Strengthening diagnostic services to achieve universal health coverage

Source: The post Strengthening diagnostic services to achieve universal health coverage has been created, based on the article “Reaching out to patients” published in “Indian Express” on 11th August 2025

UPSC Syllabus Topic: GS Paper 3- Issues relating to development and management of Social Sector/Services relating to Health,

Context: Accurate diagnosis is essential for effective treatment. India’s pledge to Universal Health Coverage (UHC) under the National Health Policy 2017 and the UN SDGs highlights the need for affordable, accessible diagnostic services. The article discusses current gaps, technological advances, and policy steps to strengthen public healthcare diagnostics. Strengthening diagnostic services to achieve universal health coverage

For detailed information on Universal Health Coverage (UHC) in India read this article here

Central Role of Diagnosis in Healthcare

1. Basis for Effective Treatment: Diagnosis, built on medical history, clinical examination, and laboratory tests, directs therapy and forecasts disease progression.
   Without timely tests, treatment may be delayed or misdirected.
2. Financial and Coverage Implications: Outpatient care forms over 60% of out-of-pocket spending, mostly on drugs, diagnostics, and transport.
   Health insurance rarely covers these costs, limiting financial protection.
3. Public Facility Gaps: Absence of local diagnostic services in public centres particularly affects rural areas and urban poor, lowering service coverage.

Bridging the Access Gap

1. Private Sector Reach and Limitations: Private diagnostics offer variety but remain out of reach for large rural and low-income urban populations.
   Mobile clinics and point-of-care devices help but cannot replace local public facilities.
2. Need for Close-to-Home Services: UHC objectives demand diagnostics at Ayushman Aarogya Mandirs and Primary Health Centres (PHCs) to ensure equitable access.
3. Adapting to Health Transitions: India faces both rising non-communicable diseases (NCDs) like diabetes and heart disease and stubborn infectious diseases such as TB and malaria. Diagnostics must respond to both.

Harnessing Technology for Precision and Reach

1. Advances in Diagnostic Tools: Molecular diagnostics, imaging, and tele-diagnostics improve accuracy and bring expert opinion to remote areas.
   Semi-auto analysers are now available at PHCs; district hospitals have enhanced imaging.
2. Cost-Effective Use of Tests: Choosing tests requires balancing cost, accuracy, and clinical benefit. Evidence-based diagnostic algorithms should guide sequencing and simultaneous testing decisions.
3. Policy Role of ICMR: The Indian Council of Medical Research (ICMR) leads in updating the National List of Essential Diagnostics (NLED) to match epidemiological and technological changes.

Expanding Diagnostic Services Across Levels

1. Strengthening Primary and Sub-Centre Services: New services include HbA1C testing for diabetes, rapid tests for genetic and infectious diseases, and dengue sample collection at sub-centres.
2. Improved TB Detection: Molecular TB testing starts at sub-centres, with in-house facilities at higher centres, addressing high TB burden and late detection.
3. Responding to Climate Change: Expanded mosquito-borne disease testing is vital as transmission seasons and regions widen.

Building Capacity for Sustainable Improvement

1. Training Human Resources: Supplying equipment must be matched with trained lab technicians and skilled frontline workers to conduct and interpret tests.
2. Role of Artificial Intelligence: AI can help interpret results accurately, reducing errors from false positives and negatives.
3. Integrating Technical and Clinical Skills: Care providers must understand statistical measures like sensitivity, specificity, and predictive values to make correct clinical decisions.

Question for practice:

Examine the role of accessible diagnostic services in achieving universal health coverage in India.