India’s Aspirations for Universal Health Coverage – Ray of Hope?

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I first came across the statement “Health for All” as a student during my medical college days and always associate it with the Alma Ata declaration in 1978 by WHO.
During college days it was more to ensure my preparedness for yet another MCQ based test (which I was never good at). Now, in 2015 – the statement still haunts me – “Health For All” – Really? I wonder the same statement has been improvised and relaunched in various context/terminologies as “Universal Health Coverage” – yet another campaign, another conference with some more interesting statistics, but

 

what does it really mean and where do we stand?
The goal of universal health coverage is to ensure that all people obtain the health services they need without suffering financial hardship when paying for them. Let’s see how far or how close we are from the above:
A. 63 million Indians sink into poverty every year due to unaffordable healthcare costs
B. 80% outpatient and 60% inpatient care provided by private sector
C. 398 medical colleges and 52000 medical graduates approx intake every year – but still India has the worst doctor to population ratio being ranked close to 67th among 133 developing countries
D. 1.2 million new cancer cases diagnosed every year – about 70% diagnosed die within the first year
E. The non communicable disease (NCD’s) burden in India – is approx 50 million patient with cardiac disorders, 63 million diabetes patients, 0.9 million cases of stroke every year and roughly 1.75 lakh renal transplants required
F. 45% of the population travel more than 100 km to access higher level of care
G. 70% of India’s healthcare infrastructure is concentrated in the top 20 cities
The above statistics do NOT really give any ray of hope. However, some of the interesting work and trends to move closer to what may be a reality in the decades to come – is seen with the below recommendations + government spend focused on highest impact intervention areas for past few years

 

  •   Maternal, newborn and child health programs by NRHM

 

  •  Immunisation campaigns

 

  • Tackling NCD’s through innovative fiscal and health policies

 

  •  Strengthening health system – focus on primary healthcare services (refer Brazil’s Family Health Strategy)

 

  •  Expanding universal health insurance

 

  • Adoption of newer technology and m-health by healthcare providers, physicians, patients and payors

Time will only tell whether our Hon’ble Prime Minister’s ambitious National Health Policy 2015 and its roll out will be successful and/or how it fares viz a viz Obamacare.

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