Strengthening Universal Health Coverage in India: The Role of Affordable & Decentralized Diagnostics

Context India’s diagnostic market is valued at ₹1.54 trillion (FY2024), dominated by pathology and in vitro diagnostics (IVD). However, only 15% of labs are part of organized chains, and a mere 1.2% of ~100,000 labs hold NABL accreditation, raising concerns over diagnostic quality and reliability.

Why Accessible Diagnostics Matter for UHC in India

• Early Disease Detection: Enables timely treatment, improving health outcomes.
• Cost-Effective Care: Reduces long-term treatment costs and hospitalizations.
• Universal Health Coverage (UHC): Expands access to essential services, especially in rural areas.
• Epidemic Preparedness: Rapid testing for TB, dengue, malaria aids outbreak control.
• Health Equity: Bridges rural-urban gaps in healthcare access and outcomes.

Key Challenges in India’s Diagnostic Ecosystem

• Infrastructure Gaps: Most Primary Health Centres (PHCs) lack basic diagnostic tools.
• Rural-Urban Divide: 75% of diagnostic revenue comes from cities; rural areas face severe access barriers.
• Workforce Shortage: Rural doctor-patient ratio is 1:11,082; trained lab technicians are scarce.
• High Costs: Private diagnostics are unaffordable for low-income groups.
• Insurance Exclusion: Most health insurance schemes exclude outpatient diagnostics.
• Weak Regulation: Voluntary NABL accreditation leads to inconsistent quality in unorganised labs.

Government Initiatives Driving Diagnostic Equity

• National List of Essential Diagnostics (NLED): Standardizes essential tests across healthcare tiers.
• ICMR Guidelines: Promote evidence-based diagnostic practices nationwide.
• PHC Upgradation: Equipped with semi-automated analyzers for basic blood and urine tests.
• Molecular Diagnostics: Expanded to all district hospitals for TB and infectious diseases.
• Vector-Borne Disease Testing: Sub-centre level dengue and malaria testing improves surveillance.
• CHC Enhancements: Dental X-rays in Community Health Centres boost oral health screening.
• Tele-diagnostics: Connects rural clinics with urban specialists via remote pathology & radiology.

Way Forward: Building a Stronger Diagnostic Network

✅ Include Outpatient Diagnostics in Insurance – Enhance financial protection under PM-JAY and state schemes.
✅ Expand Rural Diagnostic Infrastructure – Set up NABL-compliant labs in PHCs and CHCs.
✅ Scale Skill Development Programs – Train lab technicians to meet rural demand.
✅ Mandatory NABL Accreditation – Ensure quality and reliability across all labs.
✅ Leverage AI & Telemedicine – Use AI-powered tools and tele-diagnostics to overcome specialist shortages.
✅ Strengthen Sample Transport Networks – Invest in cold-chain logistics for timely sample delivery.
✅ Update Essential Diagnostics List Regularly – Align with emerging disease trends like diabetes, cancer, and antimicrobial resistance.

Conclusion: Strengthening decentralized, affordable, and quality-assured diagnostics is crucial for achieving Universal Health Coverage (UHC) in India. By integrating technology, expanding rural access, and enforcing standards, India can build an equitable, efficient, and resilient health system for all.