Marching Ahead in Achieving Universal Health Coverage

Problem Statement

Odisha faced several challenges such as high out of pocket expenditure despite high utilization of public sector, inadequate public healthcare infrastructure, HR shortage, limited use of advance medical technology, lack of assured medicines and diagnostic services and lack of continuum of care across levels of care

Programme Description

During last one decade, Odisha has introduced several reforms for strengthening delivery of health services through outcome- based, participatory planning process and additional resource allocation from State budget. Based on the guiding principles- “Sustha Odisha, Sukhi Odisha” and “Healthcare for All – Each Life matters”, over 40 free and assured health care schemes were introduced under National Health Mission and with steady increase of health financing under State Budget. The share of health budget as % of GSDP has been increased from 0.89% in 2005-06 to 1.48% in 2018-19.

Some of the key initiatives at state level include

• mobile health units under KBK
• Sishu Abong Matru Mrutyuhara Purna Nirakarana Abhijana (SAMMPurNA)
• Free Cancer Care Programme - Day Care Chemotherapy Center at DH
• Corpus Fund for Human Resource in KBK+ areas;
• Incentive for HR in difficult areas
• Reimbursement of transportation cost @ Rs. 1000/- to all pregnant women for institutional delivery in notified village
• Durgama Anchalare Malaria Nirakaran- DAMaN
• ASHA Kalyan Yojana
• Establishment of new Medical and Nursing Colleges
• Universal Eye Healthcare Programme
• Cash incentives @ Rs.500/- per month to all Blood Disorder for continuing treatment
• Free Specialists Services at Urban PHCs/CHCs under Ama Clinic
• Strengthening Ancillary Services in Public Facilities
• Drop back assistance of Rs. 500/- to pregnant women and sick infants
• Digital Dispensaries through telemedicine in difficult areas
• Free Blood Services to all at Government Blood Banks; and Free Healthcare Services for all at all public health facilities up to Medical under the Biju Swasthya Kalyan Yojana (BSKY) with cashless assistance of Rs. 5 Lakhs per family per year and additional Rs. 10 lakhs for the women members of the beneficiaries’ families

Programme Outcomes

There is a marked trend of improved utilization of health care services. For instance:

• Over 3.3 Crores patients received free medicines since 2015.
• Annually over 1.50 crores patients received Free Diagnostic Services
• Over 60,000 dialysis sessions conducted since 1st January 2018
• Over 2,95, 587 free surgeries conducted since 15th August 2018.
• Over 62,000 patients received free cancer consultation services and 22715 patients received chemotherapy and 5659 patients received radiotherapy sessions conducted since Aug, 2018
• Primary health care services provided in 6251 difficult areas through 177 Mobile Health Units
• Annually over 10 lakhs pregnant women and sick newborn benefitted under SAMMpurNA
• Increased MBBS seats from 450 to 1150 through 4 new Medical Colleges,
• Creation of 2508 posts of doctors, 400 posts of Dental surgeons and 5719 posts of paramedics.
• Around 70 lakhs families (3.5 crores people) covered under BSKY.

Financial Implication

Annually more than Rs.1712.76 Crores are being spent under State Budget schemes excluding NHM budget.

Implementation Partners

NHM and Health and Family Welfare Department All line departments, Development Partners, Private Providers and premier health institutes outside the State with financial support of NHM,

Scalability

Sustained and multi-pronged strategies adopted over the years backed with steady increase in investments in health care has created a strong foundation in the state to achieve Universal health coverage. Implementation of these strategies can provide evidence and guidance for other states to develop plans for achieving UHC. 

Source : We Care Coffee Table Book - Good, Replicable and Innovative Practices 2019