Design and development of a Universal Health Coverage policy framework for the state of Jammu and Kashmir

Access is defined as having medicines continuously available and affordable at public or private health facilities or medicine outlets that are within one hour’s walk from the homes of the population. Access to essential medicines has been viewed as an integral component of the right to health, which is a basic human right. Inequity in medicines access is widely perceived as symptomatic of weaknesses in the health-care system and represents a failure on the part of national governments to fulfill their obligations towards their citizens in terms of their right to health. Ensuring equitable access to quality pharmaceuticals is thus a key development challenge and an essential component of health system strengthen­ing and primary health care reform programmes throughout the world.
 

WHO Director General Margaret Chan’s assertion that universal health coverage is “the single most powerful concept that public health has to offer”, attests to the increasing worldwide attention given to universal coverage— even for less affluent countries—as a way to reduce financial impoverishment caused by health spending and increase access to key health services. Public sector in India is in a state of neglect and has traditionally been poorly funded. Public expenditure on health stood at around 1.04% of GDP in 2012, one of the lowest in the world. Consequently, large sections of the population depend on a poorly regulated private sector, increasingly dominated by networked corporate hospital chains, which have an infamous track record of unethical practices.  Out-of-pocket expenditure on health care (approximately 70% of households’ health care expenses) contributes to widespread poverty in India.
 

As per available statistics every fifth citizen of the state of Jammu and Kashmir is falling Below Poverty Line (BPL). A total of 24.21 lakh people are living under BPL category which includes 22 lakhs in rural areas and 7.96 percent residing in urban areas of state. With a total GSDP of INR 8731872 lakhs recorded in the year 2013-2014 and the total budgetary allocation for drugs and instruments earmarked at INR 5750 lakhs, state government spends 0.065% of its GSDP on drugs and devices. Even though healthcare indicators of Jammu and Kashmir are improving considerably, there is much more which needs to be done to rejuvenate it. Government of Jammu and Kashmir needs to take substantive measures towards ensuring equitable access to healthcare and rational use of medicines in the state. Formulating a comprehensive and robust policy framework for providing Universal Health Coverage to its citizens is the primary step that the state government needs to take.

 

This study is an attempt to analyze the situation on ground vis-a-vis availability, financial accessibility, geographical accessibility, affordability and acceptability of healthcare services particularly essential medicines at public health facilities of the state with an aim to identify the gaps, barriers, prospects and challenges towards adopting and implementing universal health coverage. Subsequently a comprehensive policy framework covering all relevant aspects concerning UHC including health service delivery, health workforce, health information systems, access to essential medicines, health systems financing, leadership and governance shall be developed that shall lay a roadmap for future policy direction of the state government towards implementing Universal Health Coverage scheme in the state.