Sectors Chapter 8 · ಆರೋಗ್ಯ

Health as a human right.

A six-layer institutional spine, one record per citizen, primary & secondary care free at the point of delivery, and — by Year 10 — universal free coverage for every unforeseen serious illness across the full diagnostic-and-treatment stack. No means test.

The Karnataka Universal Health Entitlement is a statutory right. Existing schemes — Suvarna Arogya Suraksha Trust, NHM, PMJAY-AB — converge into one citizen-facing front door. No multi-scheme navigation by the citizen.
6
institutional layers from procurement to governance (KPHDA)
~600
Mobile Clinics by Year 5, every ward + village quarterly
100%
UMRS coverage of Karnataka residents by Year 5
Year 10
universal serious-illness cover, no means test
Health as a Human Right — universal serious-illness coverage across Karnataka
The problem we solve

Health failure in Karnataka is a poverty trap.

A family that cannot rely on the public system — for primary care, for medicines, for emergency response, for the cost of a single major illness — is one accident or one chronic condition away from financial ruin. Five structural failures recur.

Weak primary care

PHCs on paper; many lack continuous Family Health Teams or follow-up for chronic conditions. Visits drop, conditions escalate, trust collapses.

Drug + diagnostic stockouts

Significant spend, broken last mile. No real-time stock visibility. No batch-to-patient tracking. No consequence when a PHC runs out.

Overcrowded tertiary

Because primary underperforms, every condition escalates to higher tiers where the unit cost of care is several times more.

Slow emergency response

Trauma care depends on response time. Karnataka's response is uneven; dispatch dashboards aren't public.

Unequal access

Rural + tribal Karnataka and the urban working poor: longer waits, fewer specialists, weaker infrastructure, higher out-of-pocket spend.

Beneath these five lies one architectural failure. The state has hospitals, schemes, and procurement budgets — but it doesn't have a coherent health-sector architecture. Karnataka builds that whole.

The architecture

KPHDA — six institutional pillars, one system.

The Karnataka Public Health Delivery Architecture is the institutional spine. The Universal Medical Record System (UMRS) is the data spine that runs on top of it. Every layer publishes on the Open Ledger; every layer is owned by a Karnataka statutory body, not by a department or vendor.

1
Procurement — KHPA
Single state-owned procurement body for medicines, consumables, diagnostics, equipment. Pooled tendering on OCDS. Generic-first policy. Four regional quality-testing labs.
H.019–H.022
2
Distribution — KDCDN
Three-tier warehouse (regional → district → facility). Real-time stock dashboard on the state operating spine. Cold-chain IoT. Batch-to-patient tracking via UMRS.
H.023–H.027
3
Care Facility Hierarchy
Six rungs: sub-centre → PHC → CHC → district hospital with medical college → 8 regional tertiary hubs → Mobile Clinic Network. Family Health Team is the operating unit at PHC tier.
H.028–H.038
4
Public Health Cadre
FHTs, ASHA + ANM expansion, three new state cadres (Mobile Health, Biomedical Engineering, Health Records Officers). Training via medical colleges + 31 Public Health Skill Hubs.
H.039–H.044
5
Financing — KHFA
Single-window for every citizen. UMRS identity + scheme eligibility + free-vs-paid determination in one query. Karnataka Catastrophic Care Fund for tertiary + rare disease.
H.045–H.049
6
Governance — KPHA
Apex statutory body. Independent board with civil-society + medical-professional + retired-judiciary members. District Health Boards (one per district) for local oversight + citizen-rating-triggered audits.
H.050–H.054
UMRS — the data spine
One record per citizen. Every interaction writes here. Every access logged. Citizen sees the access log live on JANATA.
How it shows up for you

Four journeys that define the system.

These aren't programs you sign up for — they're how the public health system runs once KPHDA is operational. No paperwork at the point of care, no scheme navigation, no chasing receipts during a crisis.

Annual checkup

Mobile Clinic at your ward, quarterly.

1

Mobile Clinic visits every ward and every village at least quarterly — schedule published on JANATA.

2

Ages 5–30: vitals + vision + dental. 30+: blood panel + urinalysis + ECG + mental-health screen. Women 25+: women-specific overlay.

3

Results flow to your UMRS record. Abnormal results auto-flag your PHC's Family Health Team for follow-up.

4

You see results and flags on JANATA in your language.

Pregnancy

Roughly 15 antenatal visits, intensified late.

1

Once pregnancy confirmed: Mobile Clinic visits monthly through month 6, then every 10 days from month 7 to delivery.

2

Each visit captures BP, weight, foetal heart-rate, scheduled blood + urine tests, counselling.

3

High-risk markers auto-route to the district hospital obstetric unit. Low-risk delivery at PHC; high-risk at district hospital.

4

Postnatal FHT home visits: day 1, 7, 14, 30 — breastfeeding + immunisation support.

Emergency (112)

Location-aware dispatch, break-glass UMRS access.

1

Call 112 → location-aware dispatch → fastest-route routing on Mission Control dashboard.

2

Stabilisation at the nearest equipped centre; onward routing per UMRS clinical context (trauma to nearest tertiary; stroke to thrombolysis-capable centre).

3

Break-glass UMRS access at the receiving facility — auto-logged, you're notified within 24 hours, quarterly review panel audits every override.

4

Helmet Programme's ring-fenced Road Safety & Trauma Care Fund part-funds the trauma-care network; reconciliation published on the Open Ledger.

Chronic care (NCD)

One FHT, one continuous case file.

1

Family Health Team screens for diabetes, hypertension, mental health, oral cancer, cervical/breast self-exam coaching at the catchment level.

2

Diagnosis confirmed via district lab. Medication initiated. Continuous follow-up coded into the FHT calendar with UMRS as the case file.

3

Stockout at your PHC auto-triggers KDCDN dispatch from the district warehouse — no patient turned away because the supply chain failed.

4

You opt in or out of individual AI risk-scoring on JANATA. Revoking deletes derived risk scores within 30 days.

Implementation roadmap

Foundations in 100 days. Full universal cover by Year 10.

Every milestone has a published Karnataka Programme Sheet (App H) and tracks live on the Open Ledger. Universalisation in Year 10 is contingent on the District Medical College + Hospital build-out reaching the published standard in every district — the Year 1–10 capital programme is sized to deliver this.

0–100 days
  • 3 statutes tabled: KPHA, KHPA, Universal Health Entitlement Acts
  • Boards constituted; interim heads named in 30 days
  • First KHPA quality lab site identified (Bengaluru)
  • Service Charters for top 20 health services published
Year 1
  • All 3 statutes enacted
  • First KHPA pooled tender (essential medicines) live on OCDS
  • UMRS pilot in 3 districts (~5% population)
  • 50 Mobile Clinics in 3 pilot districts
Year 3
  • UMRS tertiary integration; 60% citizen coverage
  • 400 Mobile Clinics statewide
  • KHFA single-window IT live
  • Karnataka Universal Health Entitlement live for primary + secondary
  • District Health Boards in all 31 districts
Year 5
  • All 8 regional tertiary hubs operational
  • ~600 Mobile Clinics steady state
  • UMRS universal — 100% coverage
  • Karnataka Catastrophic Care Fund operational
  • All 31 districts at the uniform Medical College Standard
Year 10
  • Universal free coverage for every unforeseen serious medical condition
  • Full diagnostic + treatment stack at every district hospital + tertiary hub
  • No means test for entitled care
  • Elective and lifestyle care remains paid
Headline KPIs · live on the Open Ledger

Six numbers we publish every quarter.

Full set in Vol III App A KPI Dictionary. Each KPI has a published baseline, a Year-1 target, and a Year-5 target. Facility-level performance + stockout days + emergency response times publish per facility, per quarter.

100%
UMRS coverageYear 5 universal coverage of every Karnataka-domiciled resident
600
Mobile ClinicsSteady-state fleet by Year 5; quarterly cadence at every ward/village
≥95%
Antenatal completionYear 5 ≥95% of pregnancies completing all 15 antenatal visits
≥25%
KHPA price reductionYear 5 ≥25% off baseline on top-100 procurement categories
≤1d
Stockout days/PHC/quarterYear 5 ≤1 day; current baseline measured Year 1
≥80%
Out-of-pocket reductionYear 5 reduction at bottom income quintile for entitled care
Why this can't quietly be reversed

Health is the highest-stakes data domain. We treat it that way.

UMRS holds the most sensitive personal data the state will ever hold. A future government cannot quietly read patient records, alter audit data, or sell access — the violation is mathematically detectable.

Cryptographic floor

KSSL anchors every access

Every UMRS read, every prescription, every diagnostic entry, every AI-assisted clinical decision generates a Karnataka State Service Log entry anchored to a publicly verifiable append-only structure. A patient sees their own access log live through JANATA.

Threshold cryptography

No single admin can do bulk damage

Hardware Security Modules hold UMRS key material. Threshold cryptography is mandatory for any bulk operation touching more than 1 lakh patient records at once — mass exports, schema queries, bulk consent overrides. No single administrator's keys are sufficient.

Citizen Consent Ledger

Granular, time-bound, revocable

Every flow that touches your UMRS data — across facilities, between care tiers, with research bodies — requires a consent token from the Citizen Consent Ledger. Emergency break-glass overrides are recorded as KSSL events with statutory 30-day post-hoc review.

No commercial use, ever

State-held health data is not for sale

No sale, no licensing to insurers or pharma, no advertising-derived revenue from your record. AI models are open-sourced under public licence after a 2-year proprietary window for vendor-neutral re-implementation.

CSOC oversight

The state's own attacker, watching UMRS

Karnataka Cyber Security Operations Centre runs the bug-bounty programme against UMRS first. Statutory authority to compel patching, mandate vendor change, or isolate a non-compliant facility's connection pending remediation.

Sunset on failure

Governance failure = AI suspension

If KHRA — the statutory authority operating UMRS — fails to publish quarterly transparency reports for two consecutive quarters, AI uses are automatically suspended until governance is restored. Built into the statute.

Ask the manifesto anything about Health.

The TPM bot answers from the manifesto itself — cited to Volume, Chapter, and Section. Works in Kannada and English.

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