Universal Health Coverage

Relevant for sociology optional Paper- 2 & GS Mains Paper- 2

Universal Health Coverage (UHC) is a fundamental right that every human being should have access to. It is a global movement towards ensuring that all individuals and communities receive the quality health services they need without suffering financial hardship. It is a framework for providing health services that is not only accessible but also affordable to everyone, regardless of their economic or social status. The concept of UHC has gained significant attention in recent years, especially in low- and middle-income countries like India.

India is home to over 1.3 billion people, making it the second most populous country in the world. Despite its economic growth and progress in various sectors, the country’s healthcare system still faces numerous challenges. The need for UHC in India is more significant than ever before, given the ongoing COVID-19 pandemic, which has exposed the gaps and deficiencies in the country’s health infrastructure. The pandemic has highlighted the urgency of improving the overall health system, which is essential to protect the population from future health crises.

UHC in India is defined as ensuring that all people have access to the health services they need, of sufficient quality to be effective, without suffering financial hardship when paying for them. The government of India has launched several initiatives to achieve UHC, including the Ayushman Bharat Yojana (ABY), which aims to provide health insurance coverage to more than 500 million people in the country. The ABY is the world’s largest government-funded health insurance scheme, covering over 10 crore (100 million) families across India.

The ABY has two components: the Pradhan Mantri Jan Arogya Yojana (PM-JAY) and the Health and Wellness Centres (HWCs). The PM-JAY provides cashless health insurance cover of up to Rs. 5 lakhs (approximately $6,800) per family per year for secondary and tertiary hospitalization. The HWCs are aimed at providing comprehensive primary healthcare services, including non-communicable disease prevention and management, maternal and child health services, and mental health services.

The ABY has been successful in providing health coverage to millions of people across the country. According to the National Health Authority (NHA), as of August 2021, more than 2.4 crore (24 million) hospitalizations have been authorized under the PM-JAY, with a total amount of over Rs. 35,000 crores (approximately $4.7 billion) being spent on healthcare services. The HWCs have also been successful in providing primary healthcare services to people in rural and remote areas of the country.

However, there are still several challenges that need to be addressed to achieve UHC in India fully. One of the significant challenges is the shortage of healthcare workers, including doctors, nurses, and other healthcare professionals. According to a report by the World Health Organization (WHO), India has a shortage of 600,000 doctors and 2 million nurses. The shortage of healthcare workers is particularly acute in rural and remote areas of the country, where access to healthcare services is limited.

Another challenge is the lack of adequate healthcare infrastructure, including hospitals and diagnostic facilities. According to a report by the National Sample Survey Office (NSSO), only 28% of rural households and 37% of urban households have access to inpatient healthcare services within 5 km of their residence. The lack of adequate infrastructure is a significant barrier to accessing healthcare services, especially for people living in remote and rural areas.

The cost of healthcare is also a significant barrier to achieving UHC in India. Despite the ABY’s success in providing health insurance coverage to millions of people, the out-of-pocket (OOP) expenditure on healthcare remains high. According to a report by the NHA, the average OOP expenditure per hospitalization under the PM-JAY is Rs. 7,000 (approximately $95), which is still a considerable amount for low-income households. The high OOP expenditure is a result of several factors, including the high cost of drugs and medical equipment, inadequate public healthcare infrastructure, and a lack of awareness about health insurance schemes.

Addressing the challenges of achieving UHC in India requires a multi-sectoral approach. The government needs to invest in healthcare infrastructure, including hospitals, diagnostic facilities, and healthcare workers. The government should also increase its healthcare spending, which is currently only about 1.3% of GDP, significantly lower than other countries at a similar level of development.

The private sector also has a crucial role to play in achieving UHC in India. The private sector can complement the public sector by providing affordable and quality healthcare services to people in remote and rural areas. The government should encourage public-private partnerships (PPPs) to improve healthcare services’ accessibility and affordability.

Community engagement is another crucial aspect of achieving UHC in India. The government should involve communities in designing and implementing healthcare services to ensure that services are tailored to their needs. Community health workers (CHWs) can play a vital role in improving healthcare services’ accessibility and quality, particularly in remote and rural areas.

Finally, improving health literacy and awareness is essential to achieving UHC in India. Many people in India are unaware of the healthcare services available to them, the importance of preventive healthcare, and how to use health insurance schemes. The government should invest in health education and awareness programs to improve people’s health literacy and encourage them to seek healthcare services when needed.

In conclusion, UHC is essential to achieving better health outcomes for all individuals and communities. India has made significant progress towards achieving UHC, particularly through the Ayushman Bharat Yojana. However, several challenges need to be addressed, including the shortage of healthcare workers, inadequate healthcare infrastructure, and high OOP expenditure on healthcare. Addressing these challenges requires a multi-sectoral approach, including investments in healthcare infrastructure and human resources, public-private partnerships, community engagement, and health education and awareness programs. Achieving UHC in India will require sustained efforts and significant investments, but the benefits will be far-reaching, improving the health and well-being of millions of people across the country.

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