India’s healthcare expansion — bridging the gap, sustainably.
9th January 2023
In the post pandemic world, the disparity between population and resources and the opportunities to bridge this gap have been the head liner in all healthcare conversations.
According to CBRE, India has one of the lowest population to bed rations in the world, that is, how many hospital beds are available per 1000 people. In accordance with this metric, Japan is at 13, China at 4.3, USA at 2.9 and UK at 2.5 and India at 1.4 — as against the current global average of 3.2 and WHO’s recommendation of 3 beds per 1000 people. India will need to 2.9 million more hospital beds by 2030 to match this global standard. If we were to break that down, we will need 1.3 billion sq. ft. space of standard healthcare facilities. Assuming the hospitals and clinics are built in accordance with the Indian Health Facility Guidelines, a superficial calculation would indicate a minimum of 8.6 million tons of air conditioning and therefore 19.8 million tons of CO2 emissions per day from healthcare HVAC alone by 2030 upon expansion of . This number while massive isn’t at all surprising as HVAC contributes to approximately 40% of the total energy consumption in a health care facility.
To tackle these infrastructural demands and their exorbitant costs, India is going big on telehealth care and digital healthcare as articulated in the Vision 2035 Public Health Surveillance in India, an advocacy for data driven healthcare system. The goal is to build a healthcare system functioning in a lean and robust manner so as to enable adequate resources for all. In adherence to this goal, as the major healthcare players start refocusing to build infrastructure in tier 2 and tier 3 cities, it is important to insist on sustainability on all fronts so as to preserve the air quality and thermal equilibrium in the less environmentally compromised parts of the country. This can be done in regard to HVAC by proper installation, frequent maintenance, and smart controls.
Hospitals have varied specifications, higher infection rates and more vulnerable populates. It is essential to ensure that we sidestep any compromises in quality of infrastructure as a trade off for resilience in the future. Opting for newer technologies like desiccant enhanced cooling systems that promise a 30–40% energy savings along with better indoor air quality and thermal comfort would be one of the ways for doing that. Setting standard protocol for maintenance ensures longevity of these systems while integrating smart control systems ensures their smooth and efficient running. Moreover, betterment in IAQ and reduction in infectious carryover scare can positively impact occupants’ performance as well. Staff, doctors, and surgeons not needing to be heavily clad in personal protection gear by effectively mitigating risk of infection can improve comfort and therefore translate to pleasant work environments and higher productivity. On the other hand, patient recovery rate is also increased as a result of better sanitation, lowered risk of infection, better resting, and an overall healing environment.
The impact of good infrastructure development is multifold — proper ventilation and air conditioning, sufficient sunlight and a perception of spaciousness are all qualities within the realm of good sustainable development that can positively impact the physical and mental health of occupants. It is an integral part in achieving India’s goal to “be a predictive, responsive , integrated, and tiered system of disease and health surveillance that is inclusive of Prioritized , emerging, and re-emerging communicable and non-communicable diseases and conditions. Readiness for actions at community, facility and health and governance systems are key aspects of the response”, as stated in India’s Vision for 2035 Public Healthcare Surveillance.
