universal access to health care primary, secondary and tertiary health care provided to all citizens...

Universal Access to Health Care

Primary, secondary and tertiary health care provided to all citizens free of cost

Tax-based financing Government runs most, if not all, health

centres Standards of care Regulation/socialization of private sector

Health care in Bangalore city

BBMP

Health & Family Welfare Ministry

Medical EducationESI

Private Sector

NUHM: National Urban Health Mission

ರಾ�ಷ್ಟ್ರೀ� ��ಯ ನಗರ ಆರೋ �ಗ � ಮಿಷನ್ �

NUHM National Framework

Address health concerns of urban poor City-specific planning to be institutionalized

Identification of urban poor and vulnerable populations

Existing health facilities Partnerships with NGOs

Differentiates between for-profit and not-for-profit

Communitization

NUHM in Bangalore city November: Health Ministers' conference in

Delhi November 30th: Meeting chaired by principal

secretary December 5th & 12th: NUHM Roundtables at

PHFI campus December 21st: Meeting at Vikasa Soudha

chaired by Principal Secretary, attended by Health Minister

Plan was to be released on January 25th

NUHM Roundtables - Discussions Primary Health Care

Ward as unit for PUHC, not 50,000 population Comprehensive primary health care

Diagnostic services with Lab technician Comprehensive counselor Rehabilitation services

Available and accessible to all free of cost Evening hours Convergence with all departments providing

direct and indirect services

NUHM Roundtables - Discussions

Facilities Atleast IPHS As close to poor communities as possible Rent or lease if necessary

Human Resources Ongoing recruitment and buffer staff No contract workers, only permanent staff Good salaries for USHAs etc., not incentive-

based pay Bigger role for nurses

NUHM Roundtables - Discussions

Secondary and tertiary care Referral and counter-referral systems Robust public infrastructure needed

High dependence on user fees in autonomous institutions

Medical colleges and the private sector to be involved through clearly defined mechanisms

Regulation of private sector Insurance schemes hotly debated

NUHM Meeting on December 21st

Urban Health Centres (UHCs) in all 198 wards of the city. Primary health care will be universal and free

Proposed budget for 2013-14 is Rs. 250 crore Health Minister: 100-bed secondary level

hospitals in each of the 28 assembly constituencies and specialty 500-bed hospitals in each of the 8 zones

Questions Primary care

Will it be truly comprehensive? Wards/areas with high poor populations and

lack of space Agreements with private players?

Medical Education Department and Autonomous Institutions

Currently run most tertiary care institutions No representation on State- and City-level

committees Financing of autonomous institutions

Questions

Financing Long-term sustainability Untapped/unconsidered funds such as

Construction workers' fund Communitization

Functioning of ward committees ESI

The way forward...