Universal Health Coverage in India

Universal health coverage is a pressing goal for India, home to 1.43 billion people. The challenge is immense, with children and senior citizens constituting portion of the population. Achieving universal health coverage requires innovative strategies and collaborative efforts from various sectors.

Current Context

The book “Mission Possible” by Swami Subramanian and Aparajithan Srivathsan outlines potential pathways to universal health coverage in India. It marks the need for a robust health system supported by modern technology and community involvement. The Public Health Foundation of India has proposed an Integrated National Health System. This system aims to provide universal health insurance and ensure accountable, high-quality healthcare.

Key Proposals for Health System Improvement

1. Integrated National Health System – Establish universal health insurance and autonomous organisations to uphold quality standards.
2. Strengthening Public Health – The public health system should be the main provider of health services. This includes preventive, promotive, and curative care.
3. Incorporating Private Sector – Integrate private healthcare into the national health system to enhance quality and reduce costs.

Bhore Committee

The Bhore Committee report of 1946 laid the groundwork for India’s public health system. It recommended a three-tier healthcare model that combines preventive and curative services. The aim was to ensure access to medical care regardless of financial capability. Changes in medical education were also suggested to improve healthcare delivery.

Role of Technology

Technology plays important role in modern healthcare delivery. The use of mobile phones and electronic medical records facilitates better patient management. Community health workers can perform many tasks traditionally reserved for doctors, effectively utilising technology to reach underserved populations.

Community Health Worker Model

Community health workers are essential for delivering healthcare to large populations. Each worker can serve approximately 40,000 people, working alongside district hospitals for specialised care. This model ensures that healthcare is accessible and efficient.

Training and Development

Training programmes for medical students should include community medicine exposure. This hands-on experience is vital for understanding local health needs. The proposal for an Indian Medical Service mirrors the administrative structure of the IAS, ensuring dedicated healthcare professionals manage state health systems.

Collaboration with Private Sector

Private medical centres and foundations should coexist with public healthcare. Successful models already exist, such as ophthalmology institutions in South India. These institutions connect local health workers with advanced research facilities, allowing for remote diagnosis and treatment.

Questions for UPSC:

1. Critically analyse the role of technology in improving healthcare delivery in rural India.
2. What is the Integrated National Health System? How does it propose to enhance healthcare access in India?
3. Estimate the impact of community health workers on healthcare outcomes in underserved populations.
4. Point out the historical significance of the Bhore Committee report in shaping India’s health policies.

Answer Hints:

1. Critically analyse the role of technology in improving healthcare delivery in rural India.

1. Technology enhances communication between healthcare providers and patients through mobile phones and telemedicine.
2. Electronic medical records streamline patient data management, improving care coordination.
3. Community health workers utilize technology to perform tasks traditionally reserved for doctors, increasing efficiency.
4. Remote diagnostics allow healthcare access without the need for patients to travel long distances.
5. Innovative health apps and platforms can educate and empower rural populations about health issues.

2. What is the Integrated National Health System? How does it propose to enhance healthcare access in India?

1. The Integrated National Health System aims to provide universal health insurance for all citizens.
2. It proposes the establishment of autonomous organizations to uphold quality healthcare standards.
3. The system focuses on strengthening the public health sector as the primary provider of health services.
4. It emphasizes coordinated and decentralized health governance for better management.
5. Legislation for health entitlements will ensure that every Indian has access to necessary healthcare services.

3. Estimate the impact of community health workers on healthcare outcomes in underserved populations.

1. Community health workers can serve large populations, improving healthcare accessibility and reach.
2. They provide essential preventive and promotive care, reducing the burden on hospitals.
3. Training community health workers enhances local health knowledge and skills, leading to better health outcomes.
4. They serve as a bridge between the community and healthcare facilities, facilitating timely referrals.
5. Empowering community health workers can lead to increased community engagement and health awareness.

4. Point out the historical significance of the Bhore Committee report in shaping India’s health policies.

1. The Bhore Committee report of 1946 laid the foundation for India’s public health system.
2. It recommended a three-tier healthcare model integrating preventive and curative services.
3. The report emphasized access to healthcare regardless of financial capability, promoting equity.
4. It called for reforms in medical education to improve healthcare delivery.
5. The recommendations influenced subsequent health policies and the establishment of healthcare institutions in India.