Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:
(a) whether the Government proposes to roll out Universal Health Coverage (UHC) in the country, if so, the details thereof;
(b) the details of international models that are best suited for UHC in India; and
(c) the estimated cost likely to be incurred in implementing such an initiative?
ANSWER
THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND
FAMILY WELFARE
(SHRI ASHWINI KUMAR CHOUBEY)
(a) to (c): WHO has defined Universal health coverage (UHC) means when all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.
One of the important stated objectives of the National Health Policy (NHP), 2017 is to progressively achieve UHC, which includes: -
• Assuring availability of free, Comprehensive Primary Health Care (CPHC) services, for all aspects of reproductive, maternal, child and adolescent health and for the most prevalent communicable, non-communicable and occupational diseases in the population.
• Ensuring improved access and affordability, of quality secondary and tertiary care services through a combination of public hospitals and well measured strategic purchasing of services in health care deficit areas, from private care providers, especially the not-for profit providers.
• Achieving a significant reduction in out of pocket expenditure due to health care costs and achieving reduction in proportion of households experiencing catastrophic health expenditures and consequent impoverishment.
The primary vehicle towards provision of primary and secondary healthcare by strengthening public health systems in the States/UTs for moving towards UHC is the National Health Mission (NHM).
Under NHM, the Government has already taken many steps towards universal health coverage, by supporting States/UTs for provision of a host of free services including for maternal health, child health, adolescent health, family planning, universal immunisation programme, and for major diseases such as Tuberculosis, HIV/ AIDS, vector borne diseases such as Malaria, Dengue and Kala Azar, Leprosy etc. Other major initiatives include Janani Shishu Suraksha Karyakram (JSSK) (under which free drugs, free diagnostics, free blood and diet, free transport from home to institution, between facilities in case of a referral and drop back home is provided), Rashtriya Bal Swasthya Karyakram (RBSK) (which provides newborn and child health screening and early interventions services free of cost for birth defects, diseases, deficiencies and developmental delays), implementation of Free Drugs and Free Diagnostics Service Initiatives and National Ambulance Services.
Further, in alignment with the goals of NHP 2017, Ayushman Bharat, a national flagship program was launched in 2018, with the inter-connected components of CPHC and financial protection for secondary and tertiary healthcare with a continuum of care approach.
The Ayushman Bharat model of primary, secondary and tertiary care, with a continuum of care approach, is best suited to achieve the UHC in India keeping in view, the local context and realities. Various international best practices and healthcare delivery models across the world have been suitably customized and incorporated in the Ayushman Bharat model.
Ayushman Bharat is the road map for India towards UHC and it comprises of:
1. Creation of 1,50,000 Health and Wellness Centres (AB-HWCs) by December 2022, by transforming Sub Health Centres, Primary Health Centres (PHCs) and Urban PHCs into AB-HWCs, to provide Comprehensive Primary Health Care (CPHC) universally and closer to the community. The CPHC services include maternal and child health services, healthcare for communicable and non-communicable diseases, including free essential drugs and diagnostic services, preventive and promotive health care and expanding incrementally to also include primary health care services for oral, geriatric, palliative, mental health etc.
2. Pradhan Mantri Jan Arogya Yojana (PM-JAY) provides health protection cover to about 10.74 identified eligible households for secondary and tertiary care, up to Rs. 5.00 lakh per family per year .
The National Health Policy 2017, envisages to increase the health expenditure by Government (including Central and State Governments) as a percentage of GDP from the existing 1.15% to 2.5 % by 2025.
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