Health Sector – UHC, National Health Policy, Family Planning, Health Insurance, etc.

Implementing Universal Health Coverage


From UPSC perspective, the following things are important :

Prelims level: Government Schemes and Policies in News; National Health Policy, 2017;

Mains level: Social Issues and Justice; Health Issues in India; Government Schemes and Policies in News;

Why in the news?

On the eve of World Health Day (7th April), many countries aim to implement UHC (Universal Health Coverage) in the same way as India introduced its National Health Policy, in 2017. However, there exist challenges in India too for implementing it.


  • On December 12, 2012, the UN General Assembly unanimously endorsed a resolution urging countries to accelerate progress towards UHC.
  • In India, the high-level expert group report, submitted to the Planning Commission in 2011, outlined a government intent to increase public financing for health to 2.5% of India’s GDP during the 12th Plan (2012-17).


About National Health Policy, 2017:

It aims to achieve Universal Health Coverage and deliver quality healthcare services to all at an affordable cost. It focuses on improving health status through preventive, promotive, curative, palliative, and rehabilitative services with an emphasis on quality.


What are the challenges in the Implementation of UHC in India? 

  • Federal Issue: Health is a state subject in India, but UHC policy is envisaged at the national level. This can lead to challenges in coordination between the central government and state governments.
    • While the Directive Principles of State Policy provide a basis for the right to health, the absence of a specific constitutional guarantee may create challenges in ensuring consistent and enforceable healthcare rights.
  • Migrant Population and Urban Slums:  Due to issues such as overcrowding, poor sanitation, and limited infrastructure, a significant portion of the population living in urban slums face issues with the availability and accessibility of Primary Health Services is hard to provide.
  • Lack of Finance: Implementing UHC requires significant financial resources. Reducing out-of-pocket expenditure and strengthening primary healthcare services necessitate substantial investments, which may strain government budgets and require innovative financing mechanisms to ensure sustainability.
  • Lack of Healthcare Infrastructure and Human Resources:  India faces shortages in both infrastructure and human resources, particularly in rural and underserved areas, which hinders efforts to improve healthcare accessibility and quality.
  • The vicious cycle of poverty: The vicious cycle of poverty and poor health perpetuates inequality in various spheres of life which eventually leads to the accessibility of health services.

Suggestive Measures:

  • Addressing Urban Migrants’ Health Needs: Establishing mobile healthcare units or clinics that can reach migrant communities in urban and peri-urban areas, providing essential primary healthcare services.
  • Reducing Out-of-Pocket Expenditure: Simplifying the reimbursement process by digitizing healthcare payment systems and integrating them with government identification or mobile banking platforms to facilitate easy reimbursement for medical expenses.
  • Creating Inclusive Health Systems: Introducing multilingual and culturally sensitive health information materials and services to bridge language barriers and ensure accessibility for diverse urban populations.
  • Implementing Community-Based Primary Healthcare: Establishing community health centers or clinics in urban and peri-urban areas staffed by trained community health workers who can provide basic healthcare services and referrals.

Conclusion: Building Constitutional backing, enhancing coordination, and federal with fiscal consensus with adequate infrastructure in addressing urban health needs can improve the reach of the Universal Health Program in India.

Mains PYQ

Q Public health system has limitation in providing universal health coverage. Do you think that private sector can help in bridging the gap? What other viable alternatives do you suggest? (UPSC IAS/2015)

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