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Beyond Milestones: The Road To Universal Healthcare In India

Nearly 48% of India's healthcare expenditure still comes from individual pockets, pushing many families into poverty- ranging from 2 to 8 % in urban and rural populations yearly.

Edited By : News24 Desk | Updated: Jan 26, 2024 21:43 IST
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Dr. K. Madan Gopal, Advisor, Public Health Administration, NHSRC, MoHFW GoI, and a former
senior consultant at NITI Aayog

Dr. K. S Uplabdh Gopal, health practitioner

While India boasts significant achievements in expanding access to healthcare, the journey towards universal health coverage (UHC) still needs to be completed. This calls for coordinated efforts focusing on improving accessibility, fortifying the healthcare system, and guaranteeing fairness for all.

India’s progress towards UHC is undeniable. The flagship Ayushman Bharat Jan Ayogya Yojana (ABPMJAY) has provided insurance coverage to over 600 million people, empowering them to access essential healthcare services without financial hardship. The Pradhan Mantri Jan Aushadhi Kendra (PMBJP) initiative, through more than 10000 kendras, has made essential medicines affordable for millions, reducing the burden of out-of-pocket expenditure on families. However, despite these commendable achievements, challenges persist.

Nearly 48% of India’s healthcare expenditure still comes from individual pockets, pushing many families into poverty- ranging from 2 to 8 % in urban and rural populations yearly. According to a 2021 National Health Accounts report, the average out-of-pocket spending per person in India is around $60 annually per op visit, a substantial sum for low-income families. This highlights the urgent need for further expansion of health insurance coverage, particularly for the most vulnerable populations, including those living below the poverty line and working in the informal sector.

The gap between healthcare access in rural and urban areas remains a significant concern. While the number of public health infrastructures has increased, more is required to address the challenges of recruiting and training healthcare professionals, providing essential equipment and medications, and strengthening referral systems.

Embracing technology holds immense potential for optimizing the healthcare system’s efficiency. A recent McKinsey report estimates that India can save $200 billion in healthcare costs by 2030 through digital health interventions. Telemedicine can bridge the geographical gap and provide remote access to specialists, particularly in underserved areas. Digital health records can improve patient data management and streamline administrative processes. AI-powered diagnostics can aid in early disease detection and personalized treatment plans.

Many population members must be aware of available healthcare schemes and their rights. This lack of awareness creates barriers to healthcare services and contributes to unnecessary financial burdens. Implementing targeted awareness campaigns and leveraging diverse channels like community outreach programmes, mobile technology, and vernacular language communication is crucial to empowering individuals to participate actively in their healthcare and reduce unnecessary out-of-pocket expenditures.

Women often face social and economic barriers that limit their access to quality healthcare. A 2021 Lancet Global Health study revealed that maternal mortality rates in India remain high, particularly in rural areas. Additionally, women are at a higher risk of undernutrition and infectious diseases. Implementing specific initiatives that promote women’s health, including targeted maternal care programmes, ensuring access to sanitation facilities, and addressing gender bias in healthcare delivery, is essential to achieving UHC.

Moving beyond celebrating milestones, achieving UHC requires a shift towards sustainable solutions, which entails:

  1. The government must increase public health expenditures to match the 2.5% GDP envisioned in National Health Policy 2017 to provide the necessary resources for strengthening infrastructure, expanding insurance coverage, and improving the quality of healthcare services.
  2. Public-private partnerships, social impact bonds, and crowdfunding initiatives can supplement government funding and accelerate progress towards UHC.
  3. Addressing the shortage of healthcare professionals through robust training programmes and upskilling initiatives is crucial for ensuring quality care delivery nationwide.
  4. Addressing social determinants like poverty, education, and sanitation is essential for improving overall health outcomes, which will require inter-sectoral collaboration and targeted interventions that address the root causes of health inequities.
  5. Empowering communities to take ownership of their health through participatory planning and decision-making can lead to more responsive and sustainable health systems.

Achieving UHC is not a solitary endeavour. It requires the collective effort of the government, healthcare providers, civil society organizations, the private sector, and individuals. The government must provide leadership, formulate effective policies, increase public health spending, and ensure equitable access to healthcare services nationwide, including investing in rural healthcare infrastructure, expanding health insurance coverage, and regulating drug prices. Healthcare providers must strive to deliver quality care ethically, adopt evidence-based practices, and embrace technological advancements for efficient service delivery. Building trust with patients and communities is crucial. Civil society organizations can play a vital role in raising awareness about UHC, advocating for policy changes, and providing complementary services to vulnerable populations. Partnering with the government and private sector can amplify their impact. The private sector can contribute through investments in healthcare infrastructure, technology development, and innovative financing models. Public-private partnerships can leverage personal sector expertise and resources for the public good. The individual can also actively participate in their healthcare by adopting preventive practices, seeking timely medical attention, and demanding accountability from healthcare providers. Spreading awareness and supporting UHC initiatives are equally important.

India’s journey towards universal health coverage is a long and winding path. While celebrating milestones like the expansion of insurance coverage and the opening of Jan Aushadhi Kendras, we must remain vigilant and committed to addressing persistent challenges. By strengthening the healthcare system, enhancing affordability, promoting equitable access, and embracing sustainable solutions, India can move closer to a future where every citizen can access quality healthcare without financial hardship. This future is within reach, but it requires the collective effort of all stakeholders. Let us work together to build a healthier and more equitable India where healthcare is a right, not a privilege.

(The views expressed by the author are personal in nature and do not represent the views of News24)

First published on: Jan 26, 2024 09:43 PM IST

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