Can India Achieve Universal Health Coverage by 2030?

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Can India Achieve Universal Health Coverage by 2030?

Journal Title: Journal of Quality in Health Care & Economics (JQHE) - Year 2019, Vol 2, Issue 2

Abstract

Universal Health Coverage (UHC) launched by World Health Organization in 2013 is meant to promote the human right to health that would make the biggest impact on global health. Every country in the world has committed to get this done by target year 2030, so has India too. The core tents of UHC are prioritizing the poorest and vulnerable, increased reliance on public funding, reduce Out of pocket expenditures and strengthen country’s health system. Its essentials include National Health Policies, Health Financing for UHC, Health Statistics & Information system for programming, skilled health human resource, Essential drugs & supplies and service delivery, quality and safety. Sir Joseph Bhore (Health Survey and Development) committee submitted its first ever report of 1946 that was guided by the principal of ‘nobody should be denied access to health services for his inability to pay' with a focus on rural areas. That was accepted by independent India and a start was made in 1952 to setup primary health centers to provide integrated promotive, preventive, curative and rehabilitative services to the rural population, as a component of wider Community Development Program. Until seventh five-year plans Governments made a lot of radical statements, recommended progressive measures but did not take adequate action. The first ever National Health Policy was endorsed by the Parliament of India in 1983 and updated in 2002 and then in 2017. The NHPs 1&2 missed systematic health system development and encouraged plucking low lying fruits. The 7 Key Policy Shifts in NHP 2017 that might change the health of the country are: 1. Assured comprehensive care at community level that has continuity with higher levels. 2. In Secondary and Tertiary Care: From an input oriented, budget line financing to an output based strategic purchasing of secondary and tertiary care. 3. From user fees & cost recovery based Public Hospitals to assured free, diagnostic and emergency services to all public health facilities. 4. From normative approaches in the Infrastructure & Human Resource Development to targeted approaches to reach under-serviced areas. 5. From token under-financed interventions to scaling up with a focus on urban poor, establish linkages with national programs, achieving convergence among wider determinants of health under In Urban Health initiative. 6. Integration of National Health Programs with health systems for their own effectiveness and in turn strengthening health systems efficiency. 7. A three-dimensional mainstreaming of Indian system (Ayurveda, Yoga, Unani, Siddha and Homeopathy- AYUSH) of health services to contribute for the health of the people. India has also started some newer initiatives like Swachh Bharat Mission, Smart City Mission and National Nutrition Mission all of them will facilitate achieving Universal Health Care. There are multiple challenges India faces, namely i) Low public outlay so far had made it impossible for the public sector to respond to the growing health needs of the population that needs transformational initiative in health financing, public private mix in service delivery, ii) To move from sectoral and segmented approach of health service delivery to a comprehensive need-based health care service, that has been committed in NHP 2017 aiming to undertake path breaking interventions to holistically address health (covering prevention, promotion and ambulatory care), at primary, secondary and tertiary level, iii) Aggressive implementation of agreed strategies and intensive monitoring of achieving set targets by set time line and iv) The only other challenge is ensuring accountability, through good governance. We do have good plans & strategies, but accountability is missing. Accountability can be enforced only when there is clear chain of command. India has emerged as the global pharmacy for inexpensive drugs and vaccines and the goal now is to make available in every village and urban community in the next decade. Last but most important is to involve people in deciding health priorities, own interventions through IEC social mobilization and community system strengthening to lower inequities.

Authors and Affiliations

K. Suresh*

Keywords

EP ID EP746474
DOI 10.23880/jqhe-16000119
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