Strengthening of PHCs key to success of universal health care, say experts

A study by IIT Madras revealed that the share of outpatients in private hospitals dropped after implementing universal health care project in three districts on a pilot basis in 2018. The share of outpatient services in private hospitals was about 46 per cent on an average but it dropped to 21 percent after the universal health care pilot project was launched.

Dr R Jayanthi, dean, Rajiv Gandhi Government General Hospital said that equipping primary health care centres with more facilities and services for outpatient care will help to reduce the overall dependency on the private healthcare providers.

The Primary Health Centres (PHCs) provide a restricted list of services including primary neonatal care, child immunisation and national disease control programmes, while a large section of outpatient services for chronic diseases are not available.

In a report on the universal health care in Tamil Nadu, professor T Sundararaman, dean, School of Health Systems Studies, Tata Institute of Social Sciences said that all chronic illnesses would require a doctor or appropriate specialist for confirming diagnosis and making a treatment plan. But once this is made, the follow up required can be provided by nurses or mid care providers, he said. The strengthening of PHCs to provide outpatient services is needed to avail universal health coverage.

“Due to dependence on private sector for primary care, around 70 per cent of the money spent is patient’s own money, despite government authorities claiming to provide various schemes and insurance benefits,” said Dr G R Ravindranath, general secretary, Doctors’ Association for Social Equality.

Non-communicable diseases and cardiovascular diseases are increasing in Tamil Nadu. “An area of concern that remains is the rapid rise in non-communicable diseases. The cost burden of Non-communicable diseases (NCD) as per a World Economic Forum (WEF) report by 2030 for India alone, will be Rs 4.8 trillion, which will be 50 per cent of the nation’s Gross Domestic Product (GDP),” said Dr Preetha Reddy of Apollo Hospitals.

Other challenges to universal health coverage that remain are access to primary and quality healthcare, changing disease patterns, price regulations on treatments and medical devices.