The road to universal health coverage: an overview of global and Indian scenarios

Anugraha John, Hari Teja Avirneni, Sinthu Sarathamani Swaminathan


The declaration of World Health Assembly in the year 2005 paved the way for all the member states to plan for the transition towards universal coverage to their respective citizens. This was underpinned by the notion that access to quality basic and essential health services has to be made available for everyone to combat poverty and to achieve the developmental goals worldwide. This global movement towards universal coverage is considered as one of the greatest transitions in health, the other being the demographic transition and epidemiological transition. Since the adoption of Universal Health Coverage (UHC), the road taken by each country to achieve UHC is diverse and unique to its culture, needs of people and health systems in the respective country. However, all these approaches have a commonality of promoting and providing health insurance as an important mechanism to achieve UHC. Providing health insurance to ensure health coverage for all the citizens has been well tested and proved to be a viable option. But, addressing other needs and requirements of health systems such as expansion of health infrastructure, reinforcement of the health care workforce and reorganization of the existing health systems in line with newer policies is also extremely important.


Ayushman Bharat, Health and wellness centres, Health Insurance, Out of pocket expenditures, PM-JAY, Universal health coverage

Full Text:



United Nations. Constitution of the World Health Organization. Published 1946. Available at‐en.pdf. Accessed on 12 January 2021.

World Health Organization. The World Health Report 2008 - primary Health Care (Now More Than Ever) Published 2008. Available at Accessed on 10 October 2019.

World Health Organization. Research for universal health coverage: World health report 2013. Available at https:// www. who. int/ whr/2013/report/en/. Accessed on 9 October 2019.

World Health Organization. Sustainable health financing, universal coverage and social health insurance. Available at;jsessionid=78913CEA544D94FCDF55DFD7CE354150?sequence=1. Accessed on 7 November 2019.

Rodin J, Ferranti D. Universal health coverage: the third global health transition? The Lancet. 2012;380(9845):2-861.

Garrett L, Chowdhury AMR, Pablos MA. All for universal health coverage. The Lancet. 2009;374(9697):9-1294.

Verguet S, Woldemariam AT, Durrett WN. Is the sustainable development goal target for financial risk protection in health realistic? BMJ Global Health. 2017;(2):e000216.

World Bank and World Health Organization. Tracking universal health coverage: 2017 global monitoring report. Available at Accessed on 5 October 2019.

Government of India, Planning Commission. High Level Expert Group Report on Universal Health Coverage for India. Published 2011. Available at Accessed on 25 September 2020.

Serra MR, Smith PC. Does progress towards universal health coverage improve population health? The Lancet. 2012;380(9845):823-917.

Savedoff WD, Ferranti D, Smith AL. Political and economic aspects of the transition to universal health coverage. The Lancet. 2012;380(9845):832-924.

Lagomarsino G, Garabrant A, Adyas A. Moving towards universal health coverage: health insurance reforms in nine developing countries in Africa and Asia. The Lancet. 2012;380(9845):843-933.

Sachs JD. Achieving universal health coverage in low-income settings. The Lancet. 2012;380(9845):837-944.

Government of India, National Health System Resource Centre. National Health Account Estimates for 2014-2015. Published 2017. Available at Accessed on 25 September 2020.

Bang A. Health insurance, assurance, and empowerment in India. The Lancet. 2015;386(10011):237-42.

Babu B, Kusuma Y. Universal health coverage in India: A move with hope and despair. Int J Med Sci Public Health. 2016;5(3):384.

Bhojani U, Thriveni B, Devadasan R. Out-of-pocket healthcare payments on chronic conditions impoverish urban poor in Bangalore, India. BMC Public Health. 2012;12(1):990.

Chopra H. Universal Health coverage a reality or mirage. Indian J Community Health. 2018;30(2):4.

Keshri VR, Gupta SS. Ayushman Bharat and road to universal health coverage in India. J Mahatma Gandhi Institute Med Sci. 2019;24:65‐7.

Government of India. Ayushman Bharat PM-JAY. National Health Authority. Available at Accessed on 25 September 2020.

Government of India. National Health Protection Mission. National portal of India. Available at 2020. Accessed on 25 September 2020.