To achieve universal health coverage, governments across the world seek to deliver a basic set of critical health services for all their citizens. These services, or essential health packages (EHPs), form the backbone of public health systems.
In India though, even with several different public health interventions, there is no clarity on what services should be covered under India’s EHPs and how these should be delivered, suggests a study. India’s EHP should be determined by the disease burden and existing health coverage, argue Shankar Prinja and others in the study published in the Economic and Political Weekly. Using survey data from 12,134 households across Gujarat, Haryana and Uttar Pradesh, the authors attempt to design an EHP for India.
They find that across the three states, the overall illness rate was 11.2% with an unmet need for medical treatment of 6-7%. Within this, the largest unmet need for treatment came from those suffering from cardiovascular conditions and non-communicable diseases. In contrast, treatment related to maternal and child healthcare had the lowest unmet need because of government initiatives dedicated to those conditions.
The authors also find that cardiovascular diseases, respiratory infections, injuries, and neoplasia hurt the poor the most. They suggest that treatment for these conditions should be included in a basic health package.
The authors also find that the median annual out-of-pocket expenditure on in-patient treatment was around ₹10,000 across households and estimate that an insurance cover of ₹3 lakh would be enough to cover all the needs for deprived families in rural areas. They thus recommend the insurance cover in the Ayushman Bharat scheme be decreased from ₹5 lakh to ₹3 lakh as this could lower the premium cost and make the scheme more efficient. – Live Mint