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20 March 2023: UNIVERSAL HEALTH COVERAGE

Health is a basic human right. Article 21 of India’s constitution guarantees the right to life.

CONCEPT BEHIND UNIVERSAL HEALTH COVERAGE 

  • The World Health Organization defines health as a certain totality of health that includes the realms of mental and social well-being and happiness beyond physical fitness and the absence of disease and disability.
  • This means that we cannot achieve health in its wider definition without addressing health determinants, which leads to the requirement of intersectoral convergence beyond medical and health departments such as women’s and child development, agriculture, water and sanitation, education, social welfare, etc.
  • Health for all by 2000 was proposed by Halfdan Mahler and endorsed by the World Health Assembly in 1977. Here, “for all” means universalization. So, the focus is that nobody is denied and everybody is eligible for health facilities.
  • Universal health coverage was implied as early as 1977.
  • In 1983, India, through its National Health Policy, committed itself to achieve “health for all goals by 2000.
  • Primary, secondary, and tertiary care
  • The 1978 international conference on primary health care in Alma Ata listed eight components of minimum care for all citizens. It mandated all the health promotion activities and prevention of diseases, including vaccinations, etc.
  • Any non-communicable disease, chronic diseases, including mental problems, and their investigation and treatment were not included in the primary health care system.
  • In cases of secondary and tertiary health care, it was left to the individuals to either go to the public hospitals, which are few in number, or to the private hospitals, which would lead to high out-of-pocket expenses.
  • There are not enough government-run institutions for those who can’t afford them.

STEPS TAKEN IN INDIA

  • The 2017 national health policy laid down a framework to provide universal access to high-quality health services by increasing accessibility, affordability, and equity.
  • The government has launched four mission-mode projects.
  • PM-Ayushman Bharat Health Infrastructure Mission (PM-ABHIM):
  • It is a centrally sponsored scheme that was launched to enhance the capacities of primary, secondary, and tertiary healthcare systems, strengthen existing national institutions, and create new ones, to detect and cure emerging diseases.
  • Ayushman Bharat Health & Wellness Centres (ABHWCs): Under Ayushman Bharat Health & Wellness Centres (HWCs), comprehensive primary healthcare is to be facilitated by strengthening subhealth centres (SHCs) and primary health centres (PHCs).
  • Pradhan Mantri Jan Arogya Yojana (PMJAY)
  • National Digital Health Mission (NDHM)
  • For every citizen to get a health card, the Ayushman Bharat Digital Mission (ABDM) was announced with the aim to develop the backbone necessary to support the integrated digital health infrastructure of the country. The objective of the mission is to bridge the existing gap among different stakeholders in the healthcare ecosystem through digital highways.

WAY FORWARD 

  • The slogan “universal health coverage” must be avoided because it is neither universal in its implementation nor comprehensive in its coverage of services.
  • In addition, it does not assure affordability and accessibility.
  • So health for all must be stressed more than Universal Health Coverage.