Universal Health Coverage (UHC) and India's Commitment

Universal Health Coverage (UHC), UN Resolution and India’s Commitment

Universal Health Coverage refers to ensuring all people have access to full range of quality health services they need without facing financial hardship. India is committed to achieving UHC by 2030.

Table of Contents

Context: Universal Health Coverage (UHC) is critical for improving public health and economic robustness and plays a pivotal impact in achieving health equality in India.

What is Universal Health Coverage (UHC)?

Universal access to comprehensive, high-quality health services without financial hardship.
Covers the entire continuum of care from prevention to treatment and palliative care.
Key Components:
- Strengthening primary health care
- Reducing out-of-pocket expenditure
It requires a well-equipped health workforce and strong primary healthcare.

UN Resolution and India’s Commitment

UN General Assembly resolution (2012) urged countries to progress towards UHC.
The 2011 high-level expert group report to the Planning Commission aimed to increase public health financing to 2.5% of GDP during the 12th Plan (2012-17).
India launched National Health Policy, in 2017 aimed at “universal access to good quality health care services”.

Challenges

Large migrant population: 41 million interstate migrants in 2011,
- 9% migration rate in 2020-21(PLFS 2020-21).
- 49% of the population lives in urban slums (UN-Habitat/World Bank).
- Highlights to ensure availability and accessibility of primary health services.
Health as a Human Right: No constitutional right to basic health, but Directive Principles provide a base.
- Articles 39(e), 42, and 47 address worker health, working conditions, and public health improvement.
- Panchayats and municipalities have a constitutional duty to strengthen public health (Article 243G).
- Constitutional right to health is critical to break the cycle of poverty and poor health.

Isaiah Berlin’s Two Types Of Freedom

Freedom from (Negative freedom): This means the absence of obstacles or constraints
Freedom to (Positive freedom): This recognises the possibility of autonomously determining and achieving individual or collective purposes.

- The discourse on health as a human right must be seen as the second freedom, where every citizen can achieve health and wellness as part of their right to access public health.

Suggestions for UHC Implementation

Address urban migrants’ health needs and informal sector reforms.
- Mobile and portable healthcare access is crucial for migrant populations.
Simplify reimbursement processes to reduce out-of-pocket expenditures.
- Adapt cash transfers and reimbursements for migrants and marginalised communities.
Create inclusive health systems.
- Integrate health information systems across public and private systems.
- Address language barriers and urban context complexities.
Implement community-based primary healthcare with referral systems in urban and peri-urban areas.
- Integrate services at the primary healthcare level for better follow-up and adherence.