universal access to health care primary, secondary and tertiary health care provided to all citizens...
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Universal Access to Health CarePrimary, secondary and tertiary health care provided to all citizens free of costTax-based financingGovernment runs most, if not all, health centresStandards of careRegulation/socialization of private sector
Health care in Bangalore cityBBMPHealth & Family Welfare MinistryMedical EducationESIPrivate Sector
NUHM: National Urban Health Mission
NUHM National FrameworkAddress health concerns of urban poorCity-specific planning to be institutionalizedIdentification of urban poor and vulnerable populationsExisting health facilitiesPartnerships with NGOsDifferentiates between for-profit and not-for-profitCommunitization
NUHM in Bangalore cityNovember: Health Ministers' conference in DelhiNovember 30th: Meeting chaired by principal secretaryDecember 5th & 12th: NUHM Roundtables at PHFI campus December 21st: Meeting at Vikasa Soudha chaired by Principal Secretary, attended by Health MinisterPlan was to be released on January 25th
NUHM Roundtables - DiscussionsPrimary Health CareWard as unit for PUHC, not 50,000 populationComprehensive primary health careDiagnostic services with Lab technicianComprehensive counselorRehabilitation servicesAvailable and accessible to all free of costEvening hoursConvergence with all departments providing direct and indirect services
NUHM Roundtables - DiscussionsFacilitiesAtleast IPHSAs close to poor communities as possibleRent or lease if necessaryHuman ResourcesOngoing recruitment and buffer staffNo contract workers, only permanent staffGood salaries for USHAs etc., not incentive-based payBigger role for nurses
NUHM Roundtables - DiscussionsSecondary and tertiary careReferral and counter-referral systemsRobust public infrastructure neededHigh dependence on user fees in autonomous institutionsMedical colleges and the private sector to be involved through clearly defined mechanismsRegulation of private sectorInsurance schemes hotly debated
NUHM Meeting on December 21stUrban Health Centres (UHCs) in all 198 wards of the city. Primary health care will be universal and freeProposed budget for 2013-14 is Rs. 250 croreHealth Minister: 100-bed secondary level hospitals in each of the 28 assembly constituencies and specialty 500-bed hospitals in each of the 8 zones
QuestionsPrimary careWill it be truly comprehensive?Wards/areas with high poor populations and lack of spaceAgreements with private players? Medical Education Department and Autonomous InstitutionsCurrently run most tertiary care institutionsNo representation on State- and City-level committeesFinancing of autonomous institutions
QuestionsFinancingLong-term sustainabilityUntapped/unconsidered funds such as Construction workers' fundCommunitizationFunctioning of ward committeesESI
The way forward...