India’s health system was designed in a different era, when expectations of the
public and private sectors were different . India’s population is also undergoing
transitions in the demographic, epidemiologic and social aspects of health .Disparities
in life expectancy, disease, access to healthcare and protection from financial risks
have increased . These factors are challenging the health system to respond in new
In this presentation we ‘Team Convicted’ take the given privilege as a platform to
express our viewpoints and suggestions in context to the given Theme.
Universal Access To Primary HealthCare
India And the World
Present Scenario and The Need for Change
Our Innovation and Model
Resources; Challenges; Mitigation & Impact
An initiative by
Graphic Era University
Excerpts from the WHO Commission on the Social Determinants of
Health (June 2007):
“Universal coverage is achieved when the whole
population of a country has access to the same range of
quality services according to needs and preferences,
regardless of income level, social status, gender, caste,
religion, urban/rural or geographic residency, social or
personal background, which is accessible as per need at
all times. Such a system offers a comprehensive range of
curative/symptomatic, preventive- promotive and
rehabilitative health services at primary,
secondary and tertiary levels, including
common acute life saving interventions.”
Total health expenditure is the sum of public and private health expenditures .
It covers the provision of health services(preventive and curative), family planning
activities , nutrition activities and emergency aid designated for health but does
not include provision of water and sanitation.
The graph shows the comparative
health expenditure, total(% of GDP) of
various countries in the years 2008-12.
While President Obama’s top
priority is health. And says its,
“fundamentally about all people
having equal access to care.”
Japan had been able to attain a
successful UAHC with high marks in
good health and longevity.
While here in India the situation is still grim
The level of central Government spending across the states is quite similar ,
It does not reflect differences in health needs and the amount of fiscal efforts put
in by the states.
The performance measurement of Health System is not certain.
Private spending on health in India differs enormously among states
To have successful Universal Access to Health Care;
it is less about the availability of the resources, like
Japan being low on resources, and more about
curbing the role of the market in health care.
So , India does not lack in resources . All we need
is a good strategic policy.
Government funded block-scale survey-projects – including general health data
Regular record submission by health agencies to a central body
Data sharing of patients records and other necessary details at all the levels
Accessible medical history of a person throughout the system
Regular free health checkups at block-level to collect data for everyone including
By analyzing inter and intra state differences in context and processes,
The health policies today need to be more diverse and accommodating to specific
states and districts.
Just like vehicle insurance Health insurance must be made compulsory for all.
The insurance should be valid in all the hospitals within the country.
The Insurance must include all major diseases
It should include the standardization of public healthcare facilities
Online medical history of every individual
Reduced medical expense for people below the poverty line
Yearly health checkups for the renewal
Central Level Bodies
State Level Bodies
Municipal Level Bodies
Community Health Centers
Primary Health Centers
Block Level Surveys
According to the model the
survey projects & health checkups
along with the reports from the sub
centers to be submitted to the
Primary Health Centers these along
with their own data in turn forward
it to the high level Organizations
from where the data finally reaches
a Central Level Body.
This body now prioritizes the
health system choices by
considering local factors as per the
data passed on from various levels
and assigns the required amount to
The factors would include:-
Public Health Management Capacity
Computerization of at least one hospital within a particular block.
Outsourcing can be done within the government
Promotion of ADHAAR card.
Lack of awareness among masses about primary healthcare and facilities-this can
be mitigated by organizing nukkad nataks and public awareness campaigns.
Lack of determination to get oneself enrolled within the program-this can be
mitigated by making an individual realize the importance of primary health care
facilities for the society
Revenue Generated from Insurance
For middle class, tax payers and organised sector – mandatory social health
insurance mainly with contribution from employers and employees.
For unorganised sector workers, tax based funds plus some system of contribution
from those employers/principal beneficiaries who use the services of these
For the rural population, tax based funding linked with overall increased tax based
funding linked with overall increased tax based public funds for health care,
This ‘splitting’ of health policy at the state level would better address their health
Equal access to necessary Primary health services made easy and rational.
Introduction and facilitation of health insurance with universal coverage
Increase in the overall GDP of the country due to the insurance scheme.
The model helps to measure and disseminate performance of private and public
The model helps inform and empower people to live healthier
This also helps to bring up the poorly performing states in the health sector.
The health scenario in India is very bleak. The Government has to take some
concrete measures and implement them immediately!
At the central level, the command and control role of the government is
changing, and the Union Ministry of Health and Family Welfare needs to adapt to
these changes by adapting new roles.
We believe that a more explicit central role in addressing inequities between
states is required, the need of the hour is certainly an approach that balances extra
funding for more needy states, as well as for better performance in implementing
national priorities. More specific and comprehensive state policies and strategies in
health like Decentralization and health insurance are needed now more than ever.
If India is to truly achieve the aim of becoming a developed nation in the
years to come, it needs to put its medical infrastructure in order before proceeding
ahead, because a nation of weak men and women cannot deliver.
Thank you for the opportunity : Team Convicted.