Goal three of the ambitious Sustainable Development Goals (SDGs) requires all countries to achieve Universal Health Coverage(UHC) by 2030.
What does the SDG say?
It entails access to quality essential health care services, access to safe, effective and affordable medicines and vaccines, as well as financial risk protection for all at all ages. UHC could, therefore, be regarded as an umbrella goal for health in the new development agenda.
- It not only transcends all other health-related targets but also draws linkages with the rest of the development goals.
- The achievement of UHC is critical to the success of the overarching vision of the SDGs, which is to ‘leave no one behind’.
- Given the population size and health burden of India, one can also posit that the global accomplishment of the SDGs is contingent on India’s success.
Journey of healthcare in India –
The pace of improvement in healthcare has been slow and plagued with a multiplicity of challenges. In fact, a Lancet study published last week ranks India 127th in terms of meeting the United Nations health-related SDGs – lowest among its BRICS peers. It is obvious therefore, that India’s fast economic growth has not yet translated into the health sector in a significant way.
Challenges with healthcare in India –
- The onus of a woman and child’s health is not on women alone but on the entire society. Addressing such issues requires going beyond health and delving into challenges that arise from societal attitudes, gender discrimination when it comes to nutrition, education and sanitation.
- Achieving UHC requires long-term high-level political commitment. At a macro level, the government spends a measly proportion (1.18 percent) of its Gross Domestic Product (GDP) on health – among the lowest globally. The long-awaited National Health Policy (NHP) 2017 proposed to increase public health spending to 2.5 percent of GDP by 2025. Eight years from now India intends to continue spending well below the current world average of 5.99 percent. Together with low public sector investments in health, the system also suffers from poor coordination caused by the presence of a vast number of vertical health and several institutions within the health department that must work together.
- The challenge also lies in defining the role that the government wants the private sector to play in the provision of healthcare and how it can ensure that funds are spent in a better way. One way of doing is price regulations, as done in the case of cardiac stents recently.
Way Forward –
While it may be tempting to follow the path which other countries have embarked upon to achieve UHC, it is important to remember that India has its own unique challenges and therefore requires context specific solutions. Within the country too, certain states are performing exceptionally and so rather than looking outside for lessons, Indian should look inwards and take lessons from the successes and failures of its states. The government should leverage private sector resources to fill in the healthcare delivery gaps.
In order to redesign the Indian healthcare system so as to make it conducive to UHC, India needs to first recognise its failures. Perhaps it is time for a dose of realism – identifying gaps and flaws will only help find viable solutions and lead to informed policy-making.
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