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Preparing States in India for Universal Health Coverage

India scores poorly on many health indicators. It has the highest number of malnourished children, the highest infant mortality rate, and one of the highest rates of maternal deaths in the world. This is concerning given that India's stellar economic growth in the last two decades, growth which is likely to continue. In recognition of these challenges, the Indian government will roll out universal health coverage by the year 2020 as set out under the Planning Commission's 12th Five-Year Plan. It also created a high level expert group to assist the process. Given India's population, geographical diversity, and health inequities, the path to universal health coverage is likely to vary widely across states. Using research evidence, policymakers will need to ensure a balance between prioritizing primary health care and expanding access to insurance for secondary and tertiary care. This expanded access has the potential to become a financial burden on households. This project aims to provide the evidence needed to support the rollout of universal health care in India. The Public Health Foundation of India, in collaboration with state-level institutions and decision-makers, will carry out the research. The Foundation is well-positioned to lead the project given its position as the Secretariat of the High Level Expert Group with a mandate to provide technical and logistical support to Indian states. India's universal health care rollout will take place in phases. The scale and scope of the reform is enormous for a country with a diversity of states with varying levels of economic and social development. Indian states manage health. They must be prepared to understand the costs and fiscal implications of achieving universal health coverage. Researchers will develop benchmarks to help states prepare for the rollout. They will work with states to develop an essential health package for primary, secondary, and tertiary health care services in tier one states. They will also examine how information technology can improve access to and delivery of quality health services in a transparent manner. This project will provide practical guidance that allows Indian states to implement and expand universal health coverage in a sustainable way. It will produce targeted reports for key stakeholders. The research team will share its results through media outreach and peer review publications. This important research will also help other countries moving toward universal health coverage.

Project ID
Project Status
End Date
36 months
IDRC Officer
Marie-Gloriose Ingabire
Total Funding
CA$ 858,600.00
Maternal and Child Health
Maternal and Child Health
Institution Country
Project Leader
Prof Ramanan Laxminarayan
(name of President) for and on behalf of Public Health Foundation of India