🏥 Health Insurance in WHO Southeast Asia Region: India's Gender Gap | UPSC Blog
📅 Date: July 14, 2025
📰 Source: The Lancet Regional Health – Southeast Asia
📍 What’s the News?
A new study finds that:
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Only 1 in 5 women in WHO’s Southeast Asia Region have any health insurance.
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For men, the number is 1 in 4.
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In India, 53% of women and 56% of men are covered, but gender and rural disparities persist.
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Indonesia has the highest coverage (~56%), while Myanmar has the lowest (~1.4%).
🔎 The study used data from Demographic and Health Surveys (2015–2022) and was conducted by researchers from Health Systems Transformation Platform and Population Council Consulting, New Delhi.
🌍 Countries in WHO Southeast Asia Region
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India
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Bangladesh
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Nepal
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Indonesia
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Myanmar
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Sri Lanka
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Thailand
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Maldives
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Timor-Leste
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Bhutan
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DPR Korea
🔍 Key Findings: What the Study Revealed
| Parameter | Women | Men |
|---|---|---|
| Any health insurance (region) | ~20% | ~25% |
| Social security-based insurance | 12.5% | Higher |
| Commercial insurance | ~7.5% | - |
| Coverage in India | 53% | 56% |
| Highest coverage (Region) | Indonesia | Indonesia |
| Lowest coverage (Region) | Bangladesh | Myanmar |
📌 Why Is This Important for UPSC?
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SDG 3: Good Health and Well-being targets Universal Health Coverage (UHC).
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GS Paper II: Welfare schemes, issues relating to health, and development.
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GS Paper III: Inclusive growth and issues relating to planning and implementation.
🧠 Mains Perspective: Issues & Challenges
🚫 Challenges in Health Insurance Uptake
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Gender Disparity: Women lag behind men in insurance coverage due to social and financial dependency.
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Lack of Awareness: Limited media exposure and literacy hinder enrolment.
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Rural Dependence on Informal Systems: Preference for community help over formal insurance.
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Cultural Barriers: Distrust in financial systems and fatalism.
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High Out-of-Pocket Expenditure: Insurance schemes do not cover full costs.
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Rising Premiums: Inflation has made private insurance unaffordable.
🧩 Suryavanshi IAS Recommendations: A Policy Blueprint
1. Gender-Sensitive Insurance Designs
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Targeted schemes for women-headed households and informal sector women.
2. Strengthen Government Health Insurance
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Expand Ayushman Bharat coverage with state integration.
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Include outpatient and chronic care under PM-JAY.
3. Financial Literacy & Media Campaigns
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Promote insurance literacy via SHGs, Anganwadi workers, Panchayats.
4. Community-Based Models
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Promote cooperative health insurance models rooted in local culture.
5. Regulate Private Sector
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Set standard treatment costs, simplify claim processes, and cap premium hikes.
6. Use Digital Tools
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Health ID via Ayushman Bharat Digital Mission (ABDM) can boost awareness and accessibility.
📚 Prelims Snippets
| Term/Topic | Quick Facts |
|---|---|
| PM-JAY | Ayushman Bharat: ₹5 lakh/year/family for secondary & tertiary care |
| ABDM | Digital health ecosystem with Health ID for all |
| Out-of-pocket expenditure | 55% in India (as per National Health Accounts 2022) |
| SDG Target 3.8 | Achieve UHC, access to quality healthcare & financial risk protection |
📜 Previous Year UPSC Questions
🔹 Prelims 2021
Q. Ayushman Bharat is meant to achieve which of the following?
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Making insurance affordable for underprivileged
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Strengthening public healthcare
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Establishing Health and Wellness Centres
Answer: All of the above
🔹 Mains 2020 (GS II)
Q. “Access to affordable and quality health care is the cornerstone of human development.” In light of this, examine India’s progress towards UHC.
🔹 Mains 2018 (GS II)
Q. Appropriate local community-level healthcare intervention is a prerequisite to achieving ‘Health for All’ in India. Explain.
🗣️ Mains Practice Question
Q. “Health insurance coverage in South Asia, especially among women, remains critically low due to a mix of individual, social, and institutional factors.”
Discuss the implications and suggest policy solutions to improve equitable access to health insurance in India. (250 words)
🧾 Conclusion
This report is a clear reminder that healthcare access is not just a service but a right. To meet SDG targets and ensure Universal Health Coverage, India must address socio-economic inequalities, empower women, and create trust-based, accessible health insurance systems.
📌 Stay Updated with Suryavanshi IAS
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Daily Current Affairs for UPSC
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Mains Answer Writing Practice
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Thematic Notes on Health, SDGs, and Social Issues
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