UNIVERSAL HEALTH COVERAGE/CARE – HEALTH

News: Moving forward with a newer concept of Universal Health Care

 

What's in the news?

       The article underscores the need to move forward with a newer concept of UHC, with an intersectoral convergence beyond medical and health departments.

       It also put emphasis on moving forward from the Alma Ata declaration of primary health care towards a holistic model governing all levels of healthcare.

 

Definition of Health by WHO:

       A certain totality of health to the realms of mental and social well-being and happiness beyond physical fitness, and an absence of disease and disability.

 

Universal Health Coverage:

       UHC means that everyone, everywhere, should have access to the health services they need without risk of financial hardship.

       It means that all people have access to full range of quality health services and nobody is denied this and everybody is eligible without being discriminated against on the basis of financial status, gender, race, place of residence, affordability to pay or any other factors.

       It covers the full continuum of essential health services, from health promotion to prevention, treatment, rehabilitation and palliative care.

       It thus encompasses primary, secondary and tertiary care for all who need it at affordable cost without discrimination.

 

Indicators of Universal Health Coverage as per WHO:

  1. Reproductive, maternal, new born and child health
  2. Infectious diseases
  3. Non-communicable diseases
  4. Service capacity and access.

 

Concept of 'Health for All':

       The slogan “Health for All by 2000” that was proposed by Halfdan Mahler and endorsed by the World Health Assembly in 1977.

       Universal Health Care/coverage (UHC) was implied as early as 1977. India, through its National Health Policy 1983, committed itself to the ‘Health for All’ goal by 2000.

 

Focus on Primary Health Care:

       The International Conference on Primary Health Care, at Alma Ata, 1978, listed eight components of minimum care for all citizens such as

       Education concerning prevailing health problems and the methods for preventing & controlling them.

       Promotion of food supply and proper nutrition.

       Adequate supply of safe water and basic sanitation.

       Maternal and child health care, including family planning.

       Immunisation against major infectious diseases.

       Prevention and control of locally endemic diseases.

       Appropriate treatment of common diseases and injuries.

       Provision of essential drugs.

       It mandated all health promotion activities, and the prevention of diseases including vaccinations and treatment of minor illnesses and accidents to be free for all using government resources, especially for the poor.

 

Difference between PHC and UHC:

       The main difference between PHC and UHC is that PHC is a level of care within the healthcare system, while UHC is a broader goal of ensuring access to health care for all individuals.

       PHC is typically provided at the primary care level, while UHC includes all levels of care, from primary to secondary and tertiary care.

       PHC is focused on basic health care services and health promotion, while UHC aims to provide comprehensive health care services to all individuals.

 

Issues in Primary Health Care:

       Any non-communicable disease, chronic disease including mental illnesses, and its investigations and treatment were almost excluded from primary health care.

 

Issues in Secondary and Tertiary Care:

       State was almost failed in their duty and it was mostly left to the individual care.

       Limited number of public hospitals and enough government-run institutions for the poor (who cannot afford exploitative and expensive private care).

       Increasing out of pocket expenditure from their own pockets in private sectors.

       Abdication of responsibility by the state i.e., to provide secondary or tertiary care by the state, ensured the dominant, unregulated, profit-making private sector and also health insurance sector were kept happy and thriving.

       Dichotomy between peripheral primary and institutional-referred specialist care at the secondary and tertiary levels.

 

International Efforts:

1. WHO’s Thirteenth General Programme of Work aims to have 1 billion more people benefit from UHC by 2025, while also contributing to the targets of 1 billion more people better protected from health emergencies and 1 billion more people enjoying better health and well-being.

2. International Universal Health Coverage Day (December 12) aims to raise awareness of the need for strong and resilient health systems and universal health coverage with multi-stakeholder partners.

3. SDG Target 3.8 - Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.

4. The Astana declaration of 2018 calls for “partnership” with the private sector and multi-nodal system of varied sectors, professional streams and specialities with a variety of staff to deliver Comprehensive Universal Health Care.

 

Measures taken by India:

1. National Rural Health Mission (NRHM) 2013 - Primary Health Care (PHC) Version 2 or Comprehensive PHC was defined to treat chronic illnesses and non-communicable diseases such as cardiac, neural, mental and metabolic disorders.

2. Pradhan Mantri Jan Arogya Yojana - Operationalisation of the Health and Wellness Centre as a model of implementation of Comprehensive Primary Health Care. The mission under Pradhan Mantri Jan Arogya Yojana (PMJAY) initiative, established 150,000 health and wellness centres (HWCs) and provides health insurance coverage to 40% of the country’s population - nearly 500 million people.

3. The National Health Policy (NHP) 2017 commits to free provision of primary care by the public sector, an assured, comprehensive primary care with linkages to referral hospitals, assured free drugs, diagnostic and emergency services to all in public hospitals.

4. The National Medical Commission (NMC) Act recognizes the much-needed reforms in medical education with the vision of “one nation, one healthcare sector”.

5. Telemedicine in India is growing at a compound annual growth rate (CAGR) of 20% and is expected to reach a value o $32 million by 2020.

6. Machine learning, block chain and AI will continue to strengthen India’s ability to engage effectively with other geographies towards achieving global UHC targets.

 

Challenges ahead:

Despite of reaching towards UHC, there are significant challenges in the healthcare value chain such as

1. It includes gaps in healthcare infrastructure, a divergence between rural and urban geographies, an acute shortage of skilled workers and inadequate public funding, to name a few.

2. A crucial component of Ayushman Bharat is the strategic purchasing of secondary and tertiary healthcare services from the private sector.

3. While private healthcare caters to around 70% of India’s population, there is an estimated shortage of 160,000 additional hospital beds under the scheme.

4. India requires twice the number of doctors, triple the number of nurses and quadruple the number of paramedic and support staff.

 

WAY FORWARD:

1. The starting point for universal health coverage is the political will and commitment to make substantial public investments in healthcare consistently.

2. Coverage of the population with an adequate number of health facilities with an optimal mix of health workers is the foundation on which the journey towards UHC is premised.

3. Bold and innovative policies sustained over a long period are needed to train and retain a skilled health workforce.

4. Availability of portable benefits, telemedicine and wide network of diagnostic labs does hold the promise of extending the reach of primary care to all citizens.

5. Tax-based financing, supplemented by a single mandatory social health insurance scheme for those employed in the formal sector, that is collected in a single pool of revenue offers the most feasible route to UHC in settings with a large informal sector.

6. The range of services available at no cost at the point of service needs to be comprehensive, covering both outpatient and inpatient care and the cost of drugs.

7. Publicly financed social insurance schemes for low-income populations do not succeed in expanding population coverage to universality.

8. Need for an intersectoral convergence beyond medical and health departments such as women and child development, food and nutrition, agriculture and animal husbandry, civil supplies, rural water supply and sanitation, social welfare, tribal welfare, education, forestry.

9. The National Health Mission with concurrent intersectoral thrusts on Poshan Abhiyan, National Food Security, the Mahatma Gandhi National Rural Employment Guarantee Act, water sanitation, Sarva Shiksha Abhiyan, etc. is a better model of fully tax-funded Universal Health Care.

 

Every individual has a right to be healed and not have complications, disability, and death. That right is guaranteed only by individualism in public health, the new global approach to UHC, where nobody is left uncounted and uncared for.