The document summarizes the evolution of universal health coverage in India from 1946 to present. Key milestones include recommendations from committees such as the Bhore Committee in 1946 which recommended integrating preventive and curative services and establishing primary health centers. Other committees addressed issues like medical education reform, strengthening district hospitals, and establishing a unified health cadre. National policies in 1983, 2002, and 2017 aimed to provide comprehensive primary health care through a decentralized public health system. Key programs launched include the National Rural Health Mission in 2005, National Health Mission in 2013, and Ayushman Bharat in 2018 which aims to provide health insurance coverage to 500 million Indians.

1. EVOLUTION OF UHC IN INDIA
PRESENTED BY:
K. SIVASAKTHI,
M.SC NURSING IST YEAR,
CON- PIMS.

2. UNIVERSAL HEALTH COVERAGE(UHC)
UHC means that all individuals and communities receive the health
services they need without suffering financial hardship. It includes the
full spectrum of essential, quality health services from health
promotion to prevention, treatment, rehabilitation and palliative care.

3. Bhore
committee,
1946
Mudaliar
committee,
1956
Jungalwalla
committee,
1967
Kartar singh
committee,
1973
Shrivastava
committee,
1975
Rural health
scheme, 1977
Health for all
by 2000, 1980
National
health policy,
1983
National
population
policy, 2000
National
health policy,
2002
NRHM, 2005
NHM 2013
National
health policy,
2017.
Ayushman
bharat,2018

4. Bhore committee, 1946
Sir Joseph Bhore- Chairman (Health Survey and Development Committee )
Recommendations:
1. Integration of preventive and curative services at all administration level
2. Development of Primary health centres in 2 stages.
In short-term measure
• PHC in rural area should include population of 40,000 with a secondary health
centre to serve as a supervisory, coordinating and referral institution.
Long-term programme (also called the 3 million plan)
Setting up primary health units with 75-bedded hospitals for each 10,000 to
20,000 population and secondary units with 650-bedded hospitals, and district
hospitals with 2,500 beds
3. Major changes in medical education which includes 3 month's training in
preventive and social medicine to prepare "social physicians".

5. Mudaliar Committee, 1962
Dr. A.L. Mudaliar- Chairman
Recommendations:
• Consolidate advances : first 2 five year plans
• Strengthen District Hospitals: specialists
• Each PHC not more than 40,000
• Improve quality in PHC
• Integrate medical and health services
• Constitution of All India Health Services

6. Jungalwalla committee, 1967
Chairman- Dr. N. Jungalwalla
Recommendations:
 Unified cadre
 Common seniority
 Recognize extra qualifications
 Equal pay for equal work
 Special pay for specialized work
 No private practice and good service condition

7. Kartar Singh committee, 1973
“The Committee on Multipurpose Workers under Health and Family
Planning” under the Chairmanship of Kartar Singh
Recommendations:
1. Present Auxiliary Nurse Midwives to be replaced by the newly
designated "Female Health Workers", and the present-day Basic
Health Workers, Malaria Surveillance Workers, Vaccinators, Health
Education Assistants and the Family Planning Health Assistants to
be replaced by "Male Health Workers".
2. The Programme for having multipurpose workers to be first
introduced in areas where malaria is in maintenance phase and
smallpox has been controlled.
3. For proper coverage, there should be one primary health centre for a
population of 50,000

8. 4. Each primary health centre should be divided into 16 sub-centres each
having a population of about 3,000 to 3,500.
5. Each sub-centre to be staffed by a team of one male and one female
health worker
6. There should be a male health supervisor to supervise the work of 3 to
4 male health workers; and a female health supervisor to supervise the
work of 4 female health workers
7. The present-day lady health visitors to be designated as female health
supervisors and The doctor in charge of a primary health centre should
have the overall charge of all the supervisors and health workers in his area.

9. National Health Policy 1983
The Ministry of Health and Family Welfare, Govt. of India, evolved a
National Health Policy in 1983 till 2002.
The policy lays stress on preventive, promotive, public health and
rehabilitation aspects of healthcare.
The policy stresses the need of establishing comprehensive primary
health care services to reach the population in the remote area of the
country.
India had its first national health policy in 1983 i.e. 36 years after
independence.

10. Objectives of NHP 1983
• A phased, time-bound programme for setting up a well-dispersed network of
comprehensive primary health care services, linked with extension and health education,
designed in the context of the ground reality that elementary health problems can be
resolved by the people themselves.
• Intermediation through ‘Health volunteers’ having appropriate knowledge, simple skills
and requisite technologies.
• Establishment of a well worked out referral system to ensure that patient load at the
higher levels of the hierarchy is not needlessly burdened by those who can be treated at
the decentralized level;
• An integrated net-work of evenly spread speciality and super-speciality services

11. Health for all by the year 2000
• Attainment of a level of health
• Providing PHC to underserved rural and urban.
• Accessibe to all individuals and family
• Acceptable
• Affordable
• Full participation of community

12. Rural health scheme, 1977
Recommendations:
• Involvement of medical colleges in the total health care of selected
PHC’s with the objective of reorienting medical education to the need
of rural people.
• Reorientation training of multipurpose workers engaged in the various
communicable disease programmes.

13. Shrivastava committee, 1975
• The Government of India in the Ministry of Health and Family Planning in
November 1974 set up a 'Group on Medical Education and Support
Manpower' popularly known as the Shrivastav Committee.
Recommendation:
• Creation of bands of para-professional and semi-professional health
workers from within the community itself (e.g., school teachers,
postmasters, gram sevaks) to provide simple, promotive, preventive and
curative health services.

14. Cont..
• Establishment of 2 cadres of health workers, namely - multipurpose
health workers and health assistants between the community level
workers and doctors at the PHC;
• Development of a 'Referral Services Complex.
• Establishment of a Medical and Health Education Commission for
planning and implementing the reforms needed in health and medical
education

15. National population policy, 2002
A revised health policy for achieving better health care and unmet goals has been
brought out by government of India- National Health Policy 2002.
Objectives:
• Primary Health Care Approach
• Decentralized public health system
• Convergence of all health programme under single field umbrella
• Strengthening and extending public health services
• Enhanced contribution of private and NGO sector in health care delivery.
• Increase in public spending for health care.

16. National rural health mission, 2005
Making health delivery system fully functional and accountable to the
community convergence of national health programme at all levels of
health system.
Objectives:
• Reduction in maternal and child mortality
• Universal access to affordable and quality health care services.
• Prevention and control of communicable and non communicable
disease.
• Access to integrated comprehensive primary health care.
• Population stabilization.

17. National health mission 2013
The national health mission encompasses its two sub missions, the national rural
health mission and national urban health mission.
Goals:
• Reduce MMR 1/1000 live birth
• Reduce IMR 25/1000 live birth
• Reduce TFR to 2.1
• Prevention and detection of anemia in women aged 15-49 years.
• Prevent and reduce mortality and morbidity from communicable, non
communicable, injuries and emerging disease.

18. National health policy, 2017
NHP-2017 also identifies seven priority areas for improving the environment
for health. These priority areas needing coordinated action include:
• The Swachh Bharat Abhiyan
• Balanced, healthy diets and regular exercises.
• Addressing tobacco, alcohol and substance abuse
• Yatri Suraksha - preventing deaths due to rail and road traffic accidents
• Nirbhaya Nari -action against gender violence
• Reduced stress and improved safety in the work place
• Reducing indoor and outdoor air pollution

19. Ayushman bharat
The programme ensures health promotion, disease prevention and
primary health care through 1.5 lakh health and wellness centres and
financial protection to 500 million citizens through Pradhan mantri jan
Arogya yojana(PMJAY)

20. Thank you