Challenges of Universal Health Coverage in India

Challenges of Universal Health Coverage in India

Issue – Universal Health Coverage :-

  • According to WHO and World Bank statistics, approximately half of the world’s 7.3 billion people are not able to obtain the health services they need and they still lack full coverage with essential health services.
  • Every year, countless households are pushed into extreme poverty as a result of expenditure out of an individual’s pocket on his health.

World Health Day :-

  • This year, the WHO (World Health Organization) theme for the World Health Day (April 7) is “Universal health coverage: everyone, everywhere”.

World Health Day Theme - Universal Health Coverage

Universal Health Coverage (UHC) :-

  • The main objective of Universal Health Coverage (UHC) is to provide citizens access to health services without them incurring any financial hardships and being pushed into poverty.
  • UHC is one of the 17 Sustainable Development Goals (SDGs) adopted by the United Nations for eliminating poverty.

HealthCare Situation in India :-

  • 70 per cent of healthcare is provided by the private sector in India.
  • There is a large health disparity between social classes, urban and rural populations and geographical locations.

National Rural Health Mission :-

  • National Rural Health Mission (NRHM), launched in 2005, in providing accessible, affordable and quality healthcare to the rural population in terms of Reproductive and Child Health Services.
  • It has, hence, contributed significantly in reducing the Maternal Mortality Rate and Infant Mortality Rate in India.

Challenges in India :-

  • Disparity b/w Public & Private Healthcare services :-
    The first challenge is the wide disparity in the quality of healthcare services in the public and private sector as regulatory standards are neither established nor enforced properly by the Government of India.
  • Quacks & Traditional Healers :-
    ♦ Secondly, the issue of quacks and traditional healers treating patients at the grassroot level is a serious concern.
    ♦ This is connected to the poor availability of healthcare services and service providers in rural areas. The extent of harm, morbidity and mortality resulting from such treatments is devastating.
    ♦ The government has not formulated any Bill to curb these malpractices.
  • Non-affordability of Healthcare services :-
    Thirdly, the non-affordability of healthcare services is a major problem with the vast majority of our people. They are impoverished because of high out-of-pocket healthcare expenditures. They also suffer the adverse consequences of the poor quality of care. Cases of medical negligence are on the rise and unethical medical and nursing practices are also rising.

As per Constitution :-

  • As per the Seventh Schedule of the Constitution, health has been assigned to the state governments. Therefore, there is no single model for the country.
  • The MOHFW envisages the basic right to providing universal health coverage for all citizens.

What MOHFW should do ?

  • It should aim to regulate wasteful and preventable healthcare expenditure by developing a system of financing health services, and ensure access to essential medicines and technologies and a galaxy of well-trained and dedicated health workers.
  • It also encompasses formulating draft guidelines and a healthcare law for medical negligence and patient safety, strict training of medical and nursing graduates with an exit exam or licensing exam (after completion of formal medical and nursing programmes) like in the USA and European countries.

All this would help achieve

  • High-quality clinical governance
  • Regulation
  • Safety
  • Quality benchmarks
  • Focus on financial cover for health maintenance and establishing community mental health services in a diligent and proactive manner.

Suggestions to improve Healthcare :-

  • Focus on mass surveillance of ‘at risk’ and ‘vulnerable populations’ for non-communicable diseases like cancer, diabetes and hypertension.
  • Well-planned system and policy for monitoring occupational health diseases and introduction of the concept of occupational health physicians and nurses by formulating post-graduate courses for the latter are needed.
  • Provision of hazard identification units in industrial set-ups.
  • Geographical coverage for endemic diseases.
  • Introducing prevention-based health checkups at outpatient departments of every government health facility.
  • Establishing a structured and well-organised referral system in the villages, providing comprehensive services on the concept of primary healthcare.
  • Financial compensation to basic health workers working on population-based targets.

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