Complexity in achieving Universal Health Coverage (UHC) in India

Source: The post complexity in achieving Universal Health Coverage (UHC) in India has been created, based on the article “The challenge of universal health coverage” published in “The Hindu” on 18th December 2024

UPSC Syllabus Topic: GS Paper2- Governance – Issues relating to development and management of Social Sector/Services relating to Health.

Context: The article highlights India’s diverse healthcare challenges and the need for state-specific strategies for universal health coverage. It emphasizes the importance of addressing local health profiles, reducing out-of-pocket expenses, and strengthening primary healthcare for effective solutions.

For detailed information on Universal Health Coverage (UHC)

Why is there complexity in achieving Universal Health Coverage (UHC) in India?

1. Diverse Health Systems: India has multiple health system types across states, with some states having more than one system. This diversity complicates a one-size-fits-all approach to UHC.
2. Uneven Health Expenditure: Per capita government health expenditure varies widely. For example, Himachal Pradesh spends ₹3,829, Kerala ₹2,590, and Bihar only ₹701 (National Health Accounts 2019-20).
3. State-Specific Challenges: West Bengal has a low fertility rate (1.64) but a high teenage pregnancy rate (16%). In contrast, Kerala and Himachal Pradesh have teenage pregnancy rates of only 2.4% and 3.4%.
4. High Out-of-Pocket Expenditure: Despite increased government spending, out-of-pocket costs remain high. West Bengal’s rate was 67% in 2019-20, and Andhra Pradesh’s was 64%.
5. Non-Communicable Diseases: States like West Bengal, Bihar, and Gujarat have high blood sugar rates but low hypertension. Kerala and Tamil Nadu face high rates of both conditions, requiring tailored interventions.
6. Infrastructure Gaps: A 58% shortfall in primary health centers in states like West Bengal weakens primary care delivery.
7. Misaligned Policies: High C-section rates in public hospitals of West Bengal show inefficiencies in resource utilization, despite schemes like Swasthya Sathi.

What should be done?

1. The complex healthcare landscape requires a holistic approach, considering local health profiles, historical and cultural factors, and regional public health needs.
2. A one-size-fits-all solution is ineffective; instead, state-specific strategies and enhanced primary care are essential for effective healthcare delivery.

Question for practice:

Examine the factors contributing to the complexity of achieving Universal Health Coverage (UHC) in India and suggest measures to address these challenges.