Paving the Way to Universal Health Coverage in Jammu and Kashmir
The WHO’s Health Financing Progress Matrix: Sub-national Assessment Jammu and Kashmir, India, 2024 provides a detailed evaluation of the health financing system in Jammu and Kashmir. The report reveals significant fragmentation across multiple schemes, emphasizes the need for a unified health policy, and offers key recommendations to improve revenue generation, governance, and health service delivery. With better financial management and policy coherence, Jammu and Kashmir can make significant strides toward Universal Health Coverage, setting a benchmark for other regions.
Jammu and Kashmir’s healthcare system has been under scrutiny in a recent report by the World Health Organization (WHO) titled Health Financing Progress Matrix: Sub-national Assessment Jammu and Kashmir, India, 2024. This groundbreaking analysis provides an in-depth look into the health financing structure of the Union Territory (UT), highlighting critical areas of strength and opportunities for improvement in its quest for achieving Universal Health Coverage (UHC). The assessment serves as a guide for local policymakers to better align health financing policies and ensure equitable access to healthcare services for the populatio
Understanding the Health Financing Landscape
The study explores the complex health financing landscape in Jammu and Kashmir, underscoring a fragmented system where different schemes like the Pradhan Mantri Jan Arogya Yojana (PM-JAY) SEHAT, Employee State Insurance Scheme (ESIS), and Central Government Health Scheme (CGHS) operate independently. While each scheme targets specific population groups, this lack of coordination has led to inefficiencies, duplications, and varying levels of access and quality of care.
Despite these challenges, the report notes that the health system in Jammu and Kashmir has made notable progress in some areas. Investments by both the Union and UT governments have led to a downward trend in Out-of-Pocket Expenditure (OOPE), which indicates that residents are now spending less from their own pockets for healthcare. However, the data also suggests there is still room for improvement, especially in how funds are pooled and allocated across different schemes.
Key Recommendations for Health Financing Reform
One of the central themes of the WHO report is the need for a comprehensive, UT-specific health financing policy. Currently, the health policy framework in Jammu and Kashmir heavily relies on national directives, limiting the UT’s ability to address its unique healthcare needs. The report advocates for a harmonized approach that would unify existing health schemes, reduce fragmentation, and streamline service delivery.
Additionally, revenue generation is another area flagged for reform. The report recommends implementing health taxes, such as higher taxes on tobacco and other harmful products, to discourage risky behaviors and generate additional funding for healthcare services. Such measures could not only boost health sector financing but also contribute to overall public health by reducing the prevalence of health-related risk factors.
Strengthening Governance and Financial Management
Public Financial Management (PFM) remains a major concern in Jammu and Kashmir. The report highlights that delays in fund disbursement, low budget execution, and capacity issues at lower administrative levels hinder the efficient use of resources. To address this, the WHO suggests establishing stronger linkages between the Department of Health and the Department of Finance to ensure smoother budget formulation and implementation processes. Improved coordination between these departments could help eliminate bottlenecks, allowing for timely fund allocation and optimal utilization.
The introduction of a medium-term expenditure framework is also proposed to enable better planning and predictability in resource mobilization. Such frameworks are critical for aligning financial resources with long-term health priorities and achieving sustainable health outcomes. Furthermore, the report underscores the need for systematic health resource tracking to monitor the effectiveness of recent reforms and ensure that resources are being used efficiently.
Moving Toward Universal Health Coverage
The findings and recommendations in the report serve as a roadmap for Jammu and Kashmir to move closer to UHC. By addressing fragmentation, improving governance, and ensuring sustainable financing, the UT can build a robust healthcare system that offers equitable access and high-quality services to all residents.
One of the key takeaways from the report is the need for strategic health purchasing reforms. Currently, purchasing arrangements are scheme-specific and fragmented, often resulting in conflicting incentives at the delivery level. The WHO recommends integrating purchasing functions across schemes to enhance efficiency and ensure that providers are incentivized to deliver quality care. This integration would also minimize inequities in access and improve the overall effectiveness of health service delivery.
Impact and Broader Implications
This sub-national assessment, the first of its kind globally, offers valuable insights not only for Jammu and Kashmir but also for other subnational units facing similar health financing challenges. It highlights the importance of tailored health policies and localized solutions that reflect the unique contexts and needs of individual regions. The findings set a precedent for future assessments and serve as a benchmark for tracking progress toward UHC in other regions of India and beyond.
Ultimately, the WHO’s Health Financing Progress Matrix: Sub-national Assessment Jammu and Kashmir, India, 2024 is more than just an evaluation—it is a call to action. It urges stakeholders at all levels to rethink their approach to health financing, prioritize policy coherence, and commit to achieving UHC for every citizen in Jammu and Kashmir. With strategic reforms and effective implementation, the UT has the potential to set an example for other regions striving to provide inclusive and equitable healthcare services.