SHSRCK
State Health Systems Resource Centre - Kerala
Department of Health & Family Welfare, Government of Kerala
0471 2323223

UHC District Pilot Project in Malappuram & Palakkad Districts

The Planning Commission of India based on the High Level Expert Group on Universal Health Coverage (UHC) has advocated in the 12th five-year plan for moving towards Universal Health Coverage by 2022. It has recommended that each State could pilot UHC in 2 districts. This would involve measuring the extent to which the populations and services are covered by free health services (primary, secondary & tertiary), the resources including finances available and need to increase the coverage in a systematic manner. SHSRCK in collaboration with Public Health Foundation of India (PHFI) is undertaking the piloting of UHC in Malappuram and Palakkad Districts of Kerala.

The piloting mainly involves the following

  • Advocating with the various stakeholders in the State to take forward the Universal Health Coverage as recommended by the Planning Commission.
  • Assessing of the extent to which the populations and services are covered by health services & facilities available both in the public and private sector and the resources including financial.
  • Identify 20 key top conditions which are a major source of catastrophic health expenditure of households leading to impoverishment and driven to poverty in two pilot Districts. Care pathways will be developed for these 20 conditions protect the people from such expenditure in the pilot districts.
  • Developing options with regard to the services and their delivery, populations to be covered and the financial requirement for the State government for these identified twenty conditions

Assessment & Situational Analysis of UHC Preparedness in Malappuram and Palakkad District

In order to do the piloting an assessment in Palakkad and Malappuram districts to identify the strengths and weakness of the health systems, institutional mechanisms and capacities at the State and district level to undertake UHC. The assessment would provide information on the current status, vis-á-vis what services are being provided by various stakeholders, coverage (who is covered and who is not covered), mapping of health facilities (govt., private, various systems, etc.) and services in the district. A series of workshops with experts are planned at the state and district level to evolve the care pathways for 20 key top conditions which are a major source of catastrophic health expenditure.

The purpose would be to undertake an assessment in Palakkad and Malappuram districts to identify the strengths and weakness of the health systems, institutional mechanisms and capacities at the State and district level to undertake UHC.

The assessment would provide information on the current status, vis-á-vis what services are being provided by various stakeholders, coverage (who is covered and who is not covered), mapping of health facilities (govt., private, various systems, etc.) and services in the district. Further it would also document the functioning, quality & method of delivery of services. This would be a baseline for assessing the interventions and assist in evidence based planning for rolling out the UHC in the selected pilot districts. Further it would involve documentation of the existing health financing systems & mechanisms that are being financed by various sources.

Along with the assessment at the 2 selected districts twenty top conditions would be identified which are a major cause and source of impoverishment of people in the districts. Clinical pathways with flow charts for these conditions would be developed including STG's and financing issues, which would involve infrastructure, human resource, drugs & diagnostics, training and governance aspects. Costing of the various aspects of the same would also be undertaken.

The above to be done through review of available secondary data, reports, records, observations, in-depth interviews with key informants, meetings and group discussions, desk exercise, listing, existing health information systems etc. The above would be undertaken at the State and selected district levels through a series of workshops with the core group in each of the districts, involvement of identified state level institutions and involvement of health & other department staff at the district and facility level.