Selective Universalism: The Paradoxical Strategy to Achieve Universal Health Coverage in India

Abstract

Universal health coverage (UHC), goal three of the Sustainable Development Goals (SDGs), has been on the agenda for some time now. However, India has not been able to achieve the less ambitious targets of Health for All (HFA) and the Millennium Development Goals (MDGs). In this context, this article identifies inefficiency as one key factor affecting progress towards UHC. One of the key contributors to inefficiency is lack of evidence-informed decisions in India. Using evidence from economic evaluation and global burden of disease study, seven cost-effective targets have been identified for prioritization in the Indian context. It is proposed that a selective approach targeting these seven targets would be a more efficient way of addressing the challenge of UHC in India.