India infrastructure report, 2013/14: the road to universal health coverage

The Indian population today has little or no access to good quality healthcare at affordable prices. Not surprisingly, on several of the basic health indicators India ranks amongst the lowest in the world. The health crisis is aggravated by a rising
incidence of chronic and non-infectious diseases. The public health system is in jeopardy, due to decades of appallingly low public investments; inadequate and antiquated infrastructure; severe shortage of human resources; and inadequacies
in government policies. Failed public health systems have forced people to turn to the private sector, which is costly and unregulated, with services often being provided by unqualified medical practitioners. As a result, people seeking healthcare services have the agonising choice between poor quality public
facilities and costly, yet undependable private services. Preventive and primary healthcare have been marginalised, with the focus having shifted to curative tertiary care, higher importance of clinical medicine, and extremely high dependence on clinical investigations. Health expenditures can be prohibitively high with the rural population and the urban poor being the worst sufferers. India is thus faced with the daunting challenge of providing Universal Health Coverage
(UHC) and ensuring that all people receive good quality healthcare without facing significant financial difficulty.
Twelfth in the series, India Infrastructure Report 2013-14
looks at the challenges for ensuring availability, accessibility
, affordability and quality of comprehensive healthcare to all, and explores strategies to overcome the impediments along the road to UHC. In this process, it also discusses whether initiatives taken to reduce the burden of people’s health expenditure has yielded desirable results, how to
leverage the strengths of the private sector in healthcare delivery, role played by the non-state entities in rural healthcare, imperatives of engaging with the community
, and the high impact of preventive care at low cost. The
Report draws the readers’ attention to some of the emerging issues in the health sector such as rising burden of non-
communicable diseases and mental health, human resource
crisis in health sector, and health concerns of informal sector workers, and steps required to attend to them within the UHC framework.
The result of a collaborative effort led by the IDFC Foundation, this Report brings together a range of insightful perceptions of academics, researchers and practitioners committed to improving healthcare practices. It will be an extremely useful resource for policy-makers, academics, researchers and corporates engaged in this sector.