Universal Health Coverage for India

Context : 
Universal Health Coverage (UHC) Day is observed annually on December 12.

What is Universal Health Coverage?

• Definition: UHC ensures everyone can access quality health services they need without financial hardship.
• Core Principles: Quality and equality.
• Significance: Central to achieving Sustainable Development Goal (SDG) 3.
• Key Dimensions:
  • Quality: Health services that improve desired health outcomes.
  • Access: Availability of necessary healthcare.
  • Financial Protection: Shielding individuals from financial strain due to healthcare costs.

Origins of UHC in India

• Inspired by William Beveridge's 1942 report, which shaped the UK’s National Health Service (NHS) Act of 1946.
• In India:
  • BP Adarkar (referred to as "Chhota Beveridge" by Sardar Patel) proposed a health and insurance plan for industrial workers in 1943.
  • This led to the Employees' State Insurance (ESI) Act of 1948 and the ESI Scheme (ESIS) inaugurated in 1952.

Current Status of UHC in India

• Insurance Coverage: Only 41% of Indian households had health insurance in 2019-21, varying widely across states.
• Public Healthcare Use: 50% of households avoid government health facilities due to perceived poor quality.
• Accessibility: 60% of women face challenges accessing healthcare.
• Health Worker Engagement: Only 32% of women (15-49 years) interacted with a government health worker in the past three months.
• Health Costs:
  • 49% of households faced catastrophic healthcare expenses.
  • 15% fell below the poverty line due to healthcare costs, affecting 32-39 million Indians annually.

Why State-Specific Health Plans Are Necessary

• Varied Health Systems: India has diverse healthcare models across states.
• Differences in Expenditure:
  • Kerala spends ₹2,590 per capita, while Bihar spends only ₹701.
• Unique Health Challenges:
  • Teenage pregnancy rates are 16% in West Bengal but only 2.4% in Kerala.
  • Non-communicable disease trends vary significantly, requiring tailored approaches.

Challenges to UHC in India

• High Out-of-Pocket Expenditure: Over 50% of healthcare spending in both poor and prosperous states.
• Shortage of Primary Health Centres: 58% shortfall in primary healthcare facilities.
• Ineffective Blanket Solutions: Regional diversity in health issues demands localized strategies.

What Lies Ahead?

• Develop region-specific health plans addressing local challenges.
• Integrate public health initiatives, regional policies, and climate resilience.
• Prioritize reducing inequalities in health outcomes.
• Aim to become not just an economic superpower but also the healthiest nation.