Lok Sabha Question No. 941 (UNSTARRED), answered on 2019-11-22
Subject: Universal Health Coverage
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Prasun Banerjee

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

LOK SABHA UNSTARRED QUESTION NO. 941 TO BE ANSWERED ON 22 ND NOVEMBER, 2019

## UNIVERSAL HEALTH COV ERAGE

## 941.SHRI PRASUN BANERJEE:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a)  whether  the  Government  proposes  to  roll  out  Universal  Health  Coverage  (UHC)  in  t country, if so, the details thereof;
- (b) the details of international models that are best suited for UHC in India; and
- (c) the estimated cost likely to be incurred in implementing such an initiative?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI ASHWINI KUMAR CHOUBEY)

- (a) to (c): WHO has defined Universal health coverage (UHC) means when all people and communities  can  use  the  promotive,  preventive,  curative,  rehabilitative  and  palliative services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.

One  of  the importantstated  objectives  of  the  National  Health  Policy (NHP),  2017  is  to progressively achieve UHC, which includes: -

- Assuring availability of free, Comp rehensive Primary Health Care (CPHC) services, for all  aspects  of  reproductive,  maternal,  child  and  adolescent  health  and  for  th prevalent communicable, non - communicable and occupational diseases in the population.
- Ensuring  improved  access  and affordability,  of  quality  secondary  and  tertiary  car services  through  a  combination  of  public  hospitals  and  well  measured  strate purchasing of services in health care deficit areas, from private care providers, especially the not - for profit providers.
- Achieving a significant reduction in out of pocket expenditure due to health care and  achieving  reduction  in  proportion  of  households  experiencing  catastrophic  he expenditures and consequent impoverishment.

The  primaryvehicletowards  provis ion  of  primary  and  secondary  healthcare by strengthen ingpublic health systems in the States /UTs for moving towards UHC is the National Health Mission (NHM) .

Under NHM , the Government has already taken many steps towards universal health coverage , by supporting  States /UTs for  provision  of  a  host  of  free services  including  for maternal  health,  child  health,  adolescent  health,  family  planning,  universal  immunis programme, and for major diseases such as Tuberculosis, HIV/ AIDS, vector borne diseas es such as Malaria, Dengue and Kala Azar, Leprosy etc. Other major initiatives include Janani ShishuSurakshaKaryakram (JSSK) (under which free drugs, free diagnostics, free blood an diet, free transport from home to institution, between facilities in ca se of a referral and drop back home is provided), Rashtriya Bal Swasthya Karyakram (RBSK) (which provides newborn and  child  health  screening  and  early  interventions  services  free  of  cost  for  birth diseases,  deficiencies  and  developmental  delays), implementation  of  Free  Drugs  and  Free Diagnostics Service Initiatives nd National Ambulance Services .

Further, i n alignment with the goal sof NHP 2017,Ayushman Bharat, a national flagship program  was  launched  in  2018 ,  with  the  inter - connected  components  of  CPHC  and  financial protection for secondary and tertiary healthcare with a continuum of care approach .

The Ayushman Bharat model of primary, secondary and tertiary care, with a continuu of care approach, is best suited to achieve the UHC in India keeping in view, the local cont and  realities.  Various nternational  best  practices  and  healthcare  delivery  models  across world have been suitably customized and incorporated in the Ayushman Bharat model.

Ayushman Bharat is the road map for India towards UHC and it comprises of:

1. Creation  of  1,50, 000  Health  and  Wellness  Centres  (AB - HWCs)  by  December  2022,  by transforming Sub Health Centres, Primary Health Centres (PHCs) and Urban PHCs into AB -HWCs, to provide Comprehensive Primary Health Care (CPHC) universally and closer to the community.  The CPHC services include maternal and child health services, healthcare for communicable and non -communicable diseases, including free essential drugs and diagnosti servic es, preventive and promotive health care and expanding incrementally to also inc primary health care services for oral, geriatric, palliative, mental health etc.
2. Pradhan  Mantri  Jan  Arogya  Yojana  (PM - JAY)  provides  health  protection  cover  to about 10.7 4 identified eligible households for secondary and tertiary care ,up to Rs. 5.00 lakh per family per year .

The National  Health  Policy  2017, envisages  to  increase  the health  expenditure by Government  (including  Central  and  State  Governments) as  a  pe rcentage  of  GDP  from  the existing 1.15% to 2.5 % by 2025.

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