Achieving Universal Health Coverage in India requires addressing the structural imbalance between primary care neglect and tertiary care expansion. Examine this statement in the light of India's National Health Policy 2017 and Ayushman Bharat scheme.

Question

PocketIAS · Accepted Answer

Introduction Achieving Universal Health Coverage (UHC) in India requires a balanced system. However, India faces a structural imbalance where tertiary care expansion outpaces primary care strengthening, undermining accessibility and cost-effectiveness.

Structural Imbalance in Healthcare

Skewed focus on specialised hospitals and curative care over preventive and primary services
High out-of-pocket expenditure due to inadequate primary care gatekeeping
Overburdened tertiary facilities handling avoidable conditions

National Health Policy (NHP) 2017 Perspective

Emphasises comprehensive primary healthcare as the foundation of UHC
Targets two-thirds of public health spending on primary care
Advocates preventive, promotive, and community-based care
However, implementation remains uneven with continued underinvestment in primary infrastructure

Ayushman Bharat Scheme

Health and Wellness Centres (HWCs)
- Aim to strengthen primary healthcare with expanded services (NCDs, maternal health, etc.)
- Progress significant but constrained by human resource and infrastructure gaps
Pradhan Mantri Jan Arogya Yojana (PM-JAY)
- Provides insurance coverage for secondary and tertiary care hospitalisation
- Risks reinforcing hospital-centric care model
- Private sector dominance may divert focus from public primary care

Critical Assessment

PM-JAY addresses financial protection but not preventive health needs
Weak referral systems lead to direct access to costly tertiary care
Insufficient integration between HWCs and PM-JAY
Regional disparities persist in healthcare access

Way Forward

Prioritise primary healthcare investment in line with NHP targets
Strengthen referral linkages between HWCs and higher facilities
Increase public health workforce and infrastructure
Align PM-JAY with preventive and primary care outcomes
Enhance state capacity and decentralised planning

Conclusion Without correcting the imbalance between primary and tertiary care, UHC will remain incomplete. A primary care-led, integrated health system is essential for equitable and sustainable healthcare delivery in India.

✍️ Practice Mode

Write. Evaluate. Improve. Repeat.

The model answer is ready.

Comments (0)