Читать книгу The Political Economy of the BRICS Countries - Группа авторов - Страница 74

Universal Health Coverage (UHC) has been a major topic of discussion and debate in the recent past globally, especially since the passage of a UN General Assembly resolution on UHC in December 2012.¹ While global organizations such as the WHO and the World Bank have defined UHC, it is still not apparent whether all countries interpret UHC in a similar fashion. It has been argued that UHC has been labeled in a variety of ways and implemented based on the interpretation by countries, indicating the need for a global operational definition (O’Connell, 2014). Evidence does exist, however, to indicate that broader health coverage generally leads to improved health, especially for the poor via better access to services (Rodrigo and Smith, 2012).

The first Global Monitoring Report on Tracking UHC, brought out jointly by WHO and the World Bank,² defines UHC thus: all people receiving the health services they need, including health initiatives designed to promote better health (such as anti-tobacco policies), prevent illness (such as vaccinations), and to provide treatment, rehabilitation, and palliative care (such as end-of-life care) of sufficient quality to be effective, while at the same time ensuring that the use of these services does not expose the user to financial hardship. The Sustainable Development Goals (SDGs) also contain a specific goal for UHC, making progress towards UHC a global as well national imperative.

Over the last decade or more, India has also been articulate about the country’s need to have UHC. However, the recent history of the country’s attempt at greater health coverage raises the issues of interpretation of UHC specifically, as well as prioritization of health in general. The BRICS countries as a whole are not necessarily the best examples of how UHC is to be implemented. The group is small, the economic and political situations are somewhat different, and the experiences are diverse. Nevertheless, this diversity of experiences is possibly sufficient to understand the “do’s and don’ts” in the path to UHC, and would contain important lessons for India. There are earlier analyses on this subject as well where a slightly different set of indicators have been used to look at the progress towards UHC (Marten et al., 2014). We aim to expand the analysis substantially with more recent data and also use a slightly different approach to understand where India’s position vis-à-vis the other BRICS countries in the context of UHC.

We start by laying out a framework to understand how one might measure progress towards UHC in the second section. In the third section, we look at the health status and disease profile in these countries, which is important to understand priorities within any UHC package. In the fourth section, we look at selected indicators discussed in first section to understand the countries’ progress towards UHC. Fifth and sixth sections analyze governance and health reforms, respectively. In the last section, we present our conclusions based on the analysis on how countries have fared and what India might take away as valuable lessons from these varied experiences.