Universal healthcare coverage, vulnerable communities and the need to revamp India’s primary healthcare

It is generally accepted that India’s investment on healthcare falls way short of other countries with robust healthcare systems with just 1.26% of the total GDP being spent on public healthcare.

Updated: Sep 28, 2021 5:50 PM
Universal Healthcare Coverage, healthcare facilities, underprivileged communities, medical services, curative, preventive, palliative, medical conditions, diseases, quality of life, pain relief.Universal Healthcare Coverage would mean all citizens of the country, no matter their social or economic status, receive access to the best available healthcare facilities.

By Dr. Rajan Samuel

India is a signatory to the declaration on the 2030 Agenda for Sustainable Development comprising 17 United Nations Sustainable Development Goals (UN SDGs) aimed at creating a sustainable ecosystem for the global population. SDG 3 focuses on attaining quality and affordable healthcare and ensuring the well-being of all sections of the population through the tenet of Universal Healthcare Coverage (UHC). To achieve these goals, the National Health Policy (NHP) 2017 was adopted to take India towards attaining Universal Healthcare Coverage.

Universal Healthcare Coverage would mean all citizens of the country, no matter their social or economic status, receive access to the best available healthcare facilities. It also means that underprivileged communities can avail of diverse medical services ranging from curative and preventive to palliative healthcare to treat medical conditions, prevent occurrence of diseases, enhance quality of life and ensure pain relief.

Examples of such healthcare systems would be the National Health Service of the United Kingdom or the Canadian Medicare, although their forms differ. NHS is centralised in its funding and delivery; and Canadian Medicare is decentralized, with provinces responsible for funding and delivery with assistance from the federal government.

It is generally accepted that India’s investment on healthcare falls way short of other countries with robust healthcare systems with just 1.26% of the total GDP being spent on public healthcare. It is not for the lack of trying though. The pre-independent Government of India appointed the Health Survey and Development Committee in 1943 under the Chairmanship of Sir Joseph Bhore to study health systems and services in British India. The Committee which submitted its report in 1946 recommended the restructuring of the contemporary healthcare system in India. Successive governments in post-Independent India were in many ways successful in building a network of public healthcare systems in the country. This was done through decentralisation (healthcare is a state subject) and funding for Primary Healthcare (PHC) both in urban and rural communities.

India’s success in polio vaccination and the fight against tuberculosis is a testament to the fact the system works. However, because of lack of public investment, PHC has remained just that – primary healthcare. The outbreak of the COVID-19 pandemic has brought to the fore glaring structural inequalities in the healthcare delivery systems.

India has made remarkable strides in the health domain through the roll-out of initiatives like the National Rural Health Mission to address the health needs of poor households. The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana is one initiative that worked to solve the issue of healthcare coverage with the aim of providing health insurance coverage to 50 crore citizens. In the post-pandemic era, CSR initiatives have also put in additional efforts towards strengthening public healthcare infrastructure. But this alone is not enough. We need to develop a strategy to create a long term ‘medical safety net’ through 100% access to medical insurance – including medication and consultation – for communities at the bottom of the pyramid. Delivery of healthcare services should be part of the mandate of National Health Policy too. The announcement of Biju Swasthya Kalyan Yojana scheme by the Government of Odisha is very encouraging as well. But investing on revamping the Primary Healthcare system is the route to ensure that all citizens of the country have access to best available healthcare.

(The author is Managing Director of Housing non-profit Habitat for Humanity India. The article is for informational purposes only. Please consult health experts and medical professionals before starting any therapy or medication. Views expressed are personal and do not reflect the official position or policy of the Financial Express Online.)

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