On December 12, 2012, a unanimously passed United Nations resolution marked the day for Universal Health Coverage. It has now been two years since the endorsement for universal health coverage, that has since become the pillar for sustainable development and global security. The goal of Universal Health Coverage is to ensure that all people obtain health services they need without financial hardship.This requires a strong, efficient and well-run health system.
Such a system of financing health services includes access to essential medicines, technologies, along with a cadre of well-trained and motivated health workers. India’s efforts in these directions had already begun since 2005 with the advent of the National Rural Health Mission, launched to offer accessible, affordable and quality health care to rural populations. The intent was to cater to the most vulnerable sections. The focus of the Mission is to reduce Maternal Mortality Ratio, Infant Mortality Ratio and Total Fertility Rate.
The United Nations in India supports the Government of India to move forward towards Universal Health Coverage. For this purpose it provides evidence, technical and policy advice on effective interventions as well as mechanisms to monitor all progress. The WHO Country Office in India works in conjunction with ten leading world organizations for the purpose. These are Department for International Development (DFID), Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ), International Labour Organization (ILO), UNAIDS, United Nations Development Programme (UNDP), United Nations Population Fund (UNFPA), United Nations Children’s Fund (UNICEF), United States Aid for International Development (USAID), and the World Bank.
All these organizations work together to promote better support and commitment to Universal Health Coverage in India. Both the NRHM and the recently launched National Urban Health Mission (NUHM) are now included under the National Health Mission (NHM). Although some progress is made in bits and spurts, especially after formation of NHM there remain widespread challenges that need to be tackled. Some home truths emerge, that need to be taken cognizance of:
- Inadequacy of availability of health care services (both public and private sectors).
- Questionable quality of healthcare services (both in public and private sector).
- Regulatory standards for public /private hospitals are inadequately defined and remain ineffectively enforced.
- Affordability of health care remains a serious handicap, more so for majority of impoverished populations.
- Most people incur heavy expenses for medical services purchased from the private sector.
- The total expenditure on health care (both public and private together) is 3.7 per cent of the GDP.
The first-ever Universal Health Coverage Day was observed in New Delhi to mark the two-year anniversary. The high-level event convened by the Public Health Foundation of India and World Health Organization, was supported by Rockefeller Foundation and Oxfam India as part of a coalition having over 500 health and development organizations. They are all attempting to accelerate reforms that ensure health services be provided to all citizens. The quality of health services, medicines and diagnostics will hopefully be improved, thereby facilitating efficacy of National Health Assurance Mission. For doing this successfully the entire medical fraternity at all levels needs to pitch in to make a go with combined efforts.