Universal Health Coverage: India's Commitments Under SDGs
Universal Health Coverage (UHC) is now the critical yardstick for nations to estimate and trace progress toward the 'Sustainable Development Goals (SDGs).' Being a signatory, India has began taking measures to achieve the targets laid out within the SDG framework and attaining the UHC. With India's National Health Policy (NHP) – 2017 in place, the policy environment for modifying country's health landscape tallies with that of the global approach toward building up health systems and attain UHC. It is imperative that for achieving the desired results laid down in the SDGs and NHP-2017, coordinated measures are needed comprising political action for making health an individual's right; effective supervision from the National Ministry of Health and Family Welfare; reconstruction of health-care service delivery executing a 'systems approach;' securing financial protection against health-care costs and magnifying community participation and accountability. Following these steps, consuming the lesson and emphasizing upon global experiences can assist the country strongly move forward towards attaining global and national targets, thereby ensuring UHC for all its citizens.
Challenges and gains in the Indian health sector
India today lies at a crossroad. While there have been ramarkable gains in terms of upgraded health outcomes over the past decade, on the other hand, nation and its people are experiencing various health-related challenges. The leadership from the Ministry of Health and Family Welfare (MoHFW), Government of India (GOI) and combined efforts of the state governments have resulted in impressive gains and calculated efforts have brought down the country's infant mortality rate from 58 (2005) to 34 (2016) per 1000 livebirths and maternal mortality ratio from 556/100,000 livebirths (1990) to 130/100,000 livebirths during 2014 to 2016. These decrements in mortality rates outrun the international averages for the same time-period and had called for admiration on the global forums. Additionally, India has succeeded in getting rid of diseases such as yaws, polio and maternal and neonatal tetanus and attaining Millennium Development Goal (MDG-6) on fighting human immunodeficiency virus, malaria and tuberculosis.
In spite of these developments, critical challenges still remain. India accounts for 1.2 million under-five deaths or 17 per cent of global annual child deaths, with an annual birth cohort of 26 million children. It puts up 22 per cent of the global burden of communicable, maternal, perinatal and nutritional conditions. Full immunization coverage is in the range of 61 per cent with wide interstate differences. The life expectancy of 68.3 years in India is the second lowest in the WHO South-East Asia Region and nearly 26.2 per cent of country's premature mortality is now accredited to injuries and NCDs. High rates of nutritional deficiencies and emerging and remerging infectious diseases such as chikungunya, dengue and viral encephalitis are the other significant issues, specially in urban areas.
Roadmap for India: lesson from experiences
India's health structure is marred by wide intra- and inter-state discrepancies in terms of workforce, health infrastructure, financing and service delivery. To administer the existing health challenges, the union government has taken significant policy-level initiatives in the recent years, specially after floating SDGs. The establishment of 'National Institution for Transforming India' (NITI Aayog) and the launch of the National Health Policy-2017 (NHP) are welcome steps indicating the pro-activeness of the government. To continue efforts toward attaining UHC, sustaining the momentum and achieving the demographic dividend, following a roadmap toward UHC with a comprehensive action agendum is a key.
