According to the World Health Organization (WHO) “Universal health coverage (UHC) means that all people have access to the full range of quality health services they need, when and where they need them, without financial hardship. It covers the full continuum of essential health services, from health promotion to prevention, treatment, rehabilitation, and palliative care across the life course”. The definition is undeniably compelling and seems to hit the mark, and nations all around the world are working towards achieving the same goals—especially those that haven’t yet—as well. This is especially relevant in light of the terrible pandemic that the entire world has recently experienced. The pandemic also presented some nations with additional significant issues, since their health system is underperforming and their spending is extremely low, which puts everyone at risk, particularly those from disadvantaged social groups like the Dalits in South Asian nations.

Download the Position Paper-Universal Health Coverage for The Communities Discriminated On Work And Descent here.

Dalits are Communities discriminated on Work and Descent (CDWD) they are one of the most marginalized communities, with approximately 220 million people situated in Bangladesh, India, Malaysia, Nepal, Pakistan and Sri Lanka. These communities are traditionally excluded communities based on their standing in the social hierarchy and their inherent nature of work dictated through principles of purity and pollution. According to an alternative report submitted to OHCHR Dalit women’s health is dire, with high maternal and infant mortality rates due to inadequate access to healthcare services, resulting in a life expectancy as low as 50 years and a sex ratio of 922/10001. These communities have been socially, economically and politically discriminated against by the systemic structures and dominant communities in various forms and have sustained this discrimination through atrocities and violence. The position paper highlights the state of Universal Health Coverage for the Communities Discriminated on Work and Descent (CDWD) including Dalits in the South Asian Countries namely India, Nepal and Bangladesh. Additionally, the paper also emphasises the significance of universal health coverage (UHC), the role of stakeholders, and the need to develop sustainable solutions for global health issues especially for the CWD community including Dalits. It offers strong recommendations that are directly supported by the opinions of the community.

The goal of universal health coverage is to ensure that everyone has access to high-quality medical treatment without ever having to worry about their finances. The notion of UHC is not a recently developed phenomenon. After Germany implemented public health care in 1883 to protect the health of its youthful population, this idea was first developed. It all started in 19th-century Europe with Bismarck’s reforms in Germany and the UK’s 1946 announcement of the National Health Service. The WHO constitution was established in 1948, two years later, and the importance of “Health for All” was emphasised in the Alma-Ata Declaration of 1978. Similarly, events like the World Health Report 2010 and the resolution at the 58th World Assembly in 2005 both underlined the need of pushing nations to include UHC and financing for health care systems.

On the other hand, there has been a global campaign for universal health care, or UHC. UHC is well known for improving “health, social cohesion and sustainable human and economic development and as a precursor to strengthening national health systems” in international conferences such as the Rio Summit 20+ on sustainable development.

One potential overarching objective for health is universal health coverage, which was established in the Post-2015 Development Agenda, which replaced the Millennium Development Goals. According to the 2010 WHO study, universal health coverage (UHC) aims to ensure that everyone receives the necessary medical care without having to worry about facing financial hardship due to excessively high out-of-pocket expenses. It includes coverage for financial risk protection in addition to a full range of quality healthcare services, including prevention, treatment, palliation, and rehabilitation. Universal coverage is the third feature, and it ought to be accessible to everyone. All nations are allowed to move towards universal health insurance, even though a large portion of the globe still lacks it. Enhancing information access is one such measure.

A variety of health system elements are included in UHC, such as infrastructure, medication supply management, personnel, finance policy, information systems, and service delivery (Carrin, et al., 2008) (Fesiya. 2022). To move forward to universal health coverage (UHC), each country needs to improve their existing systems. However, each country needs to make progress in three areas to reach the goal of universal health care. The first area is how many people are covered by a group of funds, the second area is how many people can be covered, and the third area is how much money is shared among the countries2. UHC means that we need to make sure that healthcare costs are not too high, that good healthcare is available everywhere, and that the cost of health care doesn’t make people less able to use it or make their families poorer (ibid. 2022).

As the cornerstone of pledges to achieve the third set of health-related Sustainable Development Goals (SDGs), the governments of South Asian nations have adopted the objective of universal health coverage. Rapid urbanisation is one of the obstacles to getting universal health coverage. Urbanisation, a major force behind the region’s social and economic development, but causes unequal development and impedes attempts to safeguard the health and provide the impoverished and urban poor in South Asian cities with access to healthcare.