I expect that the Fiscal Budget 2016-17 will focus more on improving primary health parameters and make additional investments to build a primary healthcare model. We also need to think about the quality of healthcare services to lower income and marginalized groups.
Prioritizing Primary Care
The Union Budget can provide for free preventive and primary care, which form the backbone of a successful universal health coverage model. Investing in essential and cost effective interventions, such as preventive and primary care activities, demonstrates value for money of scarce financial and human resources.
Ideally, primary care should be conceived as an integrated component with secondary and tertiary care, from an access, quality, and cost point of view.
Quality of Healthcare Services
The central and state governments will need to coordinate their efforts to define and maintain minimum quality standards of healthcare services. The central government plays a stewardship role in establishing the national information infrastructure necessary to monitor health outcomes.
Monitoring of health outcomes will improve accountability in the system, and the patient experience.
Some of the features of universal health coverage that require attention are:
Universal enrollment and proactive management of population health;
Provision of comprehensive primary care services by a multi professional team of health workers;
Introduction of performance based financing to shift focus from inputs to outcomes; and
Creation of autonomous and accountable structures to govern, finance, and provide health services.
We need to be aware that many patients can be managed at the primary care level, so that the more expensive secondary and tertiary care are only accessed through references from primary healthcare providers. This focus would imply that more attention will be paid to health financing, through a mix of central and state government funding, and to finding innovative ways to provide improved health benefits to economically weak and challenged strata of the population.
The author is Siddhartha Bhattacharya, Country Director, ACCESS Health International