Universal Health Coverage as a movement towards achieving health for all is one of the most prominent health goals set by United Nation to achieve quality access to health care, free medical finance, proper immunization, and preventive care.
Under United Nation Sustainable Goals, all member states of UN consented to achieve universal health coverage by 2030. Similarly, this year World Health Day is celebrated with the theme of “Universal Health Coverage” to ensure health for everyone, everywhere. As health experts believe emphasis should definitely be on the primary health sectors in reaching every nooks and corner of the world.
In Leh, according to Chief Medical Office data, there are 158 health institutes working as a referral mechanism. The institutes include district hospital (SNM), sub-district hospitals in Nubra and Khaltse, 18 Primary health centres, and the rest are sub-centre health care located in all inhabitant villages.
Leh has a fairly good record of providing basic health care and essential medical access to its people says Dr Motup Dorje, Chief Medical Officer. “Taking into consideration of achieving zero maternal death rates this year, schedule immunization for all, and infant mortality rates have reduced to a single digit (8%) clearly indicates that Leh is moving forward in terms of health care. Such health outcomes are truly taking steps further in making universal health coverage a reality”, he adds.
He also mentions that inhabitant villages of Leh have access to basic health care needs like mother-child service, immunization facilities, essential medicines are provided under the supervisions of pharmacists and nurse. However, a prior challenge is a shortage of medical officers and specialists in Leh despite providing plenty of job opportunities by the government. Even locals graduated medical students or practitioners prefer to work in other parts of the country.
Primary health care is the foundation of a healthy community and negligence towards establishing a functional primary health centre is the core reason behind the rapid growth of chronic ailments. Yet, many local health experts believe that the present concern is a non-communicable disease rather than primary health care.
Tsering Sandup, Executive Councilor of Health, LAHDC defines universal health coverage as a goal which aims to ensure people to have access in health services regardless of their income, social status, gender, caste, religious belief and many more.
He says “Primary health centre plays a crucial role in implementing universal health coverage by bringing patients to the first point of medical aids in remote villages and providing trained professional to diagnose and further referral for ongoing treatment.”
Talking about the problems, he informs, “Most of the primary health care centres in Leh are understaffed and underfunded. To overcome these issues, an effort has been made by Hill Council to seek funds under the government scheme of National State Source and Equipment. We have already identified specific villages that face accessibility challenges and further going to establish more sub-health centre with the goal that every person within a 5 km radius can have access to primary health care.”
Progress is being made in the matter of understaffed and shortage of specialized doctors, health councilor has made various requests to the state government to fill these vacancies. In February 2019, an additional thirty-three doctors were awarded to serve Leh district and are expected to join soon this year. Tsering believes that the gap will be fulfilled and can achieve providing health care access to far-flung villages of the district.
Furthermore, he asserts that the establishment of a medical college for Leh would contribute hugely in generating quality numbers of medical officers. The ongoing demand for medical institute would offer students and doctors to be able to undergo training and placement. At the same time, Hill Council plans to invest by seeking fund in a stronger health system that can help to prevent or mitigate diseases.
Conducting awareness camps and programs is highly crucial in letting people know about their health status and medical care. Tashi Angchuk, President of Medical Social Service Association, Leh states that “The district CMO and SNM hospital have been organizing awareness camps but failed to reach secluded areas with limited population. In order to reach awareness to those areas, a team of not only representatives from CMO and SNM hospital rather in collaboration with the community leader (Goba), health workers, and villagers is a must.”
He also identifies that people of Leh are relatively irresponsible when it comes to examining their health status and medical condition. Therefore, preventive care is every individual task to identify their health condition by taking into account their dietary habits, lifestyle and personal hygiene.
Health for all is possible when there is no financial restraint. Financially, in most district hospitals and health care centre are free of charge in medical expenses except a few lists of diagnostic and medicine. Medical finance is very minimal in the district and the charged money goes to hospital developmental fund to upgrade its infrastructural and developmental needs.
Strong and sustainable primary health care is the bedrock of universal health coverage, and the best defence against outbreaks and other health emergencies as Dr Tedros, Director of World Health Organization rightly said on World Health Day 2019.
To sum up, Leh still has a long way to go in making universal health coverage a reality but it is achievable when the people, health workers, government institutes and health sectors work collectively.