Moving forward with a newer concept of UHC

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Source- The post is based on the article “Moving forward with a newer concept of UHC” published in “The Hindu” on 20th March 2023.

Syllabus: GS2- Issues related to development and management of health

Relevance– Issues related to universal healthcare

News– The article discusses the new approach needed to ensure healthcare for all and weakness of earlier approaches.

What is the World Health Organization definition of health?

It is the totality of health. It includes mental and social well being and happiness, and an absence of disease and disability. It calls for addressing the health determinants.

This necessitates a need for an intersectoral convergence between departments such as women and child development, food and nutrition, agriculture and animal husbandry, civil supplies, rural water supply and sanitation, social welfare, tribal welfare, education, forestry.

What are some facts related to Universal Health Care?

It was proposed by Halfdan Mahler and endorsed by the World Health Assembly in 1977. It means universalisation of healthcare.

Nobody is denied this. Everybody is eligible without being discriminated against on the basis of financial status, gender, race, place of residence, affordability to pay or any other factors.

India, through its National Health Policy 1983, committed itself to the ‘Health for All’ goal by 2000.

How did partial coverage of the population and partial responsibility of the ruling government to pay for health care come into picture?

The International Conference on Primary Health Care, at Alma Ata in 1978 listed eight components of minimum care for all citizens.

It mandated all health promotion activities, and the prevention of diseases. It includes vaccinations and treatment of minor illnesses and accidents. These should be free for all using government resources, especially for the poor.

Any non­communicable disease, and its treatment were almost excluded from primary health care.

Secondary and tertiary care was left to the individual. They could either seek it from a limited number of public hospitals or from the private sector.

What were the consequences of this approach?

There were not enough government run institutions for the poor. This abdication of responsibility to provide secondary or tertiary care by the state has some consequences.

It ensured the growth of the dominant, unregulated, profit making private sector and also the health insurance sector

This created a dichotomy between peripheral primary and institutional preferred specialist care at the secondary and tertiary levels.

What is the way forward to ensure healthcare for all?

There is a need for a newer concept of UHC. It should encompass primary, secondary and tertiary care for all who need it at affordable cost without discrimination.

The Universal Health Coverage slogan must be avoided. It is neither universal in its implementation nor comprehensive in its coverage of services. It never assures accessibility or affordability.

Every individual has a right to health. That right is guaranteed only by individualism in public health. It is a new global approach to UHC.

The World Health Assembly resolution of 2011 urges countries for timely finance of the health sector to reduce out of pocket expenses. The Astana declaration of 2018 calls for “partnership” with the private sector.

A globally accepted health systems concept has emerged since the Beijing Health Systems Research Conference 2012. It is a multimodal system of varied sectors, professional streams and specialities with a variety of staff to deliver Comprehensive Universal Health Care.

The National Health Mission with concurrent intersectoral thrusts on Poshan Abhiyan, National Food Security, the Mahatma Gandhi National Rural Employment Guarantee Act, water

sanitation, Sarva Shiksha Abhiyan is a better model of fully tax funded Universal Health Care. But the Ayushman Bharat Jan Arogya Bhima Yojana damages that approach.

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