Social security as a theme has always gained importance during periods of economic instability and crises. Though the landmark Beveridge Committee Report in 1942 defined social security in the broadest possible terms as 'Freedom from Want', this definition could not be followed through and the more operational and narrow interpretation of social security as contingency related measures was adopted at the International Labour Organisation convention in the 1950s. In 1989, Dreze and Sen proposed a broadening of the definition in the context of developing countries following which Prabhu' reiterated that what is relevant for India is the concept of socio economic security ensuring enhancement of social capabilities and economic security. Health security is an integral part of such a wider notion of social security.

Health security is linked inextricably with the notion of universal health care and received prime importance following the Alma Ata Declaration in 1978 to achieve Health for All by 2000. Inspired by this goal and informed by the ICSSR- ICMR report 19812, the Government of India announced in 1983 the National Health Policy, which was subsequently replaced by the National Health Policy of 2002. The National Rural Health Mission (NRHM) was initiated in 2005 to revitalise the primary health care system in the country. Despite these policy initiatives, universal health coverage remains an unfinished agenda with basic indicators of health in India continuing to be below those of low income countries such .as Bangladesh" and crucial health Millennium Development Goals (MDGs) being missed.

India's health system mirrors the iniquitous nature of development that has taken place in the country. High income and wealth inequality' has resulted in a skewed pattern of health care oriented towards secondary tertiary level curative services, leading to the neglect of the more basic preventive and primary care services needed for the poor to survive. The World Health Organisation estimated that in 2008, 5.2 million Indians died of non- communicable diseases which accounted for 53 per cent of all deaths in the country". Income and wealth disparities are also reflected in the sharply differing health outcomes across rural and 'urban areas, states and social groups? In 2015, health inequality resulted in a loss of 24 percent of India's health index value as per the Inequality adjusted Human Development Index computed by the UNDPS.

Further, low political commitment to ensuring basic primary and preventive health care has meant that unlike education, Health for All has never been an important electoral issue, though the potential for electoral gains are evident as in the case of Andhra Pradesh. The general political apathy towards the health sector is also reflected in low budgetary allocations, with public spending accounting for not more than 1.5 per cent of GDP over the last decade despite impressive economic growth. This has meant that 75 per cent of health care costs are financed by out of pocket expenses and catastrophic health expenses regularly push a large number below the
poverty line.

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