January 12, 2011

Universal Health Care in India by 2020?

(Ivanhoe Newswire) -- India is rapidly growing, with its economy progressing to make it one of the biggest players on the world stage. However, its health care and public health systems are not sufficient and fail to address the needs of its continually growing population, according to a series of seven papers published in The Lancet. Experts in the articles have pinpointed problems faced by India's health care system and call on the country to establish a truly universal health care system by 2020.

According to the articles, India faces problems with infectious diseases. Patients often turn to private sectors. Only a functional public health infrastructure shared between central and state governments, with adequate infectious disease and epidemiology training of personnel, can prevent and control infectious diseases in order to reduce the burden on the health care system, the authors say.

About 1.8 million children under age 5 die in India every year; 68,000 mothers die due to maternal causes, and 52 million children in the country are stunted. The authors say that nutrition programs currently focus on 3- to 6-year olds, rather than children aged 2 years and under, which are critical years for preventing under nutrition.

Massive inequities also exist in India. The authors propose that India must substantially increase the share of Gross Domestic Product (GDP) that it spends on health. They offer four key principles that should guide future progress: use of equity metrics; investment in health-systems research; equity-focused decision-making in health care; and redefinition of specific responsibilities of key players.

The authors propose five major strategies to achieve universal health care: the provision of a universal health insurance scheme for all citizens; the establishment of autonomous councils for promoting accountable and evidence-based practices and for promoting the production, distribution and utilization of appropriate human resources for health; the restructure of the governance of health with convergence of all health-related ministries or departments and complete decentralization to a district-based model; and to legislate and enforce the health entitlements of Indians.

SOURCE: The Lancet, published online January 11, 2010