Can Universal Health Coverage achieve the goal of health for all in India: A theoretical and empirical exploration

Abstract

To fulfil the objective of health for all, the World Health Organisation (WHO) Alma Ata Declaration of 1978 endorsed by every country, including India, emphasised building primary health care, which is funded by the government. The Declaration played its part in shaping the first two National Health Policy documents of India (in 1983 and 2002). However, at the 2005 World Health Assembly, the WHO shifted its focus from primary health care to Universal Health Coverage (UHC). The UHC was envisaged to assure care through (a) avoiding catastrophic healthcare expenditure through health-financing reforms, and (b) the availability of equitable and quality health care services that governments will ensure. This shift is reflected in the latest National Health Policy of 2017, which talked about the ‘strategic purchase’ of services from the private sector by the government and health financing reforms. This paper critically evaluates the implications of such a strategy shift for public health care in the States of India. Implications for access to healthcare is also discussed.