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 ?
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
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
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
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
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
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
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.