ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

HealthcareSubscribe to Healthcare

Healthcare Financing in India

Public and Private Healthcare and Health Insurance in India by Brijesh C Purohit, New Delhi, California, London and Singapore: Sage Publications, 2020; pp xiii + 283, ₹ 1,195 (hardcover). India Policy Finance and Policy Report: Health Matters edited by Jyotsna Jalan, Sugata Marjit and Sattwik Santra, New Delhi: Oxford University Press, 2020; pp xvi + 166, ₹ 1,495 (paperback).

Analysis of Private Healthcare Providers

India’s health system is dominated by the private sector and as a result, out-of-pocket expenditure is very high. To provide financial risk protection and avoid catastrophic health consequences, policy emphasis is on the Ayushman Bharat programme which targets to cover 50 crore people. Such a large-scale insurance scheme needs huge infrastructural and administrative support. Unincorporated private healthcare providers comprise 99% of private health providers in India, the majority of them being small scale, employing less than 10 workers and having a strong urban bias. To better promote universal health coverage, policy emphasis on better monitoring, administering regulations, transparency in system, and ensuring quality in delivery of service is needed.

Estimates of Health Insurance Coverage in India

Financing health expenditure through health insurance is currently gaining significance as a strong social policy in countries like India where public health facilities are still inadequate. An attempt to estimate the coverage of health insurance in India shows that the coverage is low and not uniform across states and union territories, despite the fact that several public-funded schemes focus on the below poverty line population. Of the various types of health insurance schemes, public-funded health insurance schemes have a dominant position. Moreover, the likelihood of health insurance coverage is relatively higher among specific social groups and in certain areas.

Too Much Care

In the context of India where public expenditure on healthcare is low, the private sector plays an important role in delivering healthcare during childbirth. An analysis of the latest round of National Family Health Survey data to estimate the differential probability of caesarean sections in private medical facilities relative to government facilities, and focusing on unplanned C-sections, reveals that the probability of an unplanned C-section is 13.5–14 percentage points higher in the private sector. These results call for a critical assessment of the role of private sector in healthcare in the context of inadequate public provision, expanding private provision and weak governance structures.

Where Is All Our Health Data Going?

Multiple initiatives going on in India regarding the collection of digital personal health data are analysed, and the question of how the data is being used is examined. While such data could facilitate healthcare and referral services, a strong and sensitive governance structure is needed to be in place to enable its optimal use and to ensure that the data is not used to further the agendas of surveillance and control.

Interpretations and Implications of Increasing Obesity in India

The National Family Health Survey-3 and 4 data show that in the past 10 years, overweight/obesity among women in terms of Body Mass Index has increased quite sharply. In the Indian context, undernutrition and obesity are not separate problems. A large proportion of overweight/obese women are undernourished, with small stature, food transition towards more fats and increasingly sedentary lifestyles making them vulnerable towards being overweight/obese. More diversified diet reduces the risk of overweight/obesity. It is suggested that adequate and good quality diversified diets need to be ensured for comprehensive energy and nutrient adequacy. This requires an overhaul of India’s food programmes.

ASHAs’ Health Services

The intrinsic commitment of the accredited social health activists towards the well-being of the community is unduly exploited by the state in the name of “volunteerism.” It is high time a wholesome definition of work is adopted to understand the inconspicuous contributions made by these front-line healthcare workers, who form a key link in the public health system in India.

Bhopal Gas Tragedy: Medical Research in the Aftermath of the Industrial Disaster

After the Bhopal Gas Tragedy, attempts were made to understand the effects of methyl isocyanide so that the victims could avail better treatment. However, time and again, relevant information from medical surveys was kept hidden.

India’s Domestic Pharmaceutical Firms and Their Contribution to National Innovation System-building

Domestic pharmaceutical firms continue to operate under the influence of the strategy of global integration of the pharmaceutical industry and healthcare. The link between domestic firms and public sector research organisations is the weakest link in the domestic pharmaceutical industry due to misguided policies in competence-building and innovation system-building after India accepted the Trade-Related Aspects of Intellectual Property Rights Agreement in 1995. The government should rethink its strategies to get domestic firms to contribute to system-building activities and prioritise investment into the upgrading of processes of learning and building competence.

How a Flawed Understanding of PCOS Robs Women of Their ‘Femininity’

This article discusses the understanding of polycystic ovarian syndrome (PCOS) among medical professionals in the patriarchal framework and how women experience infantalisation at the hands of doctors.

How Equitable Will Ayushman Bharat Be?

Ayushman Bharat holds the promise to advance equity both within households as well as across social groups. However, the geographical inequities characteristic of India’s healthcare provisioning need to be overhauled first for the scheme to be more equitable.

Pages

Back to Top