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Equity, Efficiency, and Action: HSTP's Holistic Approach to Health Assurance

 


At HSTP, our Health Assurance approach primarily centres around advancing Universal Health Coverage (UHC). The goal is to improve accessibility and affordability to healthcare services by strengthening state financial protection schemes for individuals and families.

Recently, the Health Assurance team has made significant strides in our efforts to promote equity and improve the efficiency of the state health protection schemes. The team spearheads the discussion on the roadmap towards achieving UHC by 2030.

Our efforts have yielded notable results, and we continue to pursue better healthcare outcomes for all.

Impact of Gender Equity in State Financial Protection Scheme in Odisha

We collaborated with the Government of Odisha, represented by the Department of Health & Family Welfare (DoHFW) and the State Health Assurance Society (SHAS), to document Odisha's transformative journey towards universal health and gender equity. This initiative is a collective effort of a team of experts, including Shalini Pandit from DoHFW; Dr. Brundha D, Subhanand Mohapatra, and Dr. Bishnu Mohapatra from SHAS; and Rajeev Sadanandan, Dr. Sudha Chandrashekhar, Dr. Abdul Aziz Kattakath and Abhishek Raj from HSTP.




This comprehensive narrative underscores our collective commitment to transforming the health paradigm in Odisha. The team's work resonated with the 2024 theme of "Geopolitics, Human Security, and Health Equity in an Era of Polycrises" at the Prince Mahidol Award Conference (PMAC) in Bangkok, Thailand. It was selected for presentation at this prestigious global health forum.

The presentation at PMAC 2024 showcased the transformative impact of the targeted policy intervention in the Biju Swasthya Kalyan Yojana (BSKY), Odisha's flagship health protection scheme, to foster equitable access to healthcare services, aligning seamlessly with the Sustainable Development Goal (SDG) target 3.8, which advocates equitable access to healthcare services.

The policy intervention introduced by BSKY is a testament to Odisha's dedication to the principle of "Leave No One Behind," marking a significant step towards a healthier and more inclusive future. The joint presentation by the HSTP team and the Odisha state representatives at PMAC 2024 showcases our achievements and serves as a call to action for fostering equity in universal health coverage.

 

Enhancing Efficiency in State Health Protection Schemes

The efficacy of implementation is as crucial as inclusivity and equity in state health protection schemes. In partnership with Odisha, Chhattisgarh, and Meghalaya state governments, the HSTP team is driving significant reforms to enhance the efficiency of their respective financial protection schemes.



In Odisha, HSTP's collaboration with the Biju Swasthya Kalyan Yojana (BSKY) has yielded notable progress. A key achievement is the introduction of the BSKY Claim Adjudication Manual, a comprehensive guide ensuring standardised, fair and accurate evaluation of BSKY claims. The document is now accessible on the BSKY and HSTP websites. To further augment the efficiency, the team is finalising additional guidelines, the BSKY Anti-Fraud Guidelines, Empanelment and De-empanelment Guidelines, and Grievance Redressal Guidelines, to streamline processes and ensure transparency.

In Meghalaya, the HSTP team extends its expertise to the State Health Agency (SHA), aiming to optimise the state-funded health protection schemes. The HSTP team has provided expert guidance for transitioning from insurance to assurance mode of implementing MHIS and has developed a comprehensive roadmap to facilitate the transition. Furthermore, the team has also provided inputs on integrating the Meghalaya Employee Health Scheme with the MHIS, thereby streamlining operations and eliminating redundancy. The state is currently reviewing the recommendations put forth by the HSTP team.

Expanding its reach, the Health Assurance team has partnered with the Chhattisgarh state to optimise its health protection schemes, such as the Dr. Khoobchand Baghel Swasthya Sahayata Yojana (DBKSSY) and the Mukhya Mantri Vishesh Swasthya Sahayatha Yojana (MVSSY). Specifically, the team is providing technical support in developing state-specific packages for tertiary care specialities, including the development of the Standard Treatment Guidelines (STGs) for these packages to ensure their judicious use and prevent misuse. Future plans include simplifying the implementation of the MVSSY scheme and enhancing the IT system for improved operational efficiency.

The Health Assurance vertical of HSTP is dedicated to creating a paradigm shift in how health protection schemes operate, focusing on promptness, accuracy, and efficiency. With the ever-evolving challenges in healthcare, these initiatives aim to build more resilient health systems. Looking ahead, HSTP is committed to developing more efficient, inclusive, and robust health protection schemes in its focus states, ultimately contributing to improved health outcomes and equity in healthcare access.

Time for Action: Achieving UHC by 2030

Around Universal Health Coverage (UHC) Day 2023, HSTP actively participated in various forums, contributing to the discourse on achieving the Sustainable Development Goal (SDG) Target 3.8 by 2030.


Dr Sudhashree Chandrashekhar (Advisor, HSTP) participated in a pivotal panel discussion at the Times Health Excellence – Telangana & AP – 2023 event organised by The Times Group and IndiGlobal Media Network. The discussion focussed on 'Accessible and Affordable Quality Healthcare' - a subject of paramount importance in the contemporary healthcare landscape. Dr. Sudha emphasised the urgency of achieving UHC amid the evolving healthcare landscape and the SDG 2030 deadline. Advocating a State-Centric Approach, she highlighted the significance of each state’s achievements in India's journey towards Universal Health Coverage due to varying levels of commitment. She stressed the importance of enhancing primary healthcare at health and wellness centres and the need for India to create and implement customised designs based on global models rather than follow the latter. Advocating a holistic approach, she reiterated the importance of ensuring financial risk protection and prioritising quality care and gender equality in the journey towards UHC.



On December 11, HSTP, in collaboration with Karnataka Association of Community Health (KACH), Department of Health and Family Welfare, Govt. of Karnataka and Access Health International, organised a webinar, “Health for All: Time for Action”. The panel included distinguished public health representatives from the state Governments of Kerala (Dr Rathan U Kelkar IAS), Odisha (Dr Bishnu Prasad Mohapatra), Karnataka (Dr Pushpalatha B S), Former Special Secretary of Niti Aayog (K Rajeshwara Rao IAS Retd.), The World Bank (Sheena Chhabra), WHO (Dr Grace Achungura), Access Health International (Himani Sethi), and HSTP (Rajeev Sadanandan). Key insights, which are crucial for advancing healthcare goals, were shared by the panel. The importance of UHC in ensuring access to quality care while reducing hardships was acknowledged, along with the need for continuous adjustments to address evolving health needs. The discussions advocated a synergistic strategy, emphasising government health insurance like Ayushman Bharat and recognising the diverse approaches needed in India. Innovative financing was highlighted as crucial for sustainability, aiming to lower out-of-pocket expenses and address critical areas like maternal and child health and non-communicable diseases.

The discussion also pointed out the significance of focusing on the following as a way forward:
  • Policy interventions and expanded coverage
  • Addressing the missing middle and urban health concerns
  • Focus on vulnerable populations
  • Investment in essential public health functions and robust primary healthcare
  • Emphasis on prevention and promotive health measures
  • Creating an environment conducive to research, innovation, and digital health leveraging
HSTP values the concept of accessible and affordable quality healthcare, and therefore, we build solutions around it while strengthening public health systems to achieve UHC. Having state health protection cover helps reduce OOP expenditure on healthcare, reduces disparities, and promotes health-seeking behaviour among the marginalised. It is one of the ways healthcare becomes accessible and affordable for the people. However, it's not the only one, nor does it ensure the quality of healthcare services. Therefore, HSTP looks at an integrated approach - strengthening primary healthcare services by building the competencies of the primary healthcare workers, building the leadership of the mid-level public health officials, and improving access to essential medicines in public facilities. For quality healthcare to be accessible and affordable, public health systems must see holistic improvements.

 


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