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 ways. 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.
Contents
Universal Access To Primary HealthCare
India And the World
Present Scenario and The Need for Change
Our Innovation and Model
Resources; Challenges; Mitigation & Impact
Conclusion
An initiative by Team Convicted
Sneha Pande
Saurabh Tomar Nitin Chamoli Anurag Amar
Shubham Naithani
Graphic Era University Dehradun
Uttarakhand
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.”
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GDP
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 collection 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 the poor.
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
District Hospitals Family Welfare
Centers
Primary Health Centers
Sub Centers
Block Level Surveys
Health Checkups
According to the model the government-funded block-scale 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 state. The factors would include:- Lifestyle differences Poverty differentials Natural Risks Physical Environment Political Outlook Social Capital 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
Government Agencies 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 workers 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 problems 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 sectors 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.