UHC project leads to ‘significant change’ in TN

The study titled ‘Universal Health Coverage-Pilot in Tamil Nadu: Has it delivered what was expected?’ was undertaken by Centre for Technology and Policy, Department of Humanities and Social Sciences of the institute. The report about the findings has been submitted to the state Health Department. 

The study showed that the UHC pilot project brought about a dramatic fall in the overall dependence on private providers, particularly those seeking care from private hospitals. It also brought about a substantial fall in the out of pocket expenditure among those seeking out-patient (OP) care from both public and private providers. 

The pilot project was launched in early 2017 at Shoolagiri block in Krishnagiri health unit district (HUD), Viralimalai block (Pudukkottai HUD) and Veppur block (Perambalur HUD). The first step was to strengthen the primary health care service. As a result, health sub-centres (HSCs), which are the closest delivery points to the community, have become the building blocks of UHC in Tamil Nadu. 

After the implementation of UHC pilot, the HSCs now account for 17.8 per cent of all OPs in Shoolagiri block, 14.8 per cent in Viralimalai, and 23.1 per cent in Veppur block, respectively. Before the project was undertaken, HSCs in these three blocks accounted for less than 1 per cent of all OPs. 

A comparison between the pre (201516) and post UHC pilot (Dec.2017) shows that the share of private hospitals for OP care have dropped significantly: to 21 from 51 per cent at Shoolagiri block, to 24.2 from 47.8 per cent at Viralimalai block, and to 23.9 from 40.9 per cent at Veppur block. 

“This is perhaps the first time in the country we have a robust survey on both household health seeking behaviour and facility-based utilisation be fore and after intervention any public health intervention,” said professor VR Muraleedharan, from the Department of Humanities of the institute. 

“The report provides unambiguous evidence in support of increased access to HSCs, diversion of patients from higher level public facilities, and also from private hospitals, significant reduction in out of pocket expenses for patients seeking care from both public and private facilities, and significantly lower cost of provision of OP care per visit in pilot HSCs,” he added.