how to achieve universal health coverage in india .what are the govt initiatives and what more innovations are required to achieve it.what is the status of health manpower specially doctors and supper specialist and how their number can be increased in short time. is double shift in medical colleges is the answer or providing direct md/ms is the answer.the health planner and niti ayoug has to look into all these possibilties. do we need to redefine the definition of primary health care?simply increasing gdp on health can result in the provision of universal health coverage in india ?

2. Sub-Centers &
Primary
Health Centre
Community
Health Centre
District
Hospital
Medical
College
Private
Clinics /
Hospital
Homeopathic
System of Medicine
Ayurveda System and
other indigenous system
Quacks

4. UNIVERSAL HEALTH COVERAGE
•

5. ESSENTIAL QUALITY HEALTH CARE PROTECTS
COUNTRIES FROM
EPIDEMICS
REDUCES POVERTY
REDUCES RISK OF HUNGER

6. CREATE JOBS
ENHANCE ECONOMIC GROWTH
GENDER EQUALITY

7. •
DEATH
FINANCIAL
HARDSHIPS
BUYING
FOOD
BUYING
MEDICINE
NO ONE
HAS TO
CHOOSE
NO ONE
HAS TO
CHOOSE

8. •
If we are to meet SDG
target 3.8 on achieving
universal health
coverage by 2030.

10. DOCTORS AT PHC SPECIALIST
DOCTORS
NURSES AT PHC /
CHC
25354
22040
78530
18900
4192
69022
PRESENT HEALTH SITUATION IN RURAL INDIA
REQUIRED IN POSITION
Rural health Statistics, 2015

11. TRENDS IN ACCESS TO MEDICINES IN INDIA – 1986 – 87 to 2004
Period Free Medicines
(%)
Partly Free
(%)
On payment
(%)
Not received
(%)
In Patient
1986 – 87 31.20 15.00 40.95 12.85
1995 - 96 12.29 13.15 67.75 6.80
2004 8.99 16.38 71.79 2.84
Out patient
1986 17.98 4.36 65.55 12.11
1995 – 96 7.21 2.71 79.32 10.76
2004 5.34 3.38 65.27 26.01
National Sample Survey, Round 60

12. Country Doctors per 10000
population
Beds per 10000
population
Nurses and
Midwives per
10,000
populations
India 7.0 (10) 9.0 (20) 17.1
Bangladesh 3.6 3.0 2.2
Sri Lanka 6.8 29.0 16.4
Thailand 3.9 18.0 20.8
Myanmar 6.1 6.0 10.0
World Health Statistics, WHO 2007 - 13

13. 73.90% 26.10%
Doctors Distribution
Urban Rural
National Health Mission

14. Present Status
Doctors per 10,000
population
(Practicing Doctors)
Total doctors in
India (for
130,000,00,00
Population)
Total
demand
(1/1000
population)
Deficiency Present
Growth Rate
04 / 10,000
population
5,20,000 130,00,00 7,80,000 1.2

15. Way to 2030 Present Status Total doctors by
2030
Deficiency
estimated by
2030
Expected
Population in
2030
Doctors
needed by
2030
150,000,00,00 150,00,00 30,000
(out of 60,000 students
produced every year 50%
will be Practicing)
8,80,000
(5,20,000 + 3,60,000)
6,20,000
To achieve Universal Health Coverage there is
need to produce more (6,20,000) doctors

16. 0
5000
10000
15000
20000
25000
RURAL URBAN OVERALL
14935
24436
18268
MEDICAL EXPENDITURE (IN Rs)
RURAL URBAN OVERALL NSSO 2014

17. OUT OF POCKET
EXPENDITURE
• 17.3 % Indians spend more than 10% of their
income for treatment and
• 3.9 % spend more than 25 % of their annual
income on treatment TRACKING UHC GLOBAL
MONITORING REPORT,2017

18. 0.00%
1.00%
2.00%
3.00%
4.00%
5.00%
PRESENT SCENARIO TARGET FOR 2025 (NHP) WHO
RECOMMENDATIONS
1.15%
2.50%
5.00%
GDP EXPENDITURE ON HEALTH IN INDIA
PRESENT SCENARIO TARGET FOR 2025 (NHP) WHO RECOMMENDATIONS

19. SUPER SPECIALITY DOCTORS PRODUCED
EVERY YEAR
NEW CARDIAC CASES
EVERY YEAR
DM CARDIOLOGY 334 4.75 LAKH ANGIOPLASTY
/ YEAR
2.0 LAKH
CABG/YEARMCh CARDIO THORACIC
SURGERY
108
NATIONAL INTERVENTIONAL COUNCIL, 2015
10% – 25 %
ANNUAL INCREASE

20. COMPONENTS
OF
PRIMARY
HEALTH CARE
AVAILABILITY
ACCEPTIBILITY
AFFORDIBILITY
ACCOUNTABILITY
QUALITY
MOTIVATION
MISSING

22. PRIORITIZE
•
•

23. EXPAND COVERAGE FOR EVERY ONE
•
•

24. INCLUDING POOREST OF THE
POOR
•
•

25. POLITICAL
WILL
RESOURCES
FUTURISTIC
PLANNING &
EFFECTIVE
IMPLEMENTATION

26. HEALTH CESS
AYUSHMAN BHARAT
SWASTHA NAGRIK ABHIYAN

27. • Introduction of 1% Health
Cess in income tax from 2018
- 19

28. AYUSHMAN BHARAT
• In the union health budget 2018 – 19,
• Finance Minister of India launched “Ayushman Bharat” which include:
• Rs 5 lakh insurance cover to 10 Crore poor families
• 1 government medical college in three parliamentary constituencies
• 1200 crore for Ayushman Bharat program
• 1.5 lakh health wellness centers to be allocated in India

29. •
10 crore poor vulnerable families
approximately 50 crore beneficiaries
Rs 5 lakh per
family per year

30. The Swachh Bharat Abhiyan
Balanced, healthy diets and regular
exercises.
Addressing tobacco, alcohol and substance
abuse
SWASTHYA NAGRIK ABHIYAAN

31. Yatri Suraksha – preventing deaths due to rail and
road traffic accidents
Nirbhaya Nari –action against gender violence
Reduced stress and improved safety in the work
place
Reducing indoor and outdoor air pollution
SWASTHYA NAGRIK ABHIYAAN

32. Bhartiya Jan Aushadhi Pariyojna
Make in India
A price cap on stents
PMSSY
Union budget 2018

33. •
3348 stores in
India

34. •

35. The price of drug eluting stents revised downwards to just under Rs 28,000
The cap on bare metal stents raised from Rs 7,400 to Rs 7,660
The trade margin allowed on stents maintained at 8%
Revised price caps will remain in effect till March 31, 2019.

36. 6 institutions like AIIMS
All existing AIIMS have functional
Medical & Nursing Colleges
Upgradation of 39 Medical Colleges /
Institutions

37. • Health
and Wellness Centres
• comprehensive care

38. 1 new government medical
college for every 3
parliamentary districts

39. •
Rs 500 per month all TB
patients
The disease mainly affects
the poor and malnourished

40. PROVISION OF TERTIARY CARE SERVICES
POWER HOUSE OF MEDICAL PROFESSIONALS (MBBS AND MD
DOCTORS)
CAPACITY BUILDING OF PARA MEDICAL STAFF
MEDICAL RESEARCH

41. IMPLEMENTATION, MONITORING AND EVALUATION OF
NATIONAL HEALTH PROGRAMMES
POLICY ADVOCACY FOR CHANGES IN THE PROGRAM
STANDARD OPERATING PROCEDURE (SOP’S)
QUALITY ASSURANCE

42. A WAY TO FUTURE ESSENTIAL INNOVATIONS…
INCREASE NUMBER OF SPECIALIST AND SUPER
SPECIALIST COURSES
BIANNUAL ADMISSION TO PG SEATS
MBBS SEATS TO BE DIRECTLY CONVERTED TO
SPECIALIST SEATS

43. A WAY TO FUTURE ESSENTIAL INNOVATIONS…
Double shift of existing medical colleges
Public private partnerships
Telemedicine
Virtual medical university

44. I wish that I would become a medical student
and learn again with this technology. This is
my dream. Ultimately this is going to benefit
the people at large, because with this, you
will be able to produce good doctors and
good doctors ultimately will do a good job
for the people.
VIRTUAL MEDICAL UNIVERSITY:
MEDRC

45. VIRTUAL MEDICAL UNIVERSITY:
MEDRC
The idea is so great that it can break the
boundaries of one medical college, it
can break the boundaries of a state as
well as of a region and the medical
students all across the nation can see
the best faculty.

46. •

47. •

48. “If we don’t create the future, the
present extends itself”
- Toni Morrison (Song of Solomon)

49. Dhara bech denge, gagan bech denge…
Nadi naale parvat chaman bech denge…
Seva ke masiha agar tum na samjhe…
To satta ke masiha vatan bech denge…