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EDITORIAL ANALYSIS : Curbing individualism in public health


Source: The Hindu

  • Prelims: Current events of national importance, undernutrition, PDS, PMJAY etc
  • Mains GS Paper I & II: Social empowerment, development and management of social sectors/services related to Health and education, NEP etc


  • A failure to examine and interpret public health problems from a population perspective is leading to ineffective and unsustainable solutions as far as complex public health problems are concerned.



Public Health:

  • It is the science of protecting the safety and improving the health of communities through education, policy making and research for disease and injury prevention.


  • It denotes insufficient intake of energy and nutrients to meet an individual’s needs to maintain good health.

Methods used for undernutrition:

  • Micronutrient supplementation
  • Food fortification

Solutions needed:

  • Strengthening of the Public Distribution System
  • Supplementary nutrition programmes and Health services

Method used for chronic disease control:

  • Early diagnosis and treatment

What should be the solution?

  • Modify health behaviors (through organized community action).


  • It is used to describe holistic, person-based approach to tailoring treatment.

 Determinants of individualism:

  • Dominance of biomedical knowledge and philosophy in the field of public health with a misconception that what is done at an individual level, when done at a population level, becomes public health.
  • Visibility of health impacts among the general public: Health effects are more visible and appear convincing at the individual level
    • Improvements at the population level will be clear only after population-level analysis.
    • This needs Certain level of expertise and orientation about society: an important skill required for public health practitioners.
  • Market’s role and the effect of consumerism in public health practice: The beneficiaries for a programme become the maximum when 100% of the population is targeted.
    • Population perspective: the actual beneficiary will reduce to only 5%-10% in case of hospitalization services and 20% of those affected with COVID-19 for treatment needs.
    • Make efforts to supply evidence of the actual prevalence of public health problems, instead to cast a wide net and cover 100% of beneficiaries.


Public health programmes with individual oriented approach:

1.Pradhan Mantri Jan Arogya Yojana (PMJAY)Ayushman Bharat:


  • It is the largest health insurance scheme in the country covering hospitalization expenses for a family for ₹5 lakh a year.
  • It ensures ‘free’ curative care services for all kinds of hospitalization services.


Issues Involved:

  • Need for hospitalization: It does not talk about the need for hospitalization services per year for any population.
  • Individualistic response to the problem of hospitalization expenditure faced by populations.
  • National Sample Survey Organisation: Only 3% of the total population in India had an episode of hospitalization in a year.
  1. 2. Approach to vaccination for COVID-19:
  • COVID-19 vaccine cannot prevent people from getting the disease but only reduce hospitalization and deaths in the event of contracting COVID-19.
  • 20% of the total COVID-19 positive cases needed medical attention:
    • 5% needing hospitalization
    • 1%-2% needing intensive care (ICU) or ventilator
  • Approach used:
    • Focusing on a vaccination programme for the entire population: individual vaccination approach.

Issues Involved in the approach:

  • Most of the deaths due to COVID-19 were due to failure to offer ventilator and ICU support services to the 1%-2%
  • Curative care provisioning is never planned at an individual level as epidemiologically
    • Every individual will not necessarily need curative care every time.


Way Forward

  • There is a strong tendency in public health to prioritize individual-oriented interventions over societal oriented population-based approaches.
  • Population-based health-care planning: The Government needs to ensure health-care facilities to only 3%-5% of the population to cover all the hospitalization needs of a population.
  • To effectively manage COVID-19: We needed to have primary, secondary, and tertiary health-care facilities to manage the above proportion of cases.
  • The morbidity profile of a population across age groups: It is an important criterion for the curative care needs of a population.
    • There is large-scale data that points to this need and can be estimated across populations.
    • The need of the population as a single unit needs to be considered.
  • All forms of individualistic approaches in public health need to be resisted to safeguard its original principles of practice, viz. population, prevention, and social justice.



Q. Besides being a moral imperative of the Welfare State, primary health structure is a necessary precondition for sustainable development.” Analyze.(UPSC 2021) (200 WORDS, 10 MARKS)