State led innovations for achieving universal health coverage in a low resource setting Odisha, India: opportunities and challenges

Background: Odisha, a developing state of India, has introduced an innovative scheme known as Biju Swasthya Kalyan Yojana (BSKY), which aims at providing free health care to all the people. This paper examines scope, key features, challenges and potentiality BSKY achieve universal coverage (UHC) in Odisha.Methods: We reviewed policy documents conducted qualitative interviews with government officials other stakeholders understand implement processes constraints.Results: The intends provide people public institutions additionally, 71 lakh poor households can avail services from empanelled private hospitals financial up 5 lakhs per family women members 10 annually. is implemented assurance mode by merging state-run schemes- Rashtriya Bima (RSBY), Krushak (BKKY) Odisha State treatment fund (OSTF). implementing agency introducing several measures control unnecessary utilisation cost. Gate keeping mechanism reserved packages hospital are major initiatives this direction. Further, efforts settle claims on time IT related teething problems scheme. findings further suggest that expenditure stands 1.3% GSDP inadequate human resources infrastructure affecting service delivery.Conclusions: Achieving UHC such low spending different delivery constraints looks ambitious. may learn countries phase wise.