Maharashtra Polls: MVA Manifesto Promises to Uphold Right to Healthcare for All

Ahead of the Vidhan Sabha elections 2024, the Maha Vikas Aghadi (MVA) coalition government in Maharashtra has introduced a sweeping set of healthcare initiatives designed to establish healthcare as a fundamental right for every resident. These proposals represent a comprehensive approach to improving health outcomes, targeting diverse healthcare needs across the state. From preventive care to emergency response, the initiatives aim to close healthcare access gaps, particularly for rural and underserved populations. Below is a detailed exploration of these initiatives and why they are essential to building a healthier Maharashtra:

• Free cervical cancer vaccines for girls aged 9 to 16

Cervical cancer is a major public health challenge in India, ranking as one of the most common cancers among women. It accounts for a significant percentage of female cancer deaths in the country, with the human papillomavirus (HPV) identified as the primary cause. The MVA government’s proposal to provide free HPV vaccines for girls aged 9 to 16 is a proactive approach to addressing this issue. This initiative is not only a public health priority but also a critical step toward achieving health equity, particularly for families with limited financial resources. Cervical cancer disproportionately affects women in low- and middle-income countries, and India bears a large share of this global burden. The lack of access to preventive healthcare, regular screenings, and costly treatments leads to high mortality rates, especially in under-resourced communities. HPV, a sexually transmitted infection, is a significant risk factor, causing nearly all cervical cancer cases. The infection often goes undetected for years, with symptoms only surfacing in advanced stages when treatment is more challenging and outcomes are poor.

• Expansion of the Mahatma Phule Jan Arogya Scheme

The Mahatma Phule Jan Arogya Scheme (MPJAY), Maharashtra’s flagship health insurance program, has historically provided financial support for select ailments and covered certain treatments in government and empanelled private hospitals. MPJAY primarily focusses on critical and high-cost ailments rather than general health issues, covering around 1,000 types of procedures related to specific heart and kidney diseases, cancer treatments and neurological disorders, amongst others. The goal was to address life-threatening and severe medical conditions that could lead to financial catastrophe if left untreated. The scheme primarily benefited low-income families, giving them access to critical medical treatments they might not otherwise afford. 

Now, the MVA government proposes a significant expansion of MPJAY to cover all diseases, including those resulting from accidents. This transformative change aims to offer a broader safety net, shielding Maharashtra’s economically vulnerable populations from the financial hardships often associated with healthcare expenses. Expanding MPJAY is also an important step toward achieving Universal Health Coverage (UHC) for Maharashtra. In line with the goals of the National Health Mission, which advocates for accessible and affordable healthcare for all, MPJAY’s expansion contributes to creating a more inclusive healthcare system that ensures everyone can access quality medical services.

• Review and expansion of health insurance schemes

Recognising that the current health insurance schemes have limitations, the MVA manifesto proposes a thorough review to identify gaps and expand coverage accordingly. Many existing policies don’t cover all necessary treatments, and out-of-pocket expenses remain high. Enhanced insurance schemes will give citizens better access to advanced healthcare services, benefiting especially middle-income families who often struggle to cover medical costs. Expanding insurance coverage could also help the government partner with private providers to offer subsidised treatments.

• Free medicine availability in government hospitals

Access to free essential medicines in government hospitals is a cornerstone of affordable healthcare. This proposed policy would address the problem of patients not completing treatments due to high medication costs. Providing medicines for free ensures that economic barriers do not prevent people from receiving necessary care, especially for chronic conditions requiring lifelong medication. It also aligns with the National Health Policy’s goal to increase the availability of generic drugs in government facilities.

• Policy for Universal Healthcare Rights

By adopting a Universal Healthcare Rights policy, MVA envisions Maharashtra joining the global efforts to make healthcare accessible and equitable for all. This proposed policy includes a commitment to improving healthcare infrastructure, human resources, and service delivery in rural and urban areas alike. It prioritises inclusive care by ensuring that even the most remote regions of Maharashtra have access to high-quality healthcare.

• Equipping district hospitals with comprehensive facilities

Upgrading district hospitals to provide full medical services is essential for bridging healthcare disparities between urban and rural areas. District hospitals in Maharashtra lack the infrastructure to offer specialised treatments, forcing patients to travel long distances to larger cities. With comprehensive facilities, these hospitals can address a broader spectrum of health needs locally, reducing delays in critical care and improving health outcomes for rural populations.

• Lowering population criteria for Primary Health Centres (PHCs)

In Maharashtra, remote, hilly, and tribal regions often have limited access to healthcare facilities due to challenging terrains, dispersed settlements, and low population densities. By reducing the population requirement for establishing Primary Health Centres (PHCs) from 20,000 to 10,000 in these areas, the MVA aims to address these logistical challenges and bring healthcare closer to the people. This initiative is particularly significant for Maharashtra’s tribal communities, which represent around 9% of the state’s population. These communities, often located in the Sahyadri and Satpura ranges, face not only geographic isolation but also economic and educational barriers to healthcare. Increasing the number of PHCs in these regions will allow residents to access basic health services such as maternal and child health, immunisation, and treatment for common diseases within their localities. This approach helps address longstanding healthcare disparities in Maharashtra, particularly in districts like Gadchiroli, Nandurbar, and Palghar, where the need for accessible healthcare is critical.

Reducing the population threshold to 20,000 for setting up PHCs in other rural parts of Maharashtra will also potentially bring healthcare access within reach for rural communities across the state. PHCs play a crucial role in providing first-level medical care, handling outpatient services, preventive health education, and early diagnosis for common illnesses. By making these centres more widely available, the initiative reduces the need for residents to travel long distances to larger hospitals for minor ailments and preventive care. This not only saves time and costs for rural families but also alleviates the burden on district and sub-district hospitals, allowing them to focus on more complex cases. For rural districts like Ahmednagar, Solapur, and Jalgaon, where many residents rely on agriculture and face seasonal challenges with limited income, the increased accessibility of PHCs can make a significant difference in overall community health. With improved proximity to primary healthcare, early detection and prevention of diseases such as diabetes, hypertension, and respiratory illnesses can be achieved, helping reduce the need for hospitalisations and fostering a healthier rural population.

• Expansion of ambulance services to 2,000

The MVA’s promise to expand Maharashtra’s ambulance fleet to 2,000 vehicles is a commitment to strengthening emergency healthcare access across the state, especially for rural and remote communities where medical facilities can be hours away. In emergencies such as road accidents, natural disasters, childbirth complications, or sudden critical health conditions like heart attacks, timely medical intervention is often a matter of life and death. The increase in well-equipped ambulances, staffed by trained paramedics, will ensure that more people receive rapid, essential care at the scene and on the way to hospitals, significantly reducing response times and potentially lowering mortality rates in critical situations.

This expansion would make a tangible difference for Maharashtra’s rural districts and remote tribal areas, where many communities are located far from the nearest healthcare facility. Regions like Vidarbha, Marathwada, and the tribal areas of the Western Maharashtra, where emergency services are often hard to access, will benefit from the MVA’s focus on bridging these healthcare gaps. By proposing to increase the ambulance fleet, the MVA government aims not only to provide faster emergency responses but also to build a more resilient healthcare infrastructure that can serve all citizens, even in times of large-scale crises. This pledge shows a strong commitment to ensuring that life-saving healthcare is available and accessible across Maharashtra, delivering critical peace of mind to families statewide.

• Right to healthcare policy development for Maharashtra

Crafting a dedicated healthcare policy that aligns with state and national standards will set clear benchmarks for healthcare services in Maharashtra. This policy will provide a foundation for accountability, ensuring all residents have equal access to healthcare. It will also streamline government operations to ensure that healthcare services reach urban and rural populations effectively.

• Increasing the healthcare budget

An increase in healthcare spending is essential for supporting such a comprehensive healthcare program. The manifesto suggests incrementally raising the healthcare budget to 8% of the state’s total budget, aligning with recommendations in the National Health Policy. These funds will be directed towards upgrading infrastructure, expanding facilities, and ensuring sufficient medical supplies, enabling sustainable development of Maharashtra’s healthcare system.

• Construction of a 100-Bed modern hospital in each Taluka

Maharashtra’s 358 talukas represent the administrative backbone of the state, and establishing a 100-bed hospital in each taluka will create a decentralised healthcare system. These hospitals will provide emergency care, specialised services, and in-patient facilities, reducing the burden on tertiary hospitals and ensuring more timely care for residents in their communities.

• Community-based healthcare oversight

Activating community health committees will foster transparency and accountability in public healthcare. These committees will give local representatives and social organisations a voice in healthcare planning, empowering them to shape services that directly address their community’s needs. This model proposed by the MVA promotes citizen engagement, ensuring that healthcare remains responsive to changing local dynamics.

• Health workforce policy and regularisation of contractual nurses

Maharashtra faces significant challenges in maintaining a sufficient and well-trained healthcare workforce, particularly in public health facilities. The state’s healthcare system is often stretched thin, especially in rural and remote areas where the availability of medical professionals is limited. The proposal for introduction of a Health Workforce Policy by the MVA government seeks to address this critical issue by prioritising the filling of existing vacancies in both urban and rural healthcare settings. This policy will focus on recruiting doctors, nurses, paramedics, and other healthcare professionals to ensure that public health centres and district hospitals are adequately staffed. A key component of this initiative is the regularisation of contractual nurses, many of whom work in precarious conditions without job security or benefits. By transitioning these nurses into permanent roles, the policy will not only offer them the stability and financial security they need but also improve their long-term commitment and investment in patient care. Nurses play a central role in the healthcare delivery system, and providing them with permanent positions will lead to better continuity of care, reduced staff turnover, and improved morale. This move will also help Maharashtra address regional disparities, ensuring that both urban and rural areas have access to a well-supported and consistent healthcare workforce, which is essential for the quality of care and patient outcomes across the state.

• Increased remuneration for ASHA and Anganwadi Workers

Accredited Social Health Activists (ASHA) and Anganwadi workers play a critical role in grassroots health services. Maharashtra aims to increase their remuneration, recognising the demanding and often underpaid nature of their work. Despite their critical role, these workers often receive low pay, inadequate benefits, and limited job security, which has resulted in low morale and high turnover rates. Recognising their immense contribution, the MVA government has promised to increase their remuneration. This move will not only provide these workers with a fairer income but also acknowledge the demanding nature of their roles, especially in rural Maharashtra where access to healthcare facilities is limited. By improving the financial recognition of ASHA and Anganwadi workers, Maharashtra aims to ensure that these workers remain motivated and able to continue their vital work in improving community health, thereby reducing health inequalities in rural and underserved areas. Improved pay aligns with practices in states like Kerala, where higher compensation has boosted job satisfaction and led to better health outcomes in rural communities. As of March 2024, the monthly honorarium for an Accredited Social Health Activist (ASHA) worker in Maharashtra is ₹13,000, which is a ₹5,000 increase from the previous amount, bringing it to one of the highest paying states.

• Expanded generic medicine centres and free essential medicines

Offering free essential medicines and expanding generic medicine centers will make treatments more affordable, especially for marginalised communities. Generic centres reduce dependency on costlier branded medicines, encouraging patients to adhere to prescribed treatments and preventing diseases from worsening.

• ‘Stree Shakti’ initiative for women’s health

With over half of India’s women facing anemia, the ‘Stree Shakti’ initiative addresses a critical health issue that affects women’s productivity, pregnancy outcomes, and quality of life. This proposed initiative by the MVA will provide supplements and healthcare support, targeting anemia reduction and improving maternal and child health, leading to a healthier future generation.

• Malnutrition control and Tribal Health and Nutrition Missions

Malnutrition remains a challenge in India, especially in tribal regions. A dedicated Malnutrition Control Board and Tribal Health and Nutrition Mission will coordinate resources and interventions to tackle this problem. The Tribal Health and Nutrition Mission proposed by the MVA in particular, will focus on unique health challenges faced by tribal populations, such as sickle cell anemia and other genetic disorders, improving health equity across Maharashtra.

• Free medication for chronic diseases and preventive health initiatives

Chronic conditions such as diabetes and hypertension are rising in India. According to the manifesto of MVA, they will be providing free medication and encourage early screening so that complications can be prevented, hospitalisations can be reduced, and patients’ quality of life can be removed. Initiatives to control malaria, dengue, TB, and chikungunya reflect a proactive stance on public health.

• Expanded mental health services

Today, mental health issues like depression, anxiety, and digital addiction are being openly discussed and have also become a priority. Establishing counselling centres across the state will make mental health services more accessible, promoting mental well-being and helping residents manage life’s pressures more effectively.

• Transparency and accountability in healthcare services

By implementing a Patient Rights Charter and setting up grievance cells, MVA envisions Maharashtra to make healthcare services more accountable. This transparency will improve trust in public healthcare, giving patients the security of knowing their rights are protected and they have recourse if standards are not met.

• Telemedicine helpline and clean drinking water initiatives

As proposed by the MVA, the telemedicine helpline will provide a valuable resource for remote communities who face challenges accessing healthcare facilities. Clean drinking water campaigns, like ‘Nirmal Jal,’ will combat waterborne illnesses, improving health outcomes in regions such as Marathwada and Vidarbha.

• Addressing the safety of healthcare workers in Maharashtra

The safety of doctors and healthcare professionals is a growing concern in Maharashtra, as across the country, the rise in assaults on medical staff has become a significant issue. These incidents not only jeopardise the physical safety of doctors and staff but also undermine the overall healthcare system, creating an environment of fear and discouragement among medical professionals. To address this, the MVA government has recognised the need for robust measures to protect healthcare workers, emphasising the importance of maintaining a safe working environment for medical staff. The government is committed to taking necessary precautions, such as implementing stricter laws and enforcement against those who resort to violence, introducing better security systems in hospitals, and training healthcare workers in conflict resolution techniques. In addition, the creation of a more supportive environment, including the establishment of dedicated grievance redressal mechanisms for healthcare workers, can help prevent such incidents and ensure that healthcare providers can focus on delivering quality care without the fear of physical harm.

The MVA’s approach to tackling violence against healthcare workers is not just about improving security measures but also about changing the broader culture of healthcare in Maharashtra. The government’s focus on preventing assaults on doctors and medical staff involves not only legislative action but also enhancing public awareness about the importance of treating healthcare workers with dignity and respect. Public campaigns and outreach programs will educate the public on the challenges faced by doctors, especially in high-stress environments like government hospitals where the patient load is often high, and resources are limited. Moreover, strengthening hospital security through the installation of CCTV cameras, increasing the presence of trained security personnel, and enforcing protocols for handling volatile situations will create a safer space for healthcare providers. In the long run, these efforts will encourage more healthcare professionals to work in public hospitals, knowing that their safety and well-being are a priority, thereby improving the overall healthcare system in Maharashtra.

• Target to raise life expectancy to 77 years

Aiming to increase life expectancy reflects Maharashtra’s commitment to a holistic approach to health. Improved public health, accessible healthcare services, and initiatives focused on clean water, sanitation, and preventive care will contribute to a healthier, longer-living population, ultimately enhancing the state’s social and economic development.

Building an inclusive and comprehensive healthcare system for all

The MVA’s healthcare manifesto sets the stage for a transformative shift in Maharashtra’s healthcare landscape, focusing on inclusivity and equity in access to medical care. By implementing a universal healthcare policy, the government aims to ensure that no one, regardless of their economic background, geographic location, or social status, is left behind. The promise to expand primary healthcare services in rural, remote, and tribal areas—by reducing the population threshold for establishing Primary Health Centres (PHCs)—will bring essential healthcare services closer to communities that have historically faced challenges in accessing quality care. The increase in ambulance services to 2,000 vehicles ensures faster and more reliable emergency medical response, reducing delays that can be the difference between life and death in critical situations. This approach will help alleviate the burden on overextended urban hospitals, offering decentralised healthcare options that empower local communities.

Moreover, the commitment to free medicines, vaccination programs, and cancer treatment for women highlights the government’s drive to make healthcare affordable and accessible for all. The MVA’s initiatives will improve health outcomes in marginalised communities, such as the tribal regions of Vidarbha, Marathwada, and the Western Ghats, by addressing health disparities that have persisted for years. This focus on preventive healthcare, including expanding the availability of HPV vaccines, malnutrition control programs, and maternal and child health initiatives, will help reduce the long-term disease burden, improving overall population health and reducing the pressure on expensive hospital treatments. These measures form the foundation of a healthcare system where quality care is guaranteed as a right, not a privilege, contributing to the overall well-being of every citizen across the state.

Sustainable healthcare infrastructure and empowerment of medical workers

The MVA manifesto’s vision extends beyond just expanding access; it aims to build a sustainable healthcare infrastructure that is robust, resilient, and future-ready. With initiatives like equipping every sub-district hospital, building 100-bed modern hospitals in each taluka, and enhancing district hospital facilities, the MVA government is ensuring that Maharashtra’s healthcare infrastructure will be able to handle both present and future challenges. The inclusion of Mohalla clinics in urban areas will make healthcare services more accessible on a local level, while the creation of a Health Workforce Policy and the regularisation of contractual nurses will ensure that the state is equipped with a skilled and motivated healthcare workforce. By addressing the remuneration and job security of crucial grassroots workers like ASHA and Anganwadi workers, the MVA government is directly improving the quality of healthcare at the community level, empowering those who are often the first point of contact for rural and underprivileged populations.

These initiatives, which focus on both infrastructure and workforce development, are designed to create a healthcare system that can withstand future pressures, such as a growing population or emerging health crises. The promise to improve security measures for doctors and prevent assaults further strengthens the healthcare ecosystem by ensuring that medical professionals can work in a safe, supportive environment. Together, these transformative changes will not only increase the state’s healthcare coverage but also foster an environment where medical professionals, from frontline health workers to doctors, can thrive. By prioritising healthcare as a fundamental right and building a system that supports both patients and providers, MVA envisions Maharashtra to be on the path to becoming a model state for healthcare, one that sets new standards for accessibility, quality, and sustainability.