Kadarpeta Rahul Sankrutyayan Reddy, Anand Jaidev Singh, Achungura Grace
Joint Learning Network for Universal Health Coverage, Amref Health Africa, New Delhi, India.
Department of Health Systems and Services, World Health Organization, Country Office-India, New Delhi, India.
Health Serv Insights. 2024 May 10;17:11786329241249289. doi: 10.1177/11786329241249289. eCollection 2024.
Resilient and high-performing health systems that can respond to the global polycrisis hinge upon the effectiveness of their primary healthcare (PHC) system. This requires adequate and sustainable financing for PHC, which should be predominantly government financed. The recent Ayushman Bharat health reforms in India aim to ensure comprehensive PHC services and enhance financial risk protection through increased government financing. The government has augmented investments to fortify the PHC system by establishing Health and Wellness Centers (HWCs), equipped with an expanded benefit package for PHC services & human resource capacity. Aligned with the National Health Mission's targeted and flexible financial mechanisms, this offers States the opportunity to contextualize solutions and offer incentives to healthcare workers. However, aligning public financing arrangements to service delivery complexities and health outcomes pose intricate challenges in shaping the required reforms. The economic growth and room for increased taxation on health products provide an avenue for increased funding. Smart and efficient payment mechanism with improved accountability should complement increased investment.
能够应对全球多重危机的有韧性且高效的卫生系统取决于其初级卫生保健（PHC）系统的有效性。这需要为初级卫生保健提供充足且可持续的资金，而这笔资金应主要由政府提供。印度最近的阿育吠陀·巴拉特卫生改革旨在通过增加政府资金来确保全面的初级卫生保健服务并加强金融风险保护。政府已增加投资，通过设立健康与 Wellness 中心（HWCs）来强化初级卫生保健系统，这些中心配备了扩展的初级卫生保健服务福利包和人力资源能力。与国家卫生使命的有针对性且灵活的财务机制相一致，这为各邦提供了因地制宜制定解决方案并向医护人员提供激励措施的机会。然而，使公共融资安排与服务提供的复杂性及健康结果相匹配，在塑造所需改革方面带来了复杂的挑战。经济增长以及对健康产品增加征税的空间为增加资金提供了一条途径。具有更高问责制的明智且高效的支付机制应补充增加的投资。
