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APSP - Session 10 - K. Srinath Reddy - UHC
APSP - Session 10 - K. Srinath Reddy - UHC
2010 2011
2012
2012-2014
Economic Slowdown & Food Security Act Push UHC off Radar
2014
2015
2016
NRHM
NHM
RSBY
Gains
Gains
RMNCH + A
Improved Control of TB, Malaria
Improved Emergency Services
Infrastructure Strengthening
Attention to HMIS
Shortcomings
NCDs, Mental Health etc. excluded
Shortages of Human Resources:
Limit Access, Quality and Affordability
Marked Inter-State Differences;
Performance And Governance
Urban Component Yet to Take Off
Shortcomings
Confined to Hospital Care
Limited / No Impact On OOPS
Regulatory Challenges + Fraud
Competition With State Programmes
Source: SRS
60
WHO threshold of
22.8 per 10,000
53.9 52.6
50
40
39.9
32.4
30
20
10
7.9
6.3 5.3
Considering only doctors, nurses and midwives, HRH density comes out
Source: NSSO, 2011-12
to be 20.7 per 10,000 population
36.3
Pharmacist
41.1
14.7
58.9
85.3
33.0
67.0
45.3
AYUSH
54.7
35.8
63.7
64.2
96.8
34.1
65.9
0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0
Rural
Urban
Source: NSSO 2012-13
UHC in India
Changing Role of Centre and States
14th Finance Commission : Higher share of tax revenues to States
Central Government : States should take up more responsibility for resources, design
and delivery
NHM will continue to advance RMNCH+A; NCDs to be added at primary care level
(HT + DM + 3 Cancers: Cervix; Breast; Oral)
RSBY is being expanded as RSSY (NHPS) with a National Health Agency (NHA) to
administer with link to State Health Agencies (SHAs); States may add to and
co-brand with NHPS; some may continue with State Funded Health Insurance What
will progressive universalization mean in each state context?
Will health inequities between high performers and low performers widen?
Improve Physical and IT Connectivity Between Sub-Centres, PHCs, CHCs and District
Hospitals
Decrease in the number of pools and schemes in the country to increase efficiency
Concentration on a comprehensive benefit package for all people and in all schemes
Increased allocation for public health services
Reliance on strategic purchasing, including purchasing from empaneled private
sector providers
Supplementary role of open market private health insurance
Provide portability across the country