We adhere to the World Health Organization’s (WHO) definition of health, which includes mental and social well-being in addition to physical fitness, happiness, and the absence of illness and incapacity. This indicates that without addressing health determinants, we cannot attain health in its broader sense. Beyond medical and health departments, such as those responsible for women’s and children’s development, food and nutrition, agriculture and animal husbandry, civil supplies, rural water supply and sanitation, social welfare, tribal welfare, education, and forestry, are required as a result of this.
We all agreed with the mission statement “Health for All by 2000,” which Halfdan Mahler suggested and the World Health Assembly approved in 1977. The phrase “for Everyone,” which denotes universalization, has an intrinsic meaning in this slogan. So, no one is excluded from this and everyone qualifies without experiencing any discrimination based on their financial situation, gender, colour, or location of residence, or any other aspect. As early as 1977, universal health coverage (UHC) was suggested. India pledged to achieving “Health for Everyone” by the year 2000 under its National Health Policy from 1983.
When and where did the population’s partial coverage and the governing government’s partly financial obligation to provide healthcare then emerge? Eight elements of a minimal standard of care for all citizens were outlined at the World Conference on Primary Health Care in Alma Ata in 1978. It required all health promotion efforts, disease prevention measures including immunizations, and the free use of government resources, especially for the poor, to treat minor illnesses and accidents. The examination and treatment of virtually all non-communicable and chronic diseases, including mental disorders, were excluded from primary healthcare. It was up to the person to either seek secondary and tertiary treatment from a small number of public institutions or from the commercial sector by paying out of pocket. There weren’t enough government-run facilities for the underprivileged (who cannot afford exploitative and expensive private care). The dominant, uncontrolled, profit-making private sector as well as the health insurance industry were kept content and flourishing as a result of the state abdicating its duty to provide secondary or tertiary treatment. This led to a division between secondary and tertiary level peripheral primary care and institutional referred specialty care.
A Primary Health Care (PHC) Version 2 or Comprehensive PHC was defined in response to the realisation that even the poor can develop chronic illnesses and non-communicable diseases like cardiac, neural, mental, and metabolic disorders, which also require investigations and management at peripheral primary health institutions. It was operationalized in India starting in 2013 via the National Rural Health Mission (NRHM). The Health and Wellness Center was put into operation in the second part of the previous decade as a model for implementing Comprehensive Primary Health Care.Every person has the right to health care without difficulties, disabilities, or death. Only individualism in public health, the new global strategy for UHC, where “nobody is left uncounted and uncared for,” guarantees that right.
We can disregard the Alma Ata statement on primary healthcare as a magnificent monument to bygone ideas. Let’s go forward with a more modern definition of UHC that includes primary, secondary, and tertiary care for everyone who needs it at a reasonable cost without bias.
Since the Beijing Health Systems Research Conference in 2012, the idea of a multi-nodal system comprising various sectors, professional streams, and specialties with a diversity of people to offer Comprehensive Universal Health Care has gained widespread acceptance. The National Health Mission is a better model of fully taxfunded universal health care, but the Ayushman Bharat Jan ArogyaBhimaYojana hurts that strategy. PoshanAbhiyan, National Food Security, the Mahatma Gandhi National Rural Employment Guarantee Act, water sanitation, SarvaShikshaAbhiyan, etc. are also intersectoral thrusts under the National Health Mission.