Discuss the challenges in achieving universal health coverage in India. What role can public-private partnerships play?

Q.9  Discuss the challenges in achieving universal health coverage in India. What role can public-private partnerships play?

Ans: Universal Health Coverage (UHC) aims to ensure that all individuals have access to quality healthcare without financial hardship. Despite initiatives like Ayushman Bharat, India faces challenges in achieving UHC, including inadequate infrastructure, inequitable access, and insufficient funding. Public-private partnerships (PPPs) can play a significant role in addressing these challenges.

Challenges in Achieving Universal Health Coverage

1. Inadequate Healthcare Infrastructure: India faces a shortage of hospitals, doctors, and medical equipment, especially in rural areas. Example: As per the National Health Profile 2021, India has only 0.9 beds per 1,000 population, far below the global average.
2. Inequitable Access to Healthcare: Disparities in healthcare access between urban and rural areas and across states persist. Example: States like Bihar and Uttar Pradesh have significantly lower healthcare access compared to Kerala and Tamil Nadu.
3. High Out-of-Pocket Expenditure: A large proportion of healthcare costs are borne by individuals, pushing many into poverty. Example: According to the National Health Accounts (2019-20), out-of-pocket expenditure accounts for 48% of total health expenditure.
4. Insufficient Public Health Funding: India’s public health expenditure is only 2.1% of GDP, much lower than the global average of 6%. Example: The 2023-24 Union Budget allocated ₹89 crore to health, which is insufficient to meet the growing healthcare needs.
5. Shortage of Skilled Healthcare Workforce: India faces a shortage of doctors, nurses, and paramedical staff, particularly in rural areas. Example: The WHO recommends 1 doctor per 1,000 population, but India has only 0.8 doctors per 1,000 population.
6. Fragmented Healthcare System: Lack of integration between primary, secondary, and tertiary healthcare services affects service delivery. Example: The National Health Mission (NHM) struggles to integrate services across different levels of care.

Role of Public-Private Partnerships (PPPs) in Achieving UHC

1. Expanding Healthcare Infrastructure: PPPs can help build and manage hospitals, diagnostic centers, and clinics, especially in underserved areas. Example: The National Health Mission (NHM) has partnered with private hospitals to provide free dialysis services under the Pradhan Mantri National Dialysis Programme.
2. Improving Service Delivery: Private sector efficiency can enhance the quality and accessibility of healthcare services. Example: The Ayushman Bharat-PMJAY scheme partners with private hospitals to provide cashless treatment to 50 crore beneficiaries.
3. Leveraging Technology: PPPs can promote telemedicine and digital health solutions to reach remote areas. Example: The e-Sanjeevani telemedicine platform has facilitated over 10 crore consultations, bridging the urban-rural healthcare gap.
4. Enhancing Skilled Workforce: Private sector involvement in medical education and training can address the shortage of healthcare professionals. Example: The National Skill Development Corporation (NSDC) collaborates with private institutions to train healthcare workers.
5. Mobilizing Financial Resources: PPPs can attract private investment to supplement public funding for healthcare. Example: The National Health Stack (NHS) aims to create a digital infrastructure for healthcare, attracting private investments.
6. Innovative Healthcare Models: PPPs can introduce innovative models like health insurance and managed care to improve access and affordability. Example: The Rashtriya Swasthya Bima Yojana (RSBY) provided health insurance to below-poverty-line families through PPPs

Achieving Universal Health Coverage in India requires addressing challenges like inadequate infrastructure, inequitable access, and insufficient funding. Public-private partnerships can play a transformative role by leveraging private sector efficiency, innovation, and resources to complement public efforts.

Keywords: Universal Health Coverage (UHC) , Public-Private Partnerships (PPPs), Ayushman Bharat, Healthcare Infrastructure , Out-of-Pocket Expenditure , Telemedicine, Workforce Shortages.