Universal health coverage: A community based assessment in Himachal Pradesh, India

Background: Universal Health Coverage (UHC) has gained importance all over the world. UHC is not a new concept for India as Bhore Committee in 1946 recommended that Indian health system should be designed to provide health services for everyone who would like to use them and get all services which they need. Estimates for OOP health expenditure between 1995-96 and 2000-01vary from 80 % to about 70 % of total health expenditure. Further, OOP payments constitute 95 % of private health expenditure with a weak insurance system and other community-based financing still only emerging. Methodology: A community based cross- sectional study on 2000, > 18 yrs of age, randomly selected, in two districts of Himachal Pradesh was conducted. Current health status, preference to Govt. and private health institutions, health policy and Out of Pocket expenditure details were recorded. Results: In Kangra district 52 % and in Chamba district 78.3% were male participants and 23.4 % in Kangra, 36.3 % in Chamba rated their current health status very good. Around 30 % in Kangra district preferred Community Health Center, whereas in Chamba 63 % Primary Health Center. Reason for preferring Gov’t health facility in both districts was related to less expenditure in Govt. institutions. 56.5% in Kangra and 69.5% in Chamba district spends < 1000 Rs OOP annually on Health. Conclusion: We observed that in both districts participants use peripheral Health Govt. institutions for basic health services. Majority is heaving govt. sponsored health insurance and majority is heaving Out of Pocket expenditure. Majority of participants wants all drugs and consumables to be provided free of cost in Govt. hospitals.