Mohalla Clinics: A way to achieve Universal Health Coverage

With a huge potential to address a vital lacuna by providing community-level primary healthcare, Aam Aadmi Party Government in New Delhi initiated the concept of Mohalla Clinics, which originated from the traditional approach of Mobile Medical Units or Mobile Vans.

Mohalla Clinics are essentially the primary healthcare centres that provide basic healthcare facilities inclusive of medicines, diagnostic tests, and consultation free of cost. Available at walking distance, these clinics work for the benefit of the poor and underprivileged sections of   society. Ensuring better geographical access not only reduces the time and cost involved in availing the treatment but also makes basic healthcare services accessible to groups (particularly women) whose health needs are often neglected.

Delhi currently has more than 450 Mohalla clinics, which have served more than 15 million residents which shows that the primary force behind the implementation of this idea is the political desire to strengthen the health system rather than just providing ad-hoc solutions. “The Model is economically sound and offers basic services with no waiting period” said Dr. Shalley Kamra, state nodal officer for Mohalla Clinics, Delhi Government. In the annual budget of this year, Delhi Government allocated 375 crore rupees for the development of Mohalla Clinics and polyclinics.

Basic services offered

1)Provides basic services for common illnesses like fever, diarrhea, respiratory problems, first aid for burns, injuries, and other referral services.

2) These clinics have the provision of lab investigations and also, they provide all the necessary health-related information to the people availing treatment.

3) All the drugs according to the essential drug list are provided free of cost to the patients.

4) Provides many preventive services like antenatal and postnatal care to pregnant women with the proper assessment of their nutritional status.

Due to the provision of these basic services, it significantly reduces the patient load in secondary and tertiary health facilities in the state. Mohalla clinics are not just providing treatment but are also redefining the doctor-patient relationship. They play a critical role in reducing out-of-pocket expenditures of people from Jhuggi Jhopris (slums). Despite the strengths of this primary health care model, critics including political opponents, health providers, and journalists have pointed out operational gaps in some of the Mohalla Clinics including lack of staff, medical supplies, and diagnostics and corruption by doctors through over-inflation of patient numbers for increased payments.

Analyzing from the perspective of Universal Health Coverage

1) Accessibility

  • Increased Geographical Access- As Mohalla Clinics are available within the vicinity of 2 to 3 Kilometres, it significantly reduces the opportunity cost in terms of travelling costs and waiting time. In a way, it helps to encourage people to visit the clinics even at the early stage of illness.
  • Easily accessible for the unreachable and marginalized population- It helps to bring the under reserved population into the mainstream health system.
  • Quality Healthcare- These community clinics guarantee quality healthcare by qualified practitioners.

2) Financial protection and Efficiency

  • Reduced cost of the care through provision of assured free medicines and provision of diagnostics – The cost of medicines and diagnostics contribute to nearly 70% of healthcare cost by the people. So Mohalla clinics help people save a major part of their disposable income.
  • Making services affordable for poor- Easy access reduces the cost of transportation and waiting time.

3) Cost-Effective interventions – the services are provided at a nominal price. By establishing an effective referral linkage in which nearly 80%- 90% of health problems can be addressed at the community level, it has the potential to ease congestion at higher levels of health facilities.

With a comprehensive evaluation of the Mohalla clinics, Dr. Gro Harlem Brundtland, former Director General of World Health Organisation said ‘The healthcare reforms being undertaken in Delhi strike me as an excellent strategy to meet the huge unmet needs for free universal health care’. Given this current political push for UHC at the national level, these clinics could actually serve as a replicable model to scale up universal health coverage across India.

Many Indian states like MP, Jharkhand, Telangana have already been replicating the initiative. But it is high time to set aside all the political differences and actually work together to refine and scale the Mohalla clinic model across other states and set the stage for achieving Universal Health Coverage for all its citizens.

Khushi Gupta is a Masters student of Public Policy at Jindal School of Government and Public Policy, O.P. Jindal Global University.

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