The road to universal health care in State


Pilot health-care models in select districts soon

Kerala is all set to float its experiment at achieving ‘universal access to equitable, affordable, and quality health care services’ or Universal Health Coverage (UHC), as envisaged in the 12th Plan by initiating pilot health-care models in select districts.

The National Rural Health Mission (NRHM) had put up its proposal for piloting a primary care model in one district (Thiruvananthapuram) last year itself. The Union Health Ministry has now proposed that it will directly implement district health system pilots in two more districts in the State.

Kerala is thus in a unique position to show the way towards UHC for other States because it will be piloting two health system models. Once the care models are implemented and impact assessment done, a clear idea about the health system framework that helps Kerala achieve the goal of UHC will emerge, a senior Health official told The Hindu .

12th Plan focus

The 12th Plan focuses on the concept of UHC as a situation where people are able to access a range of quality health-care services, including preventive care, medicines, treatment, rehabilitation, and palliative care, at affordable rates.

The UHC is a broad concept which also involves the strengthening of the primary-care services through the improvement of manpower, infrastructure, and pro-active role of health workers in the community. In general, UHC is a development process and a journey towards achieving the Right to Health Care.

The NRHM’s proposal last year, submitted as part of the State’s Programme Implementation Plan for 2013-14, envisaged a pilot project for improving and evolving a model for the primary health-care system. An experiment at achieving UHC, it proposed the pilot in three institutions in Thiruvananthapuram district — the primary health centres (PHC) of Kallikkad and Chemmaruthi and the community health centre (CHC) of Venpakal.

‘‘The Union Health Ministry has approved our pilot project and has sanctioned Rs.2 crore for the same. If the project is successful, the State government will have to make budgetary allocation for its scaling up. The technical support for the project is being rendered by Mala Rao, Professor of International Health at the University of East London, U.K., who helped us prepare the proposal,’’ a senior health official said.

Formal agreement

The Health Department will soon be signing a formal agreement with the University of East London regarding the implementation. The State Health System Resource Centre will be the nodal agency to implement the project, which will also draw up a detailed plan for strengthening the infrastructure and manpower in the selected institutions. The Achutha Menon Centre for Health Science Studies, in consultation with Dr. Rao, will conduct the baseline survey in Thiruvananthapuram to map the infrastructure and the level of health services currently being provided.

In two other districts — Thrissur to be one — the National Health System Resource Centre will take up the UHC pilots, which will map the entire health system — primary, secondary and tertiary care levels.

‘‘The State has already taken up a lot of innovative and welfare initiatives in the health sector in the past two years, including the free supply of generic drugs, price regulation of branded drugs through Karunya, Karunya Benevolent Fund, and comprehensive health insurance schemes such as CHIS and CHIS Plus. Along with the improved facilities, manpower, skill development of doctors, and re-defined role of health workers in providing preventive care in the community as envisaged in our pilot projects, Kerala could be on a fast track to the goal of universal and affordable care,” the official said.

The Rs.96 crore e-Health project won by the State, which aims at utilising information technology to build up a health database of the community or the State Health Information System, which will be updated real-time as soon as data are captured on the field, is envisaged as another component of the health system overhaul to aid UHC.

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