innovations aimed at addressing these issues, including the National Health Policy (2017) and Pradhan Mantri Jan ArogyaYojana (PMJAY), which focus on expanding access to affordable healthcare. It also explores technological advancements such as telemedicine, digital health platforms and AI-driven diagnostics that are transforming healthcare delivery, particularly in remote areas. Additionally, the paper examines the role of public-private partnerships and health insurance in strengthening the healthcare infrastructure. The future prospects of India’s healthcare system are discussed, highlighting the potential for further technological integration and policy improvements to ensure a more equitable, efficient, and sustainable system. This paper provides a comprehensive analysis of these changes, offering insights into how India’s healthcare landscape is evolving and the steps needed for future improvements. Keywords: - Innovations, Medical tourism, Digital health

Artificial Intelligence (AI) is rapidly transforming India’s healthcare landscape by automating complex processes, enhancing diagnostic precision, and improving overall accessibility. This paper analyses the evolving role of AI in the Indian healthcare system, focusing on government initiatives, regulatory frameworks, and ethical challenges. Using a qualitative and descriptive approach, it evaluates the opportunities AI offers while identifying key policy gaps that impede large-scale implementation. The study concludes with strategic recommendations for developing an inclusive, ethical, and sustainable AI ecosystem in healthcare. The findings emphasize that with strong governance, transparent data practices, and public trust, AI can strengthen the quality and reach of healthcare services across India.

India's healthcare landscape is characterized by a multitude of public and private healthcare providers, yet its health systems remain weak in many areas. Informal healthcare providers (IHPs) bridge this gap, particularly in rural India, and are deeply embedded within local communities. While their importance is widely recognized, there is a knowledge gap regarding the specifics of their social networks with actors in health systems. The aim of this study was to map the social networks of IHPs to elucidate the type and nature of their relationships, in order to explore opportunities for intersectoral collaboration to achieve universal health coverage (UHC). We have adopted the social network analysis (SNA) approach using qualitative ego-network methodology to evaluate the types and strengths of ties in the Indian Sundarbans. A total of 34 IHPs participated in the study. Qualitative data were analysed using NVivo10 and Kumu.io was used to visualize the social networks. Results show that the 34 IHPs had a total of 1362 ties with diverse actors, spanning the government, private sector and community. The majority of the ties were strong, with various motivating factors underpinning the relationships. Most of these ties were active and have continued for over a decade. The robust presence of IHPs in the Indian Sundarbans is attributable to the numerous, strong and often mutually beneficial ties. The findings suggest a need to reconsider the engagement of IHPs within formal health systems. Rather than isolation, a nuanced approach is required based on intersectoral collaboration capitalizing on these social ties with other actors to achieve UHC in impoverished and underserved regions globally.

Dr. Brij Nandan Singh Walia is a towering figure in Indian medicine, whose visionary leadership and pioneering contributions have left an enduring imprint on pediatric care and medical education. A luminary in every sense, Dr. Walia continues to inspire generations of healthcare professionals with his dedication, compassion, and transformative vision. Born in 1933 in Hoshiarpur, Punjab, Dr. Walia’s passion for science and medicine was evident from an early age. He pursued his MBBS from Mahatma Gandhi Memorial Medical College, Indore, followed by a Doctorate of Medicine (MD) and a Diploma in Child Health. This strong academic foundation laid the groundwork for a lifetime of medical innovation and institutional leadership. Dr. Walia’s most profound impact was at the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, where he served in multiple capacities as Associate Professor, Head of the Department of Pediatrics, and ultimately as Director of the institute. As the founding architect of the Advanced Pediatric Centre at PGIMER, Dr. Walia transformed the landscape of child healthcare in India, establishing a model of excellence that integrates clinical care, research, and education. He was also instrumental in securing the recognition of pediatrics as a distinct specialty within the MBBS curriculum. A staunch proponent of global best practices, he facilitated international training for faculty and introduced institutional reforms that positioned PGIMER among the foremost medical institutions in the world. As Director, his dynamic stewardship brought about sweeping advancements in infrastructure, research, and patient care. Beyond the hospital walls, his commitment to community health, equity in education, and social welfare has uplifted countless lives. Through the Bhai Jaita Ji Foundation, he supported rural students and championed initiatives for underprivileged communities. He also advocated for institutions dedicated to the care of the disabled. Dr. Walia’s legacy is not merely institutional-it is transformational, exemplifying how one individual’s vision, compassion, and unwavering resolve can redefine the future of healthcare.

Digital health for all: The turn to digitized healthcare in India.

Antibiotic resistance poses a significant global health threat, necessitating a detailed analysis of antibiotic use practices in diverse healthcare environments. This study, situated in the Indian context, scrutinizes the overall practice scores associated with antibiotic utilization. In part VI of our research series, we explore intricate patterns and factors influencing antibiotic prescription, dispensation, and adherence to guidelines within Indian healthcare setups. The findings reveal multifaceted challenges faced by healthcare practitioners, encompassing issues of overprescription, inadequate awareness among patients, and varying adherence to established protocols. By employing a comprehensive approach, this study sheds light on the nuanced intricacies of antibiotic use practices, allowing for a nuanced understanding of the Indian healthcare landscape. The insights garnered in this research can inform targeted interventions, policy formulation, and educational initiatives, aiming to enhance antibiotic stewardship in Indian healthcare settings. As the world grapples with antibiotic resistance, this analysis provides valuable perspectives essential for effective and sustainable strategies in mitigating this pressing global health concern.

In contemporary healthcare systems, the pursuit of justice intertwines with fault attribution and liability determination. The exploration of no-fault liability as a potential alternative within India's healthcare landscape delves into its feasibility and implications. Drawing from international experiences, regulatory frameworks, and societal readiness, the complexities and potential benefits of adopting a no-fault liability system are elucidated. Perspectives from patients, healthcare providers, and broader societal stakeholders are considered, highlighting both the advantages and challenges associated with such a transition. Addressing disparities in access, legal reforms, and logistical hurdles underscores the groundwork necessary for potential adoption, signaling a potential paradigm shift towardequitable compensation and accountability within India's healthcare system.

The Indian health care sector will double its size to US$ 100 billion by 2015 from the present US$ 50 billion. However, the government’s contribution on health care is minimal whereas Indian households spend a disproportionate share of their consumption expenditure on health care. The National Rural Health Mission (NRHM) intends to increase the public expenditure on health from 1.1 per cent of GDP to 2–3 per cent of GDP by 2011. This increased funding through the NRHM should be supplemented by efforts to improve efficiency in resource utilization. Health economics is increasingly recognized as a discipline that has much to offer in addressing these issues. However, the information about capacity building initiatives in terms of teaching and training in the field of health economics in India is limited. This article attempts to address this knowledge gap through a systematic research by identifying various institutions offering courses in health economics across India, their intake capacity, areas of specialization and accreditation standards. The article also attempts to estimate the demand for professionals having expertise in health economics and intends to stimulate the discussion around pertinent issues around need and demand mismatch.

Adventist healthcare in India, rooted in a 150-year global legacy of holistic well-being, emphasizes the interconnectedness of physical, mental, spiritual, and social health. Pioneering medical work began in India in the late 19th century, integrating healthcare with education and spiritual outreach, leading to the establishment of key institutions like Giffard Memorial Hospital. Today, the Southern Asia Division of the Seventh-day Adventist Church operates a comprehensive network of hospitals, clinics, and educational institutions, including the Medical Trust of Seventh-day Adventists, which manages eight hospitals and a nursing college. This network is further bolstered by extensive community health programs through ADRA India, focusing on maternal and child health, immunization, and lifestyle interventions. Despite a history of overcoming challenges such as socio-political unrest and financial constraints, contemporary issues like financial sustainability, intense market competition, healthcare staffing shortages, and regulatory complexities persist. Nevertheless, the Adventist model’s unique holistic approach, evidence-based lifestyle programs, integrated educational pipeline, and deep community engagement present significant opportunities for continued growth and impact in India’s evolving healthcare landscape. This comprehensive ministry remains dedicated to extending its healing mission, contributing to improved health outcomes and overall community well-being.

In the field of global health challenges, perinatal transmission of Hepatitis C virus (HCV) infection has emerged as a serious concern, particularly within the intricate landscape of healthcare in India. The intricate dance between maternal health, prenatal care, and the viral dynamics of HCV raises complex questions about prevention, detection, and intervention strategies. Despite remarkable progress in healthcare infrastructure, India grapples with the persistent challenge of preventing mother-to-child transmission of HCV, a phenomenon that demands nuanced exploration and strategic interventions. This review embarks on an insightful journey to highlight the multifaceted aspects of the challenge of perinatal transmission of HCV infection in India, shedding light on the existing obstacles, diagnostic dilemmas, risk factors and the imperative need for comprehensive preventive strategies. As we navigate through the intricacies of this public health dilemma, a deeper understanding of the socio-economic, cultural, and medical aspects is essential to pave the way for effective solutions and, ultimately, protect the next generation from the burden of HCV-related complications.

Exploring the potential of telemedicine for improved primary healthcare in India: a comprehensive review

Objective: This study investigates the potential of technology entrepreneurship to address critical challenges within the Indian healthcare landscape. Leveraging existing literature, we develop a novel theoretical framework examining how patients, medical professionals, and the healthcare industry interact with three key elements of technology entrepreneurship: technology innovation, technology proactivity, and technology risk-taking. Analysing these interactions across three tiers – patients, medical professionals, and the industry itself – reveals practical implications for fostering positive change. Design / Methodology: The authors have conducted an extensive review of literature focusing on technological growth in the healthcare industry and its effect on entrepreneurship development in this area. The review is primarily focused on developments in the last two decades. Consequently, the authors have proposed a framework for technology entrepreneurship development (i.e., technological innovation, technological proactivity, and technological risk-taking), which is the foundation of value creation. This concept will be dealt with at three levels, namely, patients, medical professionals and hospitals, and the entire healthcare industry. Results: Many researchers have identified that innovation, proactivity, and risk-taking are the key characteristics of the entrepreneurial journey. Each of these characteristics (innovation, proactivity, and risk-taking) has been explained with supporting examples from the healthcare industry. The paper's practical implications can be separated into three categories: those for patients (support for patients and technology-based engagement techniques), organizations (digital health solutions and collaborative motivation), and the healthcare industry (infrastructure and trust building). Conclusion: The paper has outlined the challenges and opportunities for technology entrepreneurs at three levels, namely, patients, medical professionals and hospitals, and the entire industry. Prospects for research in the near future have been also identified.

Background: Indian intensive care units (ICUs) maintain highly restrictive visitation policies, typically limiting family access to 10–15 minutes with maximum two visitors, despite mounting international evidence supporting flexible family presence. These restrictive approaches conflict with India’s collectivistic culture where extended family involvement in healthcare decisions is deeply embedded. Objective: To present an evidence-based framework for implementing flexible ICU visitation policy reforms in India’s diverse healthcare landscape, addressing infrastructure constraints, cultural factors, and resource limitations. Methods: Review of international evidence on flexible visitation benefits, analysis of current Indian ICU policies, and development of a systematic implementation framework using proven change management approaches. Key Findings: International studies demonstrate significant clinical benefits of flexible visitation policies, including delirium reduction, improved family satisfaction, and potential cost savings through reduced length of stay, with no increased infection risk. The landmark ICU visits trial showed improved family satisfaction and potential ICU length of stay reductions with 12-hour versus 1.5-hour daily visiting policies. Implementation Framework: A four-phase approach is recommended: (1) baseline assessment and stakeholder mapping (months 1-3), (2) pilot implementation in 1-2 ICU units with staff training (months 4-6), (3) full implementation across all units (months 7-12), and (4) sustainability planning. Success requires comprehensive stakeholder engagement, robust staff training programs, and context-sensitive adaptation to Indian healthcare realities. Conclusions: Evidence supports flexible ICU visitation policy implementation in Indian healthcare settings. With demonstrated patient benefits, economic advantages, and alignment with Indian cultural values emphasizing family involvement, policy reform represents a valuable healthcare improvement opportunity. The proposed framework provides actionable guidance for healthcare leaders to implement family-centered care policies that improve patient outcomes while respecting cultural values and resource constraints.

Radiology serves as a crucial pillar of modern medicine, with advancements in imaging technology continuously reshaping diagnostic and therapeutic practices. Recent technological advancements have introduced 3D reconstruction techniques to produce high-resolution anatomical models that aid in diagnosing complex conditions. This article traces the evolution of Three-dimensional printing, highlighting its applications in medical fields. Three-dimensional (3D) printing has emerged as a transformative force in radiology, bridging the gap between digital imaging and physical reality. This review explores the dynamic interplay between 3D imaging and 3D 3 printing within the Indian healthcare landscape, focusing on how these innovations enhance imaging methods and improve patient outcomes. Despite the potential of 3D printing in healthcare, the literature on its implementation in India is limited. While adoption remains in the early stages, 3D printing has shown potential in various applications. However, implementation faces significant challenges; despite the obstacles, the technology offers a unique opportunity to address India's healthcare challenges, particularly in providing personalized medical solutions to its large population. Few studies have been published, highlighting the need for greater exploration of this technology 's benefits in clinical settings. This review aims to synthesize existing research, address the challenges faced in adoption, and discuss the innovative applications of 3D printing