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Universal Access to Health Care

Universal Access to Health Care. Primary, secondary and tertiary health care provided to all citizens free of cost Tax-based financing Government runs most, if not all, health centres Standards of care Regulation/socialization of private sector. Health care in Bangalore city.

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Universal Access to Health Care

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  1. Universal Access to Health Care • Primary, secondary and tertiary health care provided to all citizens free of cost • Tax-based financing • Government runs most, if not all, health centres • Standards of care • Regulation/socialization of private sector

  2. Health care in Bangalore city Health & Family Welfare Ministry Private Sector BBMP Medical Education ESI

  3. NUHM: National Urban Health Missionರಾಷ್ಟ್ರೀಯ ನಗರ ಆರೋಗ್ಯ ಮಿಷನ್

  4. NUHM National Framework • Address health concerns of urban poor • City-specific planning to be institutionalized • Identification of urban poor and vulnerable populations • Existing health facilities • Partnerships with NGOs • Differentiates between for-profit and not-for-profit • Communitization

  5. NUHM in Bangalore city • November: Health Ministers' conference in Delhi • November 30th: Meeting chaired by principal secretary • December 5th & 12th: NUHM Roundtables at PHFI campus • December 21st: Meeting at Vikasa Soudha chaired by Principal Secretary, attended by Health Minister • Plan was to be released on January 25th

  6. NUHM Roundtables - Discussions • Primary Health Care • Ward as unit for PUHC, not 50,000 population • Comprehensive primary health care • Diagnostic services with Lab technician • Comprehensive counselor • Rehabilitation services • Available and accessible to all free of cost • Evening hours • Convergence with all departments providing direct and indirect services

  7. NUHM Roundtables - Discussions • Facilities • Atleast IPHS • As close to poor communities as possible • Rent or lease if necessary • Human Resources • Ongoing recruitment and buffer staff • No contract workers, only permanent staff • Good salaries for USHAs etc., not incentive-based pay • Bigger role for nurses

  8. NUHM Roundtables - Discussions • Secondary and tertiary care • Referral and counter-referral systems • Robust public infrastructure needed • High dependence on user fees in autonomous institutions • Medical colleges and the private sector to be involved through clearly defined mechanisms • Regulation of private sector • Insurance schemes hotly debated

  9. NUHM Meeting on December 21st • Urban Health Centres (UHCs) in all 198 wards of the city. Primary health care will be universal and free • Proposed budget for 2013-14 is Rs. 250 crore • Health Minister: 100-bed secondary level hospitals in each of the 28 assembly constituencies and specialty 500-bed hospitals in each of the 8 zones

  10. Questions • Primary care • Will it be truly comprehensive? • Wards/areas with high poor populations and lack of space • Agreements with private players? • Medical Education Department and Autonomous Institutions • Currently run most tertiary care institutions • No representation on State- and City-level committees • Financing of autonomous institutions

  11. Questions • Financing • Long-term sustainability • Untapped/unconsidered funds such as Construction workers' fund • Communitization • Functioning of ward committees • ESI

  12. The way forward...

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