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

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.
Facts
International UHC Day theme (2023): “Health for all: Time for Action”

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