Universal Health Coverage | Gist of Rajya Sabha TV / RSTV (now Sansad TV) - UPSC PDF Download

Major problems of Health sector in India:

• After the independence the focus has been increased significantly on Health status of people. As a result, there has been a significant increase in life expectancy of people from 35 years to 65 years.
• However, it is unevenly distributedin different parts of the country. The health problems in India are still a cause of concern.
• As the income levels of the people have increased there is spurt in non-communicable or life style diseaseswhich accounted for nearly half of the deaths.
• The existing healthcare infrastructureis just not enough to meet the needs of the population. The central and state governments do offer universal healthcare services and free treatment and essential drugs at government hospitals.
• However, the hospitals are understaffed and under-financed. People living below poverty line continue to rely on insufficient health care facilitiesin rural areas.
• India has one of the lowest per capita healthcare expendituresin the world. The high out-of-pocket expenses in India stem from the fact that majority of Indians do not have health insurance.
• Moreover, majority of the skilled health care professionalshappen to be concentrated in urban areas. This is the main reason for rural- urban disparity in terms of healthcare.

Universal health care (UHC):

• The basic idea of UHCis that no one should be deprived of quality health care for the lack of ability to pay.
• This idea was well expressed:
  • “No society,” he said, “can legitimately call itself civilised if a sick person is denied medical aid because of lack of means.”
• The same idea inspired the Bhore Committee report of 1946, where a case was made for India to create its own NHS-type health-care system.
• In concrete terms, UHC typically relies on one or both of two basic approaches: public service and social insurance.

Healthcare challenges in India:

• The country’s diversity in terms of geography, culture, and demography
• Political system
• Unsafe boundaries
• Huge population burden
• Poor investment in health

Importance of Universal Health Coverage in India:

• The health goal under the United Nations Sustainable Development Goalsis, arguably, the most important target on the agenda of India and other member countries because of its inextricable connection with other indicators of socio-economic development like poverty, zero hunger (nutrition), quality education, gender equality, clean water and sanitation.
• The essence of this goal is to “ensure healthy lives and promote well-being for all in all ages”,which implies universal health coverage.

Conclusion:

• It is high time for UN bodies/World Health Assembly to acknowledge the need for redefining health in light of the SDGs.
• Universal health coverage should be designed based on the revised definition of health.That will lead to a better understanding, and attainment, of holistic health and well-being. This will help in directing focused priority and mobilization of resources in the right direction.
• In addition, a National framework for universal health coverageneeds to be developed by the member countries.
• This would involve inter-sectoral collaborationsat the community level with local health teams, the private sector, non-government organizations and community-based organizations to strengthen primary health and support secondary and tertiary infrastructure.
• This would not only ensure proper and complete treatmentbut also empower people to protect themselves from illness and encourage treatment-seeking behaviour for which people’s awareness needs to be built up through simple community-level ideas for health promotion, prevention and self-protection as essential part of primary healthcare.
• Joint participationwith health teams by trained volunteers in uniform, including those from National Cadet Corps (NCC), National Scout Services (NSS), nursing schools, etc., can provide a thrust for addressing social, and environmental determinants and can bring about positive change in personal hygiene, healthy behaviour and cleanliness.
• Approaching healthcare policies from the behavioural angle can ensure better systemic efficiencyand large-scale transformation.