
DOI: 10.1055/s-0040-1713708
Universal Health Coverage in India: Where Rubber Hits the Road?

Abstract
Poverty and healthcare issues are the most debatable topics today. Developing countries like India have as much as 45% of its population trapped in poverty because of various urgent healthcare needs. Universal health coverage (UHC) is a unique insurance system to provide financial protection to the marginalized groups of the country. It facilitates appropriate and immediate health needs, including required diagnostic, therapeutic and operational costs. However, UHC, a unique plan which focuses on the disadvantaged sections of the society, has some serious lacunae when it comes to its implementation in real life. This includes finances and human resources. Experts are reallocating adequate budgetary expenditure on healthcare issues, and in the meantime, a shortage of skilled health manpower is hunting down the UHC scheme in India. In recent times, different state governments are increasing budget allocation for the health sector. UHC is targeting low-income and poor families, forgetting the affordable and timely healthcare by way of improving services offered at the primary health centers and rapid expansion of the skilled health manpower across the country. UHC needs to focus on health paradigm systems, including improved healthcare-seeking behavior, nutrition, sanitation, potable water, reducing maternal and infant mortality, and dissemination of information of current technology to provide quality health services to the underserved and marginalized population of the country. These changes would symbolize a real way forward toward the immediate fulfillment of UHC goals for India.
Publication History
Publication Date:
30 June 2020 (online)
© 2020. National Academy of Medical Sciences (India). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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References
- 1 WHO.The World Health Report 1998 Life in the 21st Century: A vision for all. Available at: https://www.who.int/whr/1998/en/. Accessed June 3, 2020
- 2 Karan A, Yip W, Mahal A. Extending health insurance to the poor in India: An impact evaluation of Rashtriya Swasthya Bima Yojana on out of pocket spending for healthcare. Soc Sci Med 2017; 181: 83-92
- 3 Preker AS. The introduction of universal access to health care in the oecd: lessons for developing countries. In: S. Nitagyarumphong and A. Mills, eds. Achieving Universal Coverage of Health Care. Bangkok: Ministry of Public Health, 1998: 103-124
- 4 Sengupta A. Creating, reclaiming, defending: non-commercialized alternatives in the health sector in Asia. In: McDonald D, Ruiters G, eds. Alternatives to Privatization: Public Options for Essential Services in the Global South. New York: Routledge Press, 2012: 202-204
- 5 Zodpey S, Farooqui HH. Universal health coverage in India: Progress achieved & the way forward. Indian J Med Res 2018; 147 (04) 327-329
- 6 Rahman MM, Karan A, Rahman MS. et al. Progress toward universal health coverage: a comparative analysis in 5 South Asian Countries. JAMA Intern Med 2017; 177 (09) 1297-1305
- 7 Sharma A, Ladd E, Unnikrishnan MK. Healthcare inequity and physician scarcity: Empowering non-physician healthcare. Econ Polit Wkly 2013; 48 (13) 112-117
- 8 Wagstaff A. Reflections on and alternatives to WHO’s fairness of financial contribution index. Health Econ 2002; 11 (02) 103-115
- 9 Mackintosh M, Channon A, Karan A, Selvaraj S, Cavagnero E, Zhao H. What is the private sector? Understanding private provision in the health systems of low-income and middle-income countries. Lancet 2016; 388 (10044) 596-605
- 10 National Health Policy. Available at: http://www.cdsco.nic.in/writereaddata/National-Health-Policy.pdf. Accessed June 3, 2019
- 11 Keshri VR. Subodh Sharan Gupta Ayushman Bharat and road to universal health coverage in India. Journal of Mahatma Gandhi Institute of Medical Sciences 2019; 24 (02) 65-57
- 12 Press Information Bureau, Government of India. Cabinet Approves Ayushman Bharat-National Health Protection Mission. Available at: http://www.pib.nic.in/newsite/PrintRelease.aspx?relid=177816. Accessed March 27, 2018
- 13 Mekoth N, Dalvi V. Does quality of healthcare service determine patient adherence? Evidence from the primary healthcare sector in india. Hosp Top 2015; 93 (03) 60-68
- 14 Yellaiah J. Health insurance in India: Rajiv Aarogyasri health insurance scheme in Andhra Pradesh. IOSR Journal of Humanities and Social Science 2013; 8 (01) 7-14
- 15 De Costa A, Diwan V. ‘Where is the public health sector?’ Public and private sector healthcare provision in Madhya Pradesh, India. Health Policy 2007; 84 (2-3) 269-276
- 16 Chokshi M, Patil B, Khanna R. et al. Health systems in India. J Perinatol 2016; 36 (s3) S9-S12
- 17 Berman P. The impoverishing effect of healthcare payments in India: new methodology and findings. Econ Polit Wkly 2010; 45 (16) 65-71
- 18 Ellis R, Alam M, Gupta I. Health insurance in India: prognosis and prospects. Econ Polit Wkly 2000; 35 (04) 207-217
- 19 Prinja S, Kaur M, Kumar R. Universal health insurance in India: ensuring equity, efficiency, and quality. Indian J Community Med 2012; 37 (03) 142-149