It focused instead on primary care, socioeconomic factors influencing health and community participation (National Health Policy 1983). However, because the document was more of a vision statement than an action plan, few tangible goals or practical applications were undertaken. Although the amount of healthcare infrastructure has increased, its utilization has been low due to lack of staff, resources and monitoring. When the World Bank and other entities began to emphasize cost-effectiveness and vertical interventions in the 1990s, the country moved away from the goal of universal coverage. This decline in access to public healthcare, along with the enormous increase in private facilities accessible only to the wealthy, has increased disparities in access to care (Shukla and Duggal 2006). In response, the country created a new national health policy in 2002, containing ambitious goals, such as increasing the use of public facilities to 75% of total health care utilization (National Health Policy 2002). However, here too the policy contained no explicit strategies to achieve these goals and further decline of the public healthcare system and exponential growth of the private sector followed. Subsequently, several new programs have been implemented to attempt to meet the needs of vulnerable populations, such as the National Rural Health Mission in 2005 and the National Elderly Health Care Program in 2011, however, these programs have not had a great impact in terms of health. reduce disparities and improve the general health of the population. In 2015 the government began drafting a new version of the national health policy that aims to solve these problems by providing universal healthcare, but this new version has not yet become law (Lahariya and Menabde