This report investigates the origin, design, implementation, and preliminary evaluation of the Universal Health Coverage Primary Healthcare Startup Project in Kerala, India. It provides information about the experiences, lessons learned, and impact of this initial stage of the project.

In 2012 the Department of Health and Family Welfare in Kerala implemented the Universal Health Coverage Primary Healthcare Startup Project in the state. It was the first attempt to provide universal health coverage to a defined population in India. Since its initial startup, the project has gained national and international attention.

The lessons learned from the Universal Health Coverage Primary Healthcare Startup Project demonstrate ways to improve healthcare and build systems that make it more accessible in other states in India by using the bottom-up approach.