Digital healthcare refers to the use of information and communications technologies (ICT) in medicine and other health professions to manage illnesses and health risks and to promote wellness. Digital health has a broad scope and includes the use of wearable devices, mobile health, telehealth, health information technology, and telemedicine. For India, digital healthcare presents potential as an enabler for overall improvement of health outcomes, such as:

• Health for All:

• It can ensure availability and accessibility, in remote areas through tele-consultation by using the networks of PRIS, ASHAS, SHGs and ANMs.
• It can bring affordability by providing cashless treatment to the poor by connecting them to health insurers such as- PM Jan Aarogya Yojana.

• Effective implementation of schemes and policies: Access to health data will enable government to strengthen the implementation of health programmes and policies through geography and demography-based monitoring and decision making.
• Enabling citizens to make informed decisions: Through correct information and sources, citizens can overcome challenges such as finding the right doctors, seeking appointment, payment of consultation fee etc. to avail the best possible healthcare.
• Improving quality of care: Electronic Health Records (EHRs) by putting patients’ information in digital form at one place, can help the doctor make an accurate prognosis in a shorter time.
• Digital Innovations: Artificial Intelligence based future solutions can accurately do diagnosis of various diseases besides automating and helping in various processes, thus hringing down the requirement for healthcare professionals.

However, there are various challenges in the path to realization of the huge potential of digital healthcare in India, such as:

• Structural and functional challenges:

• Transforming traditional system: Digitization of hospital governance along with patients’ record and a common platform for both public and private hospitals for sharing information are required. National Digital Health Mission can go a long way in tackling this challenge. •
• Digital divide: Many rural and tribal areas in India have low internet penetration, low digital literacy and lack of digital health infrastructure. This will require investment in health infrastructure and capacity building programmes to train health workers like ASHAS and ANMs.
• Government Hospital Infrastructure: A 2018 report on Adoption of EHR, had highlighted the shortage of ICT infrastructure with only a few major public hospitals having computers and connectivity.

• Data privacy: Digital health records can be misused by the private healthcare sector, diagnostic labs in the absence of access to a quality public healthcare system. Dealing with ethical issues, breach of privacy, and dealing with social stigma are significant challenges.
• Adoption and resistance: Patients and doctors across the globe have shown reluctance in fully adopting e-Health. Companies not only have to prepare the best technical systems but also make sure that they are easy to understand.
• Human Resources: There is a need to hire healthcare professionals with the right skills in e- health so that they are well equipped to carry out the task of providing health care remotely.

In this context, the National Health Policy 2017 envisages creation of a digital health technology ecosystem such as National Health Stack along with other measures, which are aimed at tackling various challenges and achieving SDG 3 i.e. ensuring health to all.

According to UNICEF’s The State of the World’s Children 2019 report, malnutrition was the primary reason behind 69 percent of deaths of children below the age of five in India. Further the report mentioned that every second child in India (<5 years) is affected by some form of malnutrition. This includes stunting with 35 percent of the children, wasting with 17 percent and 2 percent overweight. Among adults, 23% of women and 20% of men are considered undernourished in India. On the other hand, 21% of women and 19% of men are overweight or obese.

Reasons for prevalence of malnutrition in India

• Insufficient access to food: Though food grains yields in India have increased over the last two decades, people’s access to food grains have not increased proportionally due to population growth, poverty and inequality, and food wastage.
• Poverty: Poor families tend to select low-quality food that costs less impacting their nutrition profile.
• Infectious diseases: Poor sanitation practices and lack of access to quality healthcare facilities are the major causes for spread of infectious diseases such as measles, diarrhoea that make the children tend to lose their ability to absorb nutrients, leading to undernutrition.
• Maternal Health: One in five women are underweight in India. Women who are themselves undernourished or have a pregnancy at an early age, are at a greater risk of delivering low birth- weight babies, who are nutritionally disadvantaged right at birth.
• Socio-cultural factors: In most of the poor households, women and preschool children especially girls receive less food than the economically active male members. Rapid succession of pregnancies adversely affects the nutritional status of the mother.

To address the issue of malnutrition, the government has come up with a National Nutritional strategy that aims to reduce all forms of malnutrition by 2030, with a focus on the most vulnerable and critical age groups. National Nutrition Mission is an important component of the strategy. The mission aims to reduce stunting, under-nutrition, anemia (among young children, women and adolescent girls) and reduce low birth weight by 2%, 2%, 3% and 2% per annum respectively by 2022 and strive to achieve reduction in stunting from 38.4% (NFHS-4) to 25% by 2022 (Mission 25 by 2022). Broad contours of the approach adopted by the mission include:

• Inter-sectoral convergence for better service delivery: Ministry of Women and Child which ensures the convergence of various programmes Anganwadi Services, Pradhan Mantri Matru Vandana Yojana (PMMVY), Scheme for Adolescent Girls, Janani Suraksha Yojana (ISY), National Health Mission (NHM), Swachh-Bharat Mission, Public Distribution System (PDS) and Mahatma Gandhi National Rural Employment Guarantee Scheme.
• Use of Information Communication technology (ICT): For real time growth monitoring and tracking of women and children. Also Community Mobilization and Behaviour Change & Communication, awareness Advocacy and Information Education Communication will be done.
• Intensified health and nutrition services for the first 1000 days: The 1,000 days from the start of pregnancy until the child’s second birthday offer a unique window of opportunity to shape healthier and more prosperous futures. The right nutrition during this 1,000 day window can have an enormous impact on a child’s ability to grow, learn, and rise out of poverty.
• Jan Andolan: The mission is envisaged to become a public movement by educating people on nutritional aspects and strengthening human resources.

An effective implementation of the strategy and the mission would help reduce the burden of malnutrition in India.