In 2015, countries around the world, including India, adopted 17 Sustainable Development Goals (SDGs) with the aim to achieve them by 2030.
Goal 3 of these 17 #GlobalGoals is to ensure good health and well-being of people of all ages across the globe, and one of the targets of this health goal is to “achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.”
On July 13, 2018, Youth Ki Awaaz, along with WHO India, hosted a Twitter chat on the theme of Universal Health Coverage to understand how #HealthForAll can be turned into a reality for millions of Indians.
Good healthcare needs people, services, products, finances, policies and information. AND it needs all of these to work together. Find out how #HealthForAll can be a reality. Join @WHO and @YouthKiAwaaz for a Twitter chat tomorrow with experts. Tweet your questions on healthcare! pic.twitter.com/6DIDF0GxQG
— Youth Ki Awaaz (@YouthKiAwaaz) July 12, 2018
The four experts participating in the Twitter chat were: Dr. Chandrakant Lahariya (@DrLahariya), National Professional Officer – UHC, at WHO India; Alok Kumar (@IasAlok), Adviser (Health and Nutrition) at NITIAayog; Sanchita Sharma (@sanchx), Health and Science Editor at Hindustan Times; and Priyanka Dutt (@priydee), Country Director, BBC Media Action India.
The Twitter chat invited participation from several enthusiastic Twitterati. Organisations including Population Foundation Of India and Oxfam India lent their perspectives to the chat, adding nuance and value to the conversation.
In case you missed the Twitter chat, here are some highlights:
What is the Universal Health Coverage?
@sanchx: Ensuring equitable access for all Indians to affordable, accountable, appropriate and quality health services. Services must be provided to all, regardless of income, social status, gender, caste or religion.
@DrLahariya: UHC means that “all individuals & communities receive health services they need without suffering financial hardship. (https://t.co/0Wwlu7r9sK) . UHC includes the full spectrum of essential, quality health services, from health promotion to prevention, treatment, rehabilitation, and palliative care.
This especially becomes relevant in the Indian context because of prevalent socio-economic #inequality.
When #education is a fundamental right, we ask- Why Indians don’t have a Right to Health. #HealthForAll— Oxfam India (@OxfamIndia) July 13, 2018
YKA: What do you think should be the ideal contribution of a country’s GDP towards public health to ensure that #HealthForAll can be a reality?
Govts in LMICs spend average 5-6% of GDP on health. When govt expenditure on health is low, burden falls on people. Poor are most commonly affected. Thus, important to have adequate Govt spending on health . #HealthForAll; #UHC @YouthKiAwaz @WHO (1/3) https://t.co/aURDe6nR6A
— Chandrakant Lahariya (@DrLahariya) July 13, 2018
Evidence shows that when govts spend more, health services become affordable to people. It is also abt institutionalizing mechanisms to ensure health services are cashless at the point of delivery and reduce OOPE. #HealthForAll; #UHC @YouthKiAwaz @WHO (2/3) https://t.co/3oaZAUfHhW
— Chandrakant Lahariya (@DrLahariya) July 13, 2018
Out-of-pocket expenditure (OOPE) r direct payments made at the time services r used. OOPE r net of any reimbursement. Includes consultation, user fees, cost of medicine or diagnostics tests, etc. Transport cost typically not considered. #HealthForAll; #UHC @YouthKiAwaz @WHO (3/3 https://t.co/F8sYcrOj6u
— Chandrakant Lahariya (@DrLahariya) July 13, 2018
How digital technology can play a key role in contributing to #UniversalHealthCoverage in a country with a 1.3 billion population
@priydee: For large & diverse populations, #UniversalHealthCoverage demands standardisation, localisation, and personalisation, which need to be designed for and delivered at scale. Digital technologies help us achieve all those in the most cost-effective manner.
Population Foundation Of India chipped in with: There are emerging apps which have a number of specialists on board- acting like a helpline of sorts. Patients can call up and outline their issue which would then redirect them to concerned consultants.
#Kilkari, a mobile based service provides lifesaving information to 2.4mil pregnant women & mothers reaches in 13 states each week, providing right information to the right family at the right time #UniversalHealthCoverage #HealthForAll
— Priyanka Dutt (@priydee) July 13, 2018
Twitter user @PhysicianRural had some more app suggestions:
@curofy @Practo are physician rating apps but we need to be careful of any conflicts of interests.
For realizing #HealthForAll, we have @NHPINDIA and #MeraAsptal https://t.co/V59INXg7Sn.
— Bipin Kumar
(@PhysicianRural) July 13, 2018
(@PhysicianRural) Tech will strengthen MIS system to ensure supply chain management of medicines.
It will also strengthen emergency health services. #HealthForAll #DawaKaHaq
Join us in our campaign to demand access to affordable medicines https://t.co/plSwQP4ytV— Oxfam India (@OxfamIndia) July 13, 2018
How diverse communities can be engaged for stronger health outcomes in India
@priydee: Partnering with community organisations in the planning & design of #UniversalHealthCare solutions is critical to achieving people-centred, integrated health services that deliver quality, access, equity & accountability. Real world communities increasingly overlap with digital communities, providing inexpensive, efficient, standardized and yet personalized ways of engaging people in achieving. Digital tools are also very effective in empowering and equipping communities with knowledge of their rights and entitlements so that they can collectively demand access to quality, cost-effective and equitable health services.
#Communities can play a pivotal role in raising #awareness, monitoring quality of health services and engaging with providers to increase #accountability for health outputs and outcomes. #HealthForAll
— Population Foundation of India (@PFI3) July 13, 2018
@OxfamIndia chipped in with a superb input:
Traditional knowledge system practiced by indigenous communities like #Adivasis should be promoted for stronger health outcomes. Tribals use blueberry to tackle #anemia, neem and turmeric as an anti-septic and bamboo shoot to address malnutrition.
— Oxfam India (@OxfamIndia) July 13, 2018
YKA: What are the 3 areas in healthcare where technology can play an important role to help us move towards #HealthForAll?
@bbcmediaaction uses tech to provide easy, timely, cost-effective & lifesaving information to those who most need it, when they most need it. Tech allows for accurate & real-time data-driven management. And of course, tech is a game-changer for health systems. #HealthForAll
— Priyanka Dutt (@priydee) July 13, 2018
primary care (basic consultations, doctors’ appointment, finding the right specialists, etc.), health insurance, access to right medical information #HealthForAll
— Population Foundation of India (@PFI3) July 13, 2018
YKA: How do you see government initiatives like constructing toilets and the #SwachhBharat Tax addressing public health concerns in India?
@sanchx:
- Poor #sanitation causes repeated bouts of #diarrhoea and infectious diseases that lead to #malnutrition, which remains a major problem in India despite economic progress.
- #Diarrhoea is the third-biggest cause of #prematuredeath across ages in India in 2016, after #heartdisease and lung diseases, according to data from the Global Burden of Disease.
- Poor #sanitation is the leading cause of #diarrhoea, #malnutrition, cholera, hepatitis A and E, worm infestations, #typhoid and enteric fevers.
- Unsafe drinking water, excreta-contaminated food, open defecation, unusable toilets, untreated sewerage and not handwashing cause #infectiousdiseases like #diarrhoea.
Although these initiatives do solve a pertinent issue of providing basic services, a lot more needs to be done on ensuring favorable health practices within people’s homes, this is an area that needs more attention from various developmental partners, to make homes safer spaces.
— Vihara Innovation Network (@Viharadotasia) July 13, 2018
Twitter user @sumiraghav had an extremely valid and crucial point to make:
I have a son w special needs born with congenital problem. No insurance provides cover for people born with chromosomal animoly and congenital problems. Shouldn’t there be an anti-discrimination clause to ensures #HealthForAll and tht ppl with special needs aren’t discriminated?
— Sumithra Raghavan (@sumiraghav) July 13, 2018
@DrLahariya: India has drafted national policy on rare diseases. The provision under this policy and then in spirit implementation should hopefully change the availability of services for a rare and congenital disease. It would accelerate #UHC.
Lessons India can adopt from other countries in the area of using technology to create awareness on preventive healthcare
@priydee: Lots to learn. Linking HRIS to HMIS. Manage chronic conditions by linking health tech with comms for patient self-management; healthcare provider alerts to changes in patients’ condition & treatment adherence, especially for chronic conditions. Also consider AI for on-demand interaction with doctor, digital supply chains, process automation to free up services providers to provide care rather than documenting it.
Uganda has used mobile technology to track malnutrition among children. In a country where 35% children are malnourished, we can use mobile technology effectively to track this problem.
— Oxfam India (@OxfamIndia) July 13, 2018
@PFI3: Reliable research databases like PubMed provide accurate and reliable medical information, just a click away. In developed countries, especially in the USA, the health insurance companies, despite their shortcomings, play a big role in ensuring that patients have access to the right information starting from diagnosis to treatment.
YKA: How do you rate India’s infrastructure progress when it comes to facilitating the delivery of quality healthcare services?
@IasAlok: India’s health outcomes have moved in the right direction; MMR has declined by over 3/4th over 1990 levels to 130, U5MR has declined nearly by 2/3rd to 43 over the same period. Driven largely with the strengthening of Public health infra under NHM, particularly at SCs, PHC, CHC & DHs. Institutional deliveries have doubled over the last decade; increased immunization and antenatal checkups; 24×7 First Referral Units, SNCUs & a focus on Quality of Care.
However, we would also like to stress on the fact that despite this commendable feat, India has failed to meet the #MDG target of reducing Maternal Deaths, by 21 points
With current MMR at 130, National Health Mission target of reducing MMR to 100 has not been met. #HealthForAll— Oxfam India (@OxfamIndia) July 13, 2018
1. Bridge urban-rural gap in ante-natal (ANC) services & ensure universal access to ANC services as recommended by @WHO.
2. Universalize institutional delivery in public health facilities & timely payment under Janani Suraksha Yojana.
3. Address shortage of health facilities— Oxfam India (@OxfamIndia) July 13, 2018
YKA: What are the key components of Ayushman Bharat Programme?
@IasAlok: #AyushmanBharat has twin missions: Health & Wellness Centres & the health insurance component: 1st to operationalize 1.5 lac H&WCs offering a comprehensive preventive & primary care; with access to free drugs & diagnostics and referral to higher levels of care.
#AyushmanBharat -NHPM provides access to #cashless , #paperless & Nationally #Portable hospitalization & care services for a pre-specified #BenefitsPackage up to a limit of Rs 5,00,000 per family per annum to 500 million people at the bottom of the income ladder. #HealthforAll pic.twitter.com/fppj5bj5BZ
— Alok Kumar
(@IasAlok) July 13, 2018
NHPS oulines providing upto Rs500,000 cover per family per year for secondary and tertiary healthcare. There’s allocation of 1200 crores towards health & wellness centers & 600 crores towards nutrition for #TB patients. 24 new govt medical colleges will also be setup.
— Population Foundation of India (@PFI3) July 13, 2018
Twitter user @dpkryan had a valid question to ask:
In our country we are already lacking the required no. of doctors for providing health services. In such situation is #AyushmanBharat scheme enough to meet the health care demand of population?
— Deepak Kumar (@dpkryan) July 13, 2018
@OxfamIndia replied:
#AyushmanBharat alone cannot meet required number of doctors. Need of the hour is to increase spend of GDP on health to 3% by 2022 as per @WHO recommendation. Current spend is only 1% of GDP. #HealthForAll
— Oxfam India (@OxfamIndia) July 13, 2018
YKA: Do you feel that the proposed NHPM can widen its scope beyond hospitalisation to include the cost of buying important life-saving drugs from pharmacies for poor patients?
Spending on drugs constitutes a large part of the Out-of-Pocket Spending. Hence, availability and access to medicines is a critical part of the #UHC journey. Free drugs & diagnostics at H&WCs , # PMBJP & price controls on essential drugs is part of our strategy. #HealthForAll
— Alok Kumar
(@IasAlok) July 13, 2018
YKA: How is @NITIAayog contributing to ensure that Goal 3 of the #SDGs become a reality for millions of Indians?
.@NITIAayog is the nodal agency for monitoring all @SDGoals, including Goal 3 (Health). We played a key role in architecting #AyushmanBharat; as also triggering action in States through #HealthIndex & through the #AspirationalDistricts Programme. #HealthForAll
— Alok Kumar
(@IasAlok) July 13, 2018
YKA: How has WHO been working with the government to improve health services delivery and advance #UHC in India?
WHO has provided evidence based technical advice, conducted policy dialogues, shared global best practices and lessons learnt on UHC from other countries. #WHO work focuses in reducing inequities, improving financial protection. #HealthForAll; @YouthKiAwaz https://t.co/7kfdmswKYF
— Chandrakant Lahariya (@DrLahariya) July 13, 2018
YKA: How will the Health & Wellness Centres under the ABP initiative help India in improving the quality of primary healthcare?
@DrLahariya: Well, HWCs design aims to strengthen PHC by (a) reducing time to access health facilities, (b) expanding services, (c) augmenting HR, (d) making medicine n diagnostics available &, (e) functional referral linkage.
The success of HWC initiative lies in getting both design n implementation right, from the very beginning. Rapid scale-up, capital investment, attention on poor performing states, urban PHC, program monitoring would help.
YKA: In October, global leaders are meeting at the primary healthcare conference to address key health challenges. Why is primary healthcare important for achieving #HealthForAll?
@DrLahariya: PHC can address up to 80-90% of #health needs of any population. That makes it efficient and affordable approach to deliver health services. PHC is community oriented, aims to provide a broad range of services closer to where people are.
Absolutely agreed, but this can only happen if the current shortage of health centers, human resource, equipment, medicines and electricity is met.
Currently, only 11% of SHC, 16% of PHCs, 16% of CHCs meet IPHS standards.— Oxfam India (@OxfamIndia) July 13, 2018
Twitter user @shreetishakya had an important question:
@YouthKiAwaaz I was recently i bero block in JH, there some men told me that they do not know that services other than ANC and delivery are available in Sub centres. How do you ensure #healthforall when comprehensive primary health care info is not given to all?
— shreeti (@shreetishakya) July 13, 2018
@DrLahariya replied:
Hi, this is sadly a reality n that’s why successful implementation n scale up of health n wellness centres (HWC) under #AyushmanBharat is vital to strengthen #PHC in India. State such as #Jharkhand nd 2 get priority. @YouthKiAwaaz @RajivKumar1 @dasraghubar @JPNadda @IasAlok https://t.co/dRHpi7lJEg
— Chandrakant Lahariya (@DrLahariya) July 13, 2018
What role can mainstream media play to advance #UHC
@sanchx: Media must identify gaps in #publichealth delivery for quick course correction and celebrate successes that can be scaled up to benefit more people. Correct and unbiased reporting can help identify gaps in delivery and best practices to improve #publichealth services and reach the under-served. Mass media and communication, including social media, should be used to share correct information about the services available and people’s rights as citizens.
Media orgs like @IndiaSpend have been doing a fantastic job in going beyond attractive headlines and mining healthcare data to show ground realities. Eg: calculation of govt spend of Rs 3 a day on Indians. Mainstream media must play watchdog of UHC, a scheme of monumental scale
— Oxfam India (@OxfamIndia) July 13, 2018
Twitter user @dr_pritamroy asked @DrLahariya: What will be your message to State Health Programme Officers to make UHC reality?
I would suggest them to follow Five pronged strategy of “Make- Build- Choose- Launch – Converge” to achieve UHC in Indian states. That's what the role of state program managers . @JPNadda @MoHFW_INDIA @NITIAayog @YouthKiAwaaz @IasAlok @RajivKumar1 (1/4) https://t.co/74McMSTNWX
— Chandrakant Lahariya (@DrLahariya) July 13, 2018
(1)Make a commitment, draft and agree on a road-map to achieve UHC in a defined period;
(2)Build upon the existing programs and initiatives to increase breadth and depth of coverage;
(2/4) @YouthKiAwaaz @IasAlok @MoHFW_INDIA @NITIAayog https://t.co/Zg2TBHnYx2— Chandrakant Lahariya (@DrLahariya) July 13, 2018
(3) Choose which dimension to expand first; however, all 3 dimensions (population coverage, services coverage and financial protection) are needed;
(4)Launch additional initiatives as well to address the identified and emerging health challenges and address inequities;
(3/4) https://t.co/7kRoODsMcp— Chandrakant Lahariya (@DrLahariya) July 13, 2018
(5)Converge all health sector initiatives; with stakeholders and with other non-health sectors to achieve the common goals of health systems, including delivery of services in people centric and integrated manner.
(4/4) @YouthKiAwaaz @NITIAayog @MoHFW_INDIA https://t.co/cq8iWATBdU— Chandrakant Lahariya (@DrLahariya) July 13, 2018
Youth Ki Awaaz and WHO have joined hands to advocate for the right for everyone to have access to basic health care. Be a part of this movement online using hashtag #HealthforAll and follow the conversation here.
Organised as a part of #HealthForAll, a campaign by WHO India and Youth Ki Awaaz to advocate access to healthcare for everyone, everywhere, the Twitter chat reached close to 3 million people on Twitter.
How do you think we can make quality healthcare affordable and accessible for all? Tweet your responses @YouthKiAwaaz with #HealthForAll!
The post ‘Health Is A Human Right’: 4 Experts Share How We Can Make #HealthForAll A Reality appeared first and originally on Youth Ki Awaaz and is a copyright of the same. Please do not republish.