Universal access to medicines: evidence from Rajasthan, India
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Date
2014-07
Journal Title
Journal ISSN
Volume Title
Publisher
WHO Regional Office for South-East Asia
Abstract
India has outlined its commitment to achieving universal health coverage and
several states in India are rolling out strategies to support this aim. In 2011,
Rajasthan implemented an ambitious universal access to medicines programme
based on a centralized procurement and decentralized distribution model. In
terms of the three dimensions of universal health coverage, the scheme has
made significant positive strides within a short period of implementation. The key
objectives of this paper are to assess the likely implications of providing universal
access to essential medicines in Rajasthan, which has a population of 70 million.
Primary field-level data were obtained from 112 public health-care facilities using
multistage random sampling. National Sample Survey Organization data and
health system data were also analysed. The per capita health expenditure during
the pre-reform period was estimated to be `5.7 and is now close to `50. Availability
of essential medicines was encouraging and utilization of public facilities had
increased. With additional per capita annual investment of `43, the scheme has
brought about several improvements in the delivery of essential services and
increased utilization of public facilities in the state and, as a result, enhanced
efficiency of the system. Although there was an attempt to convert the scheme
into a targeted one with the change in government, strong resistance from the civil
society resulted in such efforts being defeated and the universality of the scheme
has been retained.
Description
Keywords
drug availability, drug stock-outs, essential medicines, financial risk protection, universal health coverage
Citation
WHO South-East Asia Journal of Public Health 2014;3(3&4): 289-299.