A National Conference on Financing Universal Health Coverage was organized by PHFI and partners, supported by USAID to disseminate new evidence on how State Governments can facilitate implementation of Universal Health Coverage at sub national level. Dr. K. Rajeshwar Rao, Joint Secretary, MoHFW, Government of India, Dr. Henk Bekedam, WHO Representative to India, Dr. Girija Vaidyanathan, Additional Chief Secretary, Government of Tamil Nadu, Mr. Alok Kumar, Advisor, Health, NITI Aayog, Prof. A.K. Nandakumar and Professor K. Srinath Reddy, President, PHFI were key dignitaries present on the occasion. The consultation disseminated critical evidence on the nature and quantum of financial flows, both public and private, to develop a better understanding of policy thrust areas for State governments; on the processes and impacts of government-sponsored insurance schemes in select states to understand the effectiveness of risk pooling mechanisms; and on costing of essential health packages to facilitate implementation of Universal Health Coverage at sub-national level.
The evidence disseminated was executed by PHFI with four partner institutions: IIT-Madras, Sree ChitraThirunal – Trivandrum, TISS – Mumbai and PGIMER – Chandigarh. The consortium currently has MoU with 7 states governments:Himachal Pradesh, Punjab, Maharashtra, Madhya Pradesh, Kerala, Tamil Nadu and Odisha.
The overarching purpose of the program is to help introduce more equitable, evidence-based, and cost-effective health financing approaches for the bottom two quintiles of the population to protect against the impoverishing effects of illness, especially those that impact maternal, infant and child mortality. The program is supported by USAID.
Key Findings from the Research conducted
Resource flows, as characterised by State Health Accounts for six states, depict a clearly the incidence of high burden of out-of-pocket payments in all the states, with expenditure on pharmaceutical goods taking up bulk of the share. The findings also show a significant gap in risk pooling and financial risk protection mechanisms in all the states, an area in which most of the state governments and the national government has put policy emphasis. However, amongst all the state governments, Tamil Nadu and Kerala has witnessed significant developments largely through the state governments’ own initiatives financed through tax-based mechanisms or insurance mechanisms. The experience of states like Tamil Nadu can provide important template for UHC implementation in other states in the country.
The consultation was organised on the basis that lack of a robust data and information support system for health financing policy making has contributed to the inequity and poor performance of the health financing system. It has seriously constrained governments’ ability to design and implement a health care financing system that works for the poor.
About the SESSIHFI project
The purpose of the program is to work with the governments in India, both states and central; and Indian research think tanks to a) build their institutional capacity in design and implementation of comprehensive health financing programs for targeted populations; b) institutionalise the periodic production and usage of National and State-level Health Accounts of international standards in policy formulation and decision making; and c) promote policy-relevant economic modelling, research and analyses in the area of health finance and health economics.
In the six states the SESSIHFI project engaged with the respective state government health departments and agencies in order to produce the State Level Health Accounts Estimates (a state-level detailed counterpart of the National Health Accounts estimates which was released recently). The production of health accounts reflects upon the nature and quantum of resource flows towards various kinds of health care services from both public and private sources. It helps in understanding the policy stance of governments in making investments in key issues of the health sector.
In 3 states of Tamil Nadu, Maharashtra and Himachal Pradesh the program evaluated the role and performance of Government sponsored Health Insurance Schemes (CMCHIS in TN, RGJAY in Maharashtra and RSBY+ in HP) in providing financial risk protection to the vulnerable population from financial penury arising out illnesses.
In 4 states of Tamil Nadu, Kerala, Odisha and Himachal Pradesh, the program undertook an assessment of health system preparedness for Universal Health Coverage with special focus on RMNCH+A & TB and costing of essential health services.
For more information, please visit: www.phfi.org