Expanding Access to Diagnostics: Building a Resilient Ecosystem for India’s Last Mile
About the Author: Anshu Raina, Manager – Climate Health & Environmental Innovation at Villgro, member of NATHEALTH, brings a multifaceted background in healthcare innovation, diagnostics, and life sciences research. At Villgro, she previously served as a Senior Analyst and earlier at the IIT Delhi’s FITT, she facilitated academic innovation and tech commercialization. As a Management Intern at DBT-BIRAC, she supported national biotech programs like the BIG scheme. Anshu also has research experience at NCCS Pune and CSIR-NCL.
Diagnostics are the foundation of quality healthcare, allowing for timely detection, treatment, and prevention of disease. India’s diagnostics industry is well set for explosive growth, reaching USD 20 billion by 2026, yet access is uneven, with rural, remote, and climate-risk populations frequently suffering consistent barriers, leading to delayed or avoided diagnoses and inferior health outcomes. This gap needs to be bridged in order to achieve equitable healthcare and a resilient health system.
Challenges in Last-Mile Diagnostics
The most significant challenge is that there is a dearth of infrastructure and access in remote and rural areas. Most of these areas lack proper diagnostic facilities because they are geographically remote, have unreliable transport systems, and periodic disruptions due to floods, droughts, or extreme weather conditions. Such constraints generally deny people even elementary diagnostic tests.
Inconsistencies in quality and regulations complicate the issue further. India’s diagnostics industry is regulated by piecemeal legislation and inconsistent quality parameters. This patchwork of regulation contributes to non-uniform service delivery, particularly in remote areas where assurance mechanisms for quality are inadequate or nonexistent.
Workforce constraints contribute to the difficulty. Chronic shortages of trained professionals able to use diagnostic equipment and interpret test results exist in rural settings. Skilling initiatives have not yet successfully harnessed the energy of local communities, especially women, who could be effective healthcare brokers if properly trained.
Further, the potential of digital health is yet to be realized because of infrastructural bottlenecks. Poor internet connectivity and poor levels of digital literacy in rural districts constrain the efficient deployment of tele-diagnostics and digital health records. Climate change has further added complexity, shifting disease patterns and the frequency of extreme weather events that affect the delivery of healthcare services.
Strengthening Diagnostics Access: A Multipronged Strategy
To overcome these hurdles, India has to embrace a “One Nation, One Diagnostics” strategy. Having one single regulatory environment with uniform quality and safety standards will facilitate scaling up innovative and mobile diagnostics models from state to state. This would provide a floor of quality even in the poorest settings.
Promoting diagnostic service deployment in rural and climatically affected areas will also need to be supported through targeted incentives. Initiatives like GST exemptions, subsidies, and corporate social responsibility (CSR) initiatives can drive the use of low-cost and portable diagnostic options that are appropriate in local settings.
Workforce development should be a keystone of any policy. Skill India-type national skilling programs need to be scaled up to skilled train the local youth and women as diagnostic technicians and community health workers. Strengthening the community also addresses workforce shortage, as well as building trust and enhancing service utilization at the community level.
Digital platforms hold vast possibilities for filling diagnostic gaps if the infrastructure beneath is fortified. The convergence of diagnostics data with national platforms like the Ayushman Bharat Digital Mission (ABDM) is possible, which can allow real-time monitoring of disease, enable optimal resource utilization, and facilitate quicker public health responses.
The Power of Partnerships
Collaborative models that engage the government, private sector players, and community actors are increasingly crucial in enhancing diagnostics access. Public-private-community partnership models have been found to be successful, especially in climate-risk exposure zones. Examples like community health entrepreneurs (CHEs), which equip local women with portable diagnostic kits for doorstep delivery of services, best illustrate how localized, inclusive solutions could supplement traditional healthcare systems.
These models not only bring diagnostics to the doorstep of people but also build resilience and community ownership. Combined with scalable technology, these partnerships have the potential to act as replicable models across states and varied geographies.
Outlook
India’s vision for universal health cover relies on providing quality diagnostics to all parts of the country. By emphasizing combined standards, special incentives, capacity building of the workforce, digital convergence, and cooperative partnerships, we can establish a diagnostics ecosystem that is inclusive and resilient. The destiny of diagnostics is scalable, community-based solutions that operate in harmony with public health systems so that no one is left behind.
*The views expressed by the author are her own.
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