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...