Universal health coverage final

 Universal health coverage (UHC) means that all
people and communities can use the promotive,
preventive, curative, rehabilitative and palliative
health services they need, of sufficient quality to
be effective, while also ensuring that the use of
these services does not expose the user to
financial hardship.

 Theme of world health day :
“UNIVERSAL HEALTH COVERAGE: EVERYONE,
EVERYWHERE”
 The ultimate goal of UHC is to ensure that
everyone, everywhere, should have access to
essential healthcare services without facing
financial hardship
 Progressive realization of UHC is also one of
the key features of the United Nations’
Sustainable Development Goals

 Healthcare need is not only uncertain and
unpredictable but also catastrophic to families
living on the margins
 INADEQUATE MANPOWER: Against the
recommended 85 doctors and 255 nurses and
ANMs per lakh population, there is just 45 doctors,
and 75 nurses and ANMs
 QUALITY OF HEALTH CARE SERVICES: It varies
considerably in both the public and private sector.
Private sector also has the problem of unqualified
doctors. Regulatory standards for public and
private hospitals are neither adequately defined nor
effectively enforced

 AFFORDABILITY: Poor and vulnerable families not only spend
money out-of-pocket (OOP) due to ill health but also have to
suffer wage loss to seek healthcare
-Estimates suggest that in India, around 50 million
households fall in poverty annually on account
of OOP healthcare expenditures
-One of the reasons for high rate of OOP expenditures is
limited access to healthcare in public
sector, which compels patients to seek care in the private
sector
-Evidence suggests that a dynamic interaction between three
factors forces patients towards
private sector in India: (i) healthcare provisioning dominated
by private sector
(ii) high share of private expenditure as
compared to public expenditure in TOTAL
HEALTH EXPENDITURE (THE)

 Health For All
 Millennium Development Goal
 Sustainable Development goal

 This definition of UHC embodies three
related objectives:
 Equity in access to health services - everyone
who needs services should get them, not only those who
can pay for them.
 The quality of health services should be good enough to
improve the health of those receiving services; and
 People should be protected against financial-risk, ensuring
that the cost of using services does not put people at risk of
financial harm.
 UHC is firmly based on the WHO constitution of 1948
declaring health a fundamental human right and on the
Health for All agenda set by the Alma Ata declaration in
1978. UHC cuts across all of the health-related Sustainable
Development Goals (SDGs) and brings hope of better health
and protection for the world’s poorest.

* principles guided the formulation of UHC in
India:
 Universality
 Equity
 Non-exclusion and non-discrimination
 Comprehensive care that is rational and of good quality
 Financial protection
 Protection of patients’ rights that guarantee
appropriateness of care, patient choice, portability and
continuity of care.
 Consolidated and strengthened public health provisioning
 Accountability and transparency
 Community participation
 Putting health in people’s hands.

 HEALTH FINANCING AND FINANCIAL PROTECTION:
Government should increase public expenditure on
health, from the current level of 1.2% of GDP to at least
2.5% by the end of 12th Five Year Plan, and to at least 3%
of GDP by 2022
-General taxation should be used as the principal
source of healthcare financing, not levying sector
specific taxes
-Expenditures on primary health care should account
for at least 70% of all healthcare expenditure.
-The World Health Organization (WHO) has identified
four key financing strategies to achieve UHC -
increasing taxation efficiency, increasing government
budgets for health, innovation in financing for health
and increasing development assistance for health

 ACCESS TO MEDICINES, VACCINES AND TECHNOLOGY:
Enforcement of price control and price regulation, especially
on essential drugs, and revision, expansion, and rational use
of Essential Drug List
-Protection of safeguards provided by Indian patents law and
the TRIPS Agreement against the country’s ability to produce
essential drugs
-To recognise barrier to the access and to overcome
especially for disadvantaged and people located far from
facilities, and differently-abled, and also making it gender
sensitive and child friendly
 HUMAN RESOURCES FOR HEALTH: Strengthening of Institute
of Family Welfare and Regional Faculty Development Centres
to ensure availability of adequately trained faculty
-Establishment of District Health Knowledge Institutes and
National Council for Human Resources in Health (NCHRH)

 HEALTH SERVICE NORMS: Development of National Health
Package, that offers, as a part of the entitlement of every citizen,
essential health services at different levels of the healthcare
delivery system
-There should be equitable access to health facilities in the
urban areas, by rationalising services and focusing particularly
on the health needs of the urban poor
 MANAGEMENT AND INSTITUTIONAL REFORMS: Introduction of All
India and State level Public Health Service Cadres and a
specialised State Level Health System Management Cadre should
be introduced in order to give greater attention to Public Health
and also to strengthen the management of the UHC system
-Establishment of a National Health Regulatory and Development
Authority (NHRDA), a National Drug Regulatory and Development
Authority (NDRDA), and a national Health Promotion and
Protection Trust (NHPPT) is recommended

 COMMUNITY PARTICIPATION AND CITIZEN
ENGAGEMENT: Existing Village Health Committees
should be transformed into participatory Health
Councils
 MONITORING AND EVALUATION SYSTEM: Routine
monitoring and evaluations are to collect
disaggregates information on disadvantaged
segments of the population, so that to compare
access of services to these groups and their impact
and also with general population

 ‘Health for All' Ayushman Bharat Yojna or Pradhan Mantri
Jan Arogya Yojana (PMJAY) or National Health Protection
Scheme or ModiCare is a centrally sponsored scheme
launched in 2018, under the Ayushman Bharat Mission of
MoHFW in India.(Biggest govt.sponsered Health
Scheme in the world.)
Ayushman Bharat rests on the twin pillars of Health and
Wellness Centres for provision of comprehensive primary
healthcare services and the Prime Minister's National
Health Protection Mission for secondary and tertiary care
to 100 million families.
 FIRST PILLAR(NATIONAL HEALTH PROTECTION)
 we are reaching out to approximately 40 per cent of
country's population roughly covering 500 million
individuals, who will be provided an insurance cover of

 SECOND PILLAR (HEALTH AND WELLNESS CENTER)
 About 1,50,000 health and wellness centres would
bring healthcare closer to people, so that every Indian
can have timely access to health care, including
diagnostic services and free essential drugs.
 Pregnancy care and maternal health services
 Neonatal and infant health services
 Child health
 Chronic communicable diseases
 Non-communicable diseases
 Management of mental illness
 Dental care
 Geriatric care Emergency medicine

Continuumof
Services
Routine
Monitoring
of Interventions
Constant
innovations
Reachthemaximumnumberofpeople,inthemostremote
cornersoftheCountrythrough:-

JAANCH-
Vision of JAANCH: To enable a
universal healthcare system that uses
information to empower individuals and
to improve the health of the population
Mission of JAANCH: To improve
healthcare of all Indians through
meaningful use of Health information
technology

 UHC will achieving an acceptable
standard of good health for people of Ind

Universal health coverage final

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