Universal Health Coverage: Definition, Present Situation and Recommendations

What is universal health coverage?

• Health is a vital public good and basic human right.
• WHO definition: Universal Health Coverage means ensuring that everyone, everywhere can access essential quality health services without facing financial hardship.

सार्वभौमिक स्वास्थ्य कवरेज: परिभाषा, वर्तमान स्थिति एवं सिफारिशें

Health sector in India: Present Situation

• India spends around 1% of GDP on health.
• Sri Lanka, Bangladesh and Bhutan perform better in various health indicators.

• The budgetary allocation of Ayushman Bharat is also far low from the par level. Moreover, the scheme is for the financially weaker section, the middle class is still at risk.

• The commitment of govt to spend 2.5% of GDP as envisaged under National Health Mission is yet to be implemented.
• Only one fifth of the hospitals are in rural areas. Also, doctors are in the ratio of 3.8:1 (urban:rural).
• India’s ranking in Human Development Index remained constant—131 position 2020 among 185 countries—in last 4 yrs.
• According to the Ministry of Health and Family Welfare, more than 57% of doctors are not qualified.

Health sector India: Recommendations

• Need for comprehensive health care model. Issues like Gorakhpur incident, Delhi pollution, Punjab narcotic crises should not be dealt in isolation.
• Promote health literacy among the masses. Even WHO calls to promote it.
• Investment in health sector gives huge return in the future in the form of human capital.
• Need for a centralised health agency to coordinate with multiple departments.
• Japan’s experience in providing the UHC (Universal Health Coverage) to its people can help India.
  • Japan established research and control centre on diarrhoea in Kolkata.
  • Cooperated in strengthening urban health cooperation in Tamil Nadu.
  • Japan worked with India in eradicating polio. In return, Japan could take help in the areas like Ayurveda.
• Regulation needed in the way the prices of drugs are set. More focus should be given to generic drugs.
• Need to renew code of medical ethics.
• Need to reduce price of various medical equipment and normalise GST rates for medicines.
• Need to promote e-pharmacy to bring competition in the market, with regulation.
  • The brick-and-mortar model of medicine selling (medical shops) led to cartelisation and thus affected the competition in the market.
• Need to ensure accessibility, quality, and affordability while promoting digital health.
• WHO recognizes self-care interventions as a means to expand health service.

Health issue in India: Way forward

• Right to timely medical treatment in government hospitals is a Fundamental Rights under Article 21.
• Article 47 under DPSP of Indian Constitution calls for states action to improve public health.
• Ensuring Universal Health Coverage will also contribute significantly n achieving the targets under SDG 3.

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