Emerging Health Landscape in the Small Indian Cities

India’s largest private hospital chain, Apollo plans to increase capacity by adding 2,860 more beds to its current 10,000+ tally by 2026. The expansion is planned in multiple Tier 2 cities like Varanasi and Mysuru. Meanwhile, the 2nd-largest chain, Manipal is focusing on building healthcare units with 250-325 beds that cater to a micro market. The healthcare landscape of India is undergoing a significant shift, with larger hospital chains redirecting their focus to small cities due to rising real estate costs and limited urban space. With an 83% year-on-year increase, Tier 2 cities have surpassed Tier 1 cities in medical consultations!

Meanwhile, with a network of only 11 hospitals mostly in Bihar and West Bengal, Glocal Hospitals has been extending accessible healthcare to underserved communities. In Begusarai, Glocal Hospital has provided high-quality affordable healthcare with an impressive ICU survival rate of nearly 90%. With over 85% of its patients in the Below Poverty Line category, the hospital has been honoured for its outstanding performance under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY).

Along with angiography and angioplasty, minimally invasive procedures have begun to be operated in small-town hospitals as well. Timely intervention of heart-attack cases has been successfully dealt with in Yavatmal and Gondia in Maharashtra. Despite advancements in small-town healthcare, patients often prefer treatment in larger cities due to a persistent trust barrier. Dr. Nidheesh Mishra, Secretary of Cardiological Society of India- Nagpur Chapter, plans to address this by organising academic events for small-town doctors and awareness campaigns for patients.

In February, 2 free health check-up camps were carried out in Ramdurg & Gokak in northern Karnataka. Previously, the Mahantesh Kavatagimath Foundation had also organised a health camp in nearby Savadatti, which benefited over 7,000 people. Meanwhile, Fujifilm India has partnered with GVN Hospital to introduce a mobile endoscopy unit called Endo Bus for early detection of gastrointestinal cancer across smaller cities in India. Elekta, a Swedish Med-Tech company has partnered with AIIMS to expand LINAC machines that are crucial in pinpointing & destroying cancer cells using high-energy radiation.

Furthermore, small cities are also witnessing a surge in demand for medicines post-pandemic due to increased health awareness, emerging pharma companies & government health schemes. Cipla Generics is India’s largest generic pharmaceutical, with a network of 5,500 stockists ministering to 15,000 pin codes. Mobile apps have also started facilitating remote consultations, medicine orders & lab test scheduling. MediBuddy has a network of 90,000 doctors, 7,100 diagnostic centres, 2,500 pharmacies & 8 million subscribers.

MedPay is enabling a network of over 40,000 local pharmacies to join the digital economy & cater to the needs of their customers, harmonising the market to enhance healthcare accessibility. However, last year the Ministry of Health issued show-cause notices to over 20 companies, including Tata-1mg, PharmEasy & Reliance Netmeds, in response to pressure from the All India Organisation of Chemists & Druggists. This highlighted the need for preventing monopoly over wholesale drug distributors & effective regulation in the evolving e-commerce market.

Accessibility to health in smaller cities is also growing through the home-healthcare industry driven by lower service costs, digital technology, & accessibility to insurance. Companies like HCAH & Portea Medical are tying up with insurers like StarHealth, ICICI Lombard, & GoDigit to reduce out-of-pocket expenses, offering services at 25-30% lower costs compared to hospitals.

Despite such transformations, many small cities are burdened with smaller staff & the lack of adequate equipment. They are also negatively affected by the perception that better healthcare is only available in larger cities, which leads patients to travel long distances for treatment. With increasing investments in healthcare beyond metropolitans, India’s healthcare landscape is changing slowly for the better.

Have you noticed any new developments in local healthcare services in your city? Let us know in the comments section below!