The pizza boxes are strewn around the table in a backroom of the health department of Delhi government. The chatter, attitude and energy of the men sitting around on plush couches make the place look like a well-funded startup. Also, the reason why certain quarters of the government have been raising eyebrows.

The mood in the room is bittersweet. Two years ago, the state government inherited 260 primary healthcare units and made a grand promise of establishing 1000 more mohalla clinics—one doctor-primary healthcare units—across the city. On 15 March, the state inaugurated 49 mohalla clinics reaching a total of 150. The achievement, which may appear meagre against the promise, is unprecedented for any state government and thus, the pizza lunch for celebration.

Robert Yates is impressed. A globally acclaimed expert on Universal Health Coverage (UHC) and project director of the UHC Policy Forum at the London-based Centre on Global Health Security, Yates is visiting Delhi to understand the state’s strategy. He cannot think of any example in the world, where new facilities have been introduced in such a short time in one city.

He is not the only one. Reputed medical journal, The Lancet, and former Secretary-General of United Nations (UN), Kofi Annan have lauded this free clinics model of healthcare delivery. Other state governments are trying to emulate it. Treating high-incidence low-cost illnesses like cold, cough and viral fever for free at the doorstep of Delhiites makes financial sense too.

That’s also the first ladder of universal healthcare, seen as a holy grail because it’s a tricky game of execution and political will. Letting people buy healthcare through myriad insurance schemes is less head-scratching than providing care at doorsteps, sort of, to check costs. And disease escalation. Nearly 30 emerging economies are moving towards it. In Delhi, the Aam Aadmi Party (AAP) government began this experiment in July 2015. There’s no qualitative data to show how it’s working, but there are initial signs that people and care providers like it even though the opposition doesn’t.

Money is not a problem

The cost of primary healthcare

Director of the state health mission, Dr Tarun Seem, explains that primary healthcare is very cheap. So cheap that it could be done under a tree. It is not about reinventing the wheel but sticking to a simple and minimalistic design with some innovation.

Delhi’s annual health budget is Rs 5736 crore. It could, like India as a whole, do with more but for now, this money is good. Director of the state health mission, Dr Tarun Seem, explains that primary healthcare is very cheap.

AUTHOR

Ruhi Kandhari

Ruhi writes on the impact of healthcare policies, trends in the healthcare sector and developments on the implementation of Electronic Health Records in India. She has an M. Sc. in Development Studies from the London School of Economics.

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