The South Asian region isfaced with some of the world’s worst
socioeconomic inequities, and these compound widespread gaps
in access to healthcare.1 Although there is a fairly extensive
body of literature on the disparities that contribute to health
inequity and their effect on health outcomes, lessis known about
the response from policy makers in South Asia.
As the commitment to universal health coverage (UHC) gains
increasing global momentum,2
regional initiativesfor expanding
health access for poor people have risen up the policy agenda,
and universal coverage forms the overarching framework for
health targets in the sustainable development goals.3 Equitable
access can be accelerated by health ministries through action
on financing, governance, or human resources to direct health
resources towards poor people4 5
or through action on social
determinants of health.6
In this article, we focus on the recent proliferation of policy
initiatives in South Asia aimed at making access to healthcare
more equitable. These initiatives typically involve insurance
schemes and contracting of private sector services. Insurance
schemes partially or fully subsidised by the government are
thought to improve access through risk pooling and reducing
point of service payments.7 The unpredictability of healthcare
needs, rising costs of treatment, and underlying poverty have
given impetus to use of insurance. Strategic contracting of
services through formal agreements between health ministries
and the private sector, funded by government budgets, is
increasingly being used to fill coverage gaps in disadvantaged
areas.