Q6(b). Issues and challenges to achieving Universal Health Care (UHC) in India.

India aspires to UHC under the National Health Policy 2017, but several systemic challenges hinder progress.

Major Challenges

1. Low Public Health Expenditure

India spends 1.9% of GDP on health far below the global average of 6%. This increases out-of-pocket expenses (48% of all health spending).

2. Shortage of Health Workforce

Doctor–population ratio remains inadequate in rural areas; rural India faces 75% specialist shortages.

3. Urban–Rural Inequality

Specialized services cluster in cities; districts and tribal areas face limited access.

4. Inadequate Primary Healthcare

Weak preventive care, limited diagnostic facilities, and poor referral systems.

5. Disease Burden

India faces a double burden of communicable (TB, dengue) and non-communicable diseases (diabetes, heart disease).

6. Fragmented Health Insurance

Schemes like Ayushman Bharat–PMJAY cover the poor, but middle-class and informal workers remain inadequately covered.

Achieving UHC requires higher public spending, stronger primary care, human resources strengthening, and effective digital health systems.