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Universal Health Coverage
Context:
Universal Health Coverage (UHC) ensures that all individuals, regardless of economic status, have access to essential and quality healthcare services without financial hardship. It is integral to achieving equitable health outcomes and economic growth.
What is Universal Health Coverage?
- Comprehensive Healthcare Access: UHC provides access to a full spectrum of health services, including prevention, treatment, rehabilitation, and palliative care.
- Inclusive Services: Includes essential interventions like vaccinations, maternal and child health services, and treatment for communicable and non-communicable diseases.
Benefits of Universal Health Coverage
- Equitable Access: Ensures that healthcare is available to everyone, irrespective of income levels.
- Financial Protection: Reduces out-of-pocket (OOP) expenses, preventing families from falling into poverty due to medical costs.
- Improved Health Outcomes: Leads to better health and productivity through comprehensive service availability.
- Economic Growth: A healthy population boosts productivity and reduces the financial burden on households and economies.
Challenges in Achieving Universal Health Coverage
- Funding and Resource Allocation: Insufficient government health expenditure, especially in states like Bihar and Uttar Pradesh, hinders progress.
- Health System Inefficiencies: Poor management and coordination reduce the delivery of essential services.
- High Out-of-Pocket Expenditure: More than 50% of health spending in states like Kerala and Punjab comes from individuals, pushing many into poverty.
- Access to Quality Services: Shortages of skilled health workers and primary healthcare facilities, like in West Bengal, where there is a 58% shortfall in wellness centers.
- Healthcare Disparities: Significant variation in state-wise health spending and access to public health resources.
Potential Solutions for UHC
- Increased Government Spending: Invest in primary healthcare and ensure efficient use of funds to improve coverage.
- Health System Reforms: Introduce better management, enhanced coordination, and technology-driven service delivery.
- Financial Protection Measures: Implement health insurance schemes and subsidies to reduce the OOP burden.
- Equitable Access Initiatives: Address disparities by providing targeted support to underserved and vulnerable populations.
Indian Example: Ayushman Bharat
- World’s Largest Health Assurance Scheme: Covers over 500 million people, focusing on the socioeconomically weaker 40%.
- Comprehensive Coverage: Provides ₹500,000 per family annually for cashless treatment across a wide range of medical services.
- Primary Healthcare Emphasis: Transforms facilities into Health and Wellness Centers for holistic services.
Global Example: National Health Service (NHS), UK
- Established in 1948: Funded through taxation, providing healthcare free at the point of use.
- Equity in Access: Guarantees comprehensive health services to all UK residents, ensuring financial protection.
Global Trends and Challenges
- Limited Progress on SDG 3.8: Global UHC service coverage index increased from 45 to 68 (2000-2021) but progress has stagnated since 2015.
- Financial Hardship: Around 2 billion people face financial difficulties due to OOP expenses, with 344 million slipping into extreme poverty.
- COVID-19 Impact: The pandemic disrupted essential health services in 92% of countries during its peak, with lingering effects in 84% of nations by 2022.
WHO Recommendations
- Primary Health Care (PHC) Approach: Deliver 90% of essential UHC interventions via PHC, saving 60 million lives and increasing global life expectancy by 3.7 years by 2030.
- Health System Resilience: Build resilient systems to recover from disruptions and expand service coverage.
