About tHE tHEME
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. This requires a strong, efficient, well-run health system; a system for financing health services; access to essential medicines and technologies; and a sufficient capacity of well-trained, motivated health workers.
Ensuring that every individual in this diverse nation obtains the needed health services without suffering financial hardship
The National Rural Health Mission (NRHM) launched by the Government of India in 2005 seeks to provide accessible, affordable and quality health care to the rural population, especially the most vulnerable. It also sought to reduce the Maternal Mortality Ratio in the country from 407 to 100 per 100,000 live births. Infant Mortality Ratio from 60 to 30 per 1000 live births and the Total Fertility Rate from 3.0 to 2.1 within the seven year period of the Mission.
Now, the NRHM along with the recently launched National Urban Health Mission (NUHM) has been subsumed under the National Health Mission (NHM). Despite significant progress especially since the launch of NRHM, challenges remain:
The availability of health care services provided by the public and private sectors taken together is inadequate;
The quality of healthcare services varies considerably in both the public and private sector as regulatory standards for public and private hospitals are not adequately defined and, are ineffectively enforced; and
The affordability of health care is a serious problem for the vast majority of the population, especially at the tertiary level.
Due to the lack of extensive and adequately funded public health services, a large proportion of the population incurs heavy out-of-pocket (OOP) expenditure on services purchased from the private sector. Figure 1 shows that the OOP expenditure as a proportion of total health expenditure is a very high 61.7 per cent in India as compared to the global average of 20.5 per cent.
The total expenditure on health care in India, including public and private expenditure is broadly comparable to other developing countries at similar levels of per capita income. The total expenditure on health care (both public and private together) is 3.7 per cent of the GDP. However, according to the World Health Statistics 2013, public expenditure on health is very low constituting 28.2 per cent of total health expenditure According to the Government of India’s 12th Five Year Plan, public health expenditure in India was only 1.04 per cent of GDP in 2011–12 as compared to the global average of 5.4 per cent (See Figure 2)
The Union Government’s Ministry of Finance disburses funds to the Ministry of Health and the States. The public sector also funds a number of insurance schemes. Currently, Union-funded insurance schemes cover an estimated population of 181 million through the Employee State Insurance Scheme (ESIS) - (60 million); Central Government Health Scheme (CGHS) - (3 million) and Rashtriya Swasthya Bima Yojana (RSBY) - (118 million). While ESIS and CGHS provide for comprehensive health care, RSBY provides for only hospitalization cover with a benefit limit of INR 30,000 (US$ 500 approximately) per enrolled household per year (See Figure 3). In addition, 110 million people in the South Indian states including 70 million in Andhra Pradesh; 35 million in Tamil Nadu and 5 million in Karnataka receive coverage under state government funded health insurance schemes. However, most of these schemes cover only in-patient care, mainly at the tertiary level.
The 12th Five Year Plan and the NHM’s Framework for Implementation commit to undertake upto three UHC pilots in each state, which will pave the way for scaling up of Universal Health Coverage across the country. These pilots need to be adequately funded and well planned with their performance measured against carefully selected and standardized indicators.
Convened by the World Health Organization (Country Office) in India, 10 organizations including DFID, GIZ, ILO, UNAIDS, UNDP, UNFPA, UNICEF, USAID and the World Bank are working together to promote greater commitment to Universal Health Coverage in India
The United Nations in India is committed to supporting the Government of India in its progress towards Universal Health Coverage by providing evidence, technical and policy advice on effective interventions and the mechanisms to monitor progress.
Professor Indrani Gupta, Institute of Economic Growth, Delhi, India; Dr Nata Menabde, WHO Representative to India; Ms Lise Grande, UN Resident Coordinator and experts from the World Health Organisation including Dr Vivian Lin, Dr Rüdiger Krech, Dr Alaka Singh and Dr Antonio Duran deliberated on India’s route to universal coverage and lessons to be learnt from countries in different regions of the world at a panel discussion organised by the United Nations in India on 8 May 2014.
Health Baithak: Film Screening Fire in the Blood; Thursday, 29 May, 3pm, WHO India Country Office. The film ‘Fire in the Blood’, directed by Dylan Mohan Gray, highlights the life-saving role that the Indian generic drug industry has played in making anti-AIDS medicines available to millions of poor patients in Africa at a fraction of the cost charged by innovator brands.The film set a new all-time record for the longest theatrical run by any non-fiction feature film in Indian history following a five-week stint in Mumbai. The screening will be followed by a discussion.
The goal of Universal Health Coverage (UHC) is to ensure that all people obtain the health services they need without suffering financial hardship when paying for them. This requires a strong, efficient, well-regulated health system for providing the needed services, supported by availability of essential medicines and technologies; and a well-trained and motivated health workforce of sufficient capacity, all being appropriately financed, mainly by the government.
Advancing UHC in India: Learning from international experience
Sustained effort required for universal health coverage
Key statistics from India’s health sector that indicate the need for universal health coverage.
In this report, WHO outlines how countries can modify their financing systems to move more quickly towards universal coverage and to sustain those achievements. The report synthesizes new research and lessons learnt from experience into a set of possible actions that countries at all stages of development can consider and adapt to their own needs. It suggests ways the international community can support efforts in low-income countries to achieve universal coverage.
Universal health coverage ensures everyone has access to the health services they need without suffering financial hardship as a result. In December 2012, a UN resolution was passed encouraging governments to move towards providing universal access to affordable and quality health care services. As countries move towards it, common challenges are emerging -- challenges to which research can help provide answers.
In recent years, there has been a growing movement across the globe for universal health coverage ensuring that everyone who needs health services is able to get them, without undue financial hardship. This has led to a sharp increase in the demand for expertise, evidence, and measures of progress towards UHC and a push for UHC as one of the possible goals of the post-2015 development agenda. This discussion paper proposes a framework for tracking country progress towards UHC, assessing both the aggregate and equitable coverage of health services, as well as financial risk protection.
The High Level Expert Group (HLEG) on Universal Health Coverage (UHC) was constituted by the planning Commission of India in October 2010, with the mandate of developing a framework for providing easily accessible and affordable health care to all Indians. The HLEG undertook a situational analysis of each of the key elements of the existing health system and has developed recommendations for reconfiguring and strengthening the health system to align it with the objectives of UHC, bridging the presently identified gaps and meeting the projected health needs of the people of India over the next decade.
The handbook includes basic principles on health financing, country examples and evidence-based arguments to support Civil Society Organizations advocating for health funding policies that promote equity, efficiency and effectiveness, and ensure that the rights of the most vulnerable are not forgotten.
The World Health Statistics series is WHO’s annual compilation of health related data for its 194 Member States, and includes a summary of progress made towards achieving the health related Millennium Development Goals (MDGs) and associated targets. In 2013 it also includes highlight summaries on the topics of reducing the health gaps between the world’s most-advantaged and least-advantaged countries, and on current trends in official development assistance (ODA) for health.
The 2011 WHO Global Health Expenditure Atlas presents health expenditure data from the 194 Member States of the Organization in individual country profiles and in individual country profiles and in regional and global summaries. The GHED is updated annually and can be accessed at http://apps.who.int/nha/database/DataExplorerRegime.aspx
Catastrophic health expenditure
Financing universal healthcare
Anuradha Gupta, Additional Secretary and Mission Director, National Health Mission, Government of India on government efforts to provide healthcare to all.
Universal health coverage: Role of civil society
Public financing of health
This video, produced by the World Health Organization, explains the concept of universal coverage and uses examples from six countries - China, Oman, Mexico, Rwanda, Thailand and Turkey - to show ways that all countries can provide accessible and affordable care for their people.
WHO's report On the path to universal coverage takes evidence from all over the world to show how all countries, rich and poor, can adjust their health financing mechanisms so more people get the health care they need.
The United Nations in India in partnership with World Comics India uses the power of comics to tell stories from across India, across communities, and across languages. Through workshops held in the country, young people, women, men and children who are poor and from marginalized communities find expression through comics. The collection of stories from common people are a reflection of the issues they face to access quality healthcare and medicines at affordable cost.
What is Universal Health Coverage?
What does Universal Health Coverage actually mean?
United Nations resolution on universal health coverage
Questions and Answers on Universal Health Coverage and the post-2015 Framework
The Lancet Series- India towards Universal Health Coverage, 2011
Human Resources for Universal Health Coverage: Special Issue of Bulletin
Director General of WHO’s 2013 Convocation Address at the AIIMS
World Bank Group President on Universal Health Coverage in Emerging Economies
Thematic Guide: Universal health Coverage
Universal Health Coverage Initiative for India
Towards Universal Health Coverage
Quality health care with public funds
[Date: 11 June 2014, Source: The Hindu (op-ed)]
Empower community health workers with technology: Experts
[Date: 29 May 2014, Source: First Post]
Coming soon: Health cover for all, says Harsh Vardhan
[Date: 28 May 2014, Source: The Economic Times]
ALL NOT WELL IN HEALTHCARE!
[Date: 27 May 2017, Source: The Pioneer]
What the new govt can do to set the health system right
[Date: 26 May 2014, Source: Live Mint (op-ed)]